Sometimes depression is so stubborn, isn't it? There are those among us who are tired of taking medication and seeking counseling without any relief. Similarly, for a condition that does not respond to other treatments, what we call 'treatment-resistant depression', there is now a treatment that brings new hope. That is this special treatment called vagus nerve stimulation, or VNS. This is a treatment that is given through surgery. Let's see how to understand this simply.
How does this VNS treatment work?
Imagine this, this is a minor surgery. During this surgery, your doctor will implant a small battery-operated device under the skin of your upper chest. It's like a pacemaker that helps your heart beat. It's about the size of an old rupee coin.
Next, another small incision is made on the left side of your neck, and a thin wire from the device in your chest is passed under the skin and connected to the main nerve called the Vagus, which runs through your neck to your brain.
Now, from this device in your chest, at specific intervals, very subtle electrical impulses are sent along that wire to the vagus nerve. Those impulses travel along the nerve directly to the brain.
So what happens with these electrical pulses?
In fact, doctors aren't 100% sure how these electrical pulses reduce symptoms of depression. But the main idea is that these signals affect the way nerve cell circuits in our brains that are believed to be involved in controlling mood . Simply put, they may change the way those nerve cells communicate with each other.
But this won't happen overnight. It's a process that takes time. Studies have shown that it can take several months, sometimes as long as 9 months, to see results. So this isn't something you're looking for as a quick fix.
Can this device be controlled?
Yes. Your doctor can change the settings of this machine at any time, in his room, using a special device (programming wand). That is, he can increase or decrease the dose and frequency of the electrical pulses. Usually, it is set to turn on automatically at the right time. If you want, you can also use a special magnet to temporarily stop it.
What are the risks and side effects of this treatment?
As with any medical treatment, VNS therapy can have some risks and side effects. It is important to be aware of these.
| Risk/side effect type | Description and what to know |
|---|---|
| Common Side Effects | Temporary hoarseness, coughing, and difficulty breathing may occur. However, most of these only occur for a short period of time, about 30 seconds, while the stimulator is on. These usually go away when it is stopped. |
| Surgical Risks | As with any surgery, there is a small risk of infection of the wound. There are also very small risks associated with anesthesia. |
| Battery Replacement | Just like a pacemaker, over time (usually after a few years), the battery in this device will wear out. Then another minor surgery will be required to replace it. |
| Device Damage | Rarely, if the device or wiring is damaged, surgery may be required to repair or replace it, even before the battery can be replaced. |
Are there any effects on other medical tests?
Yes, this is a very important matter.
- Mammogram: Because this VNS device is located in the chest, it may interfere with getting a clear image during a mammogram for breast cancer. Therefore, it is essential to inform the relevant staff that you have a VNS device before the test. Then they can perform the test in a special position.
- MRI scan and other treatments: MRI scanThere is a high risk of damage to the VNS device due to things like testing. Also, certain medical treatments, such as defibrillation, can damage the device when the heart stops beating.
Therefore, if you have a VNS device, you must inform your doctor and the relevant staff before any medical treatment or test.
Finally, it is important to note that even if you receive VNS treatment, you will still need to continue your other treatments for depression, such as depression medicine and therapy. VNS is not a replacement for other treatments, but rather an adjunct to other treatments to enhance their effectiveness. If you have any questions about this, please feel free to talk to your mental health professional for more information.
Take-Home Message
- VNS (Vagus Nerve Stimulation) is a specialized surgical treatment for treatment-resistant depression that has not responded to other treatments.
- In this, a small device implanted under the skin of the chest sends electrical signals to the brain via the vagus nerve in the neck, thereby affecting the parts of the brain that control mood.
- It may take several months to see results, so this is not a quick-fix treatment.
- Temporary side effects such as hoarseness and coughing may occur. Also, the risks are common to any surgery.
- Even if you undergo VNS treatment, it is important to continue taking your prescribed antidepressant medication and counseling services. Talk to your doctor for more information about this.
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