Don't medications reduce depression? Let's learn about brain stimulation therapies.

Sometimes you may be suffering from Major Depressive Disorder (MDD). Even if you take the medication prescribed by your doctor or attend counseling (psychotherapy), your mind may not be feeling much better. You may feel better for a while and then return to your old state. Or you may feel the same sadness without any change. In medicine, we call this type of depression that is difficult to control with medication 'Treatment-Resistant Depression' . But, don't think that this is the end of your story. Don't give up hope. There are new, advanced treatments for such cases. That is Brain Stimulation Therapy. These try to restore brain function using electricity, magnetic waves, or small devices implanted in the body. Today, we will talk about three such main treatments.

Electroconvulsive Therapy (ECT)

The name may sound a little scary, but ECT is a treatment that has been around for over 80 years, has been extensively researched, and has been shown to be very safe and effective. It is often used to treat conditions such as severe depression and bipolar disorder that are resistant to other treatments .

How do you do this?

You won't feel anything during this treatment, because you're completely anesthetized. Just like before an operation . You'll also be given a medicine to stop your muscles from shaking. Then the doctor will stick sticker-like pads on certain parts of your head. These are called `electrodes.' After you fall asleep, a very controlled, small electrical impulse is delivered to your brain through these `electrodes.' This causes a controlled seizure in the brain that lasts less than 60 seconds. It is believed that this resets the functioning of the neurons and chemicals in the brain. When you wake up in a few minutes, you won't remember anything about the treatment or what you felt at that time. When the effects of the anesthetic wear off, you can go home.

Typically, between 6 and 12 treatments are performed, usually two or three times a week. The number of sessions you need will depend on the severity of your symptoms and how quickly you recover.

Repetitive Transcranial Magnetic Stimulation (rTMS)

This method uses magnetic waves. This stimulates the brain. Scientists are still not sure exactly how this cures depression. But they think that these magnetic pulses increase the activity of nerve cells in the parts of the brain that control mood.

How do you do this?

You don't need to be awake to receive rTMS treatment. You're seated in a chair. But you'll need to wear earplugs because the machine makes a loud 'ticking' sound. The doctor will place an electromagnetic coil on your forehead and scalp. The magnetic pulses from this coil create small electrical currents in your brain. You'll feel like you're being hit by a small toucan. You can go home after the treatment. You can drive a car if you haven't been lulled into a dream.

Usually, one session takes about 30-40 minutes. This treatment has to be done about 5 days a week for about a month.

Vagus Nerve Stimulation (VNS)

There is a long nerve that runs from your brain to your stomach on both sides of your body. This is called the Vagus Nerve. This nerve stimulation (VNS) therapy was first used to treat epilepsy. But it was later discovered that it also provides relief from treatment-resistant depression.

How do you do this?

This involves a minor operation. The doctor will place a small battery-operated device under the skin of your chest, usually on the left side. This is called a ``pulse generator.'' It is like a pacemaker. Then, an electrical wire from this device is passed through your neck and connected to the vagus nerve. After the surgery, when the wounds have healed, the doctor will turn on this device. It will send small electrical pulses to the nerve at regular intervals (for example, every 5 minutes, for 30 seconds).

How successful is this treatment?

This is the most important question. In fact, not everyone responds to treatment in the same way. Therefore, it is impossible to predict in advance which treatment will work for you, or whether it will work at all. It may take several months to see results. Often, psychotherapy or antidepressants are needed to manage depression while you are receiving these brain-stimulating treatments. After treatment, you may need to have maintenance treatments once a week or every few months to maintain your level of recovery. Only you and your doctor can decide what is best for you.