Deep brain stimulation works like a pacemaker, but it’s used in the brain instead of in the heart. This technique requires surgically placing a small conductor, called an electrode, permanently in the brain. The electrode delivers a low-level impulse that aids in regulating mood. In this article, we shall talk about deep brain stimulation for depression.
Deep brain stimulation (DBS) is an elective surgical procedure most commonly used to treat movement disorders, like Parkinson’s disease. However, deep brain stimulation is now becoming a treatment that can soothe even the most stubborn symptoms in certain mental illnesses.
For example, major depressive disorder, often simply referred to as depression, can be challenging to treat. Unfortunately, some do not experience relief from medication and psychotherapy. However, treatment-resistant depression can benefit from deep brain stimulation.
Experiencing severe depression can be a painful, isolating, and frustrating journey. If you’re reading this, you’re likely interested in how recent innovations in mental health care can alleviate even the most persistent depressive symptoms. Read on to see if this treatment could be a fit for you or a loved one.
Table of Contents
What Is Depression?
Depression is a mood disorder that impacts an estimated 1 in 6 adults. It is marked by depressed moods where one loses interest in things that once excited them, impaired cognition (think brain fog and slowed speech), difficulty sleeping, and a loss of appetite. While our collective interest in mental health has now made “depression” a household term, it is a serious diagnosis that can be completely debilitating without proper treatment.
Are You Depressed?
If you’re noticing that you’re feeling hopeless, are no longer intrigued by things that once brought you joy, are either sleeping too much or not enough, and no longer want to eat, you may be experiencing depression. It is best to seek out a trained mental health professional to determine an accurate diagnosis and develop a treatment plan.
Treatment typically consists of psychotherapy and medication. But, as explained earlier, that isn’t a fit for everyone.2 This means that after initial trial and error, talk therapy and medication are not providing relief, and debilitating symptoms that impact day-to-day functioning are persisting.
A 2016 study states that based on the breadth of research on depression treatments, electroconvulsive therapy is the best therapy for treatment-resistant depression. However, deep brain stimulation is beginning to gain steam and accumulate data proving its efficacy.
What Is Deep Brain Stimulation?
In deep brain stimulation treatment, electrodes are planted into different parts of the brain during surgery. These electrodes begin to regulate abnormal brain activity through a series of electrical pulses. The electrodes are controlled by a device called a generator. It is often compared to a pacemaker because it is planted in the upper chest and is connected to the electrodes by a wire running from the chest to the brain.
A doctor determines, based on the recorded abnormal brain activity, where the electrodes are planted. Typically, the electrodes will be placed on both sides of the brain, allowing the brain to receive bilateral stimulation. Under some circumstances, medical professionals will opt to utilize unilateral stimulation, meaning only one side of the brain is receiving the electric pulses.
Engaging in deep brain stimulation is a process. There is a recovery period from the surgery that takes a few weeks.
Once recovery is complete, there is a period of time when the correct settings for the electric pulses are tested. This means a medical provider will turn the generator on and test which settings are the most effective.
It is worth noting that this can be a somewhat challenging process at first due to some side effects. The most common side effect reported early in treatment is mild speech issues.
How Deep Brain Stimulation Can Reduce Depression Symptoms
Deep brain stimulation specifically targets the nucleus accumbens aka NAc.This is part of the brain that rules major mental health functions, including mood, and influences levels of the neurotransmitters dopamine and serotonin.
Electrode Placement
The electrodes are planted onto that part of the brain, though specific electrode placement will depend upon the doctor’s treatment plan. Once the generator is functioning, it will begin to fire off electric pulses to the impacted parts of the brain. These pulses reset the brain’s metabolism by blocking malfunctioning neurons.
Advantages of Using Deep Brain Stimulation for Depression
A 2014 review of clinical outcomes published in Neurotherapeutics states 20% to 30% of individuals experiencing depression do not respond to medication.
This staggering statistic illustrates the promise alternative therapies provide to those experiencing emotional pain. The aforementioned 2014 article reported significant improvement in depressive symptoms associated with deep brain stimulation.
Disadvantages of Treating Depression With Deep Brain Stimulation
Deep brain stimulation is a great option for those experiencing treatment-resistant depression, but it isn’t for everyone.
Surgery May Be Stressful for Some
First, undergoing surgery may be something many opt out of. Between the actual surgical procedure and the subsequent recovery time, it can be too stressful for someone already experiencing depressive symptoms.
Some People May Experience Side Effects
For those who do undergo deep brain stimulation, the side effects are worth considering. Speaking and thinking may become slowed immediately following the surgery, though these side effects are typically temporary.
However, there have been reports of folks experiencing tremors and breakthrough depressive symptoms. Breakthrough depressive symptoms refer to symptoms that come back even while you’re taking antidepressants. When you’ve been taking the same medication for a long period of time, your antidepressant may no longer be as effective.
Relief Felt After DBS May Not Last
Deep brain stimulation isn’t a completely foolproof treatment, there is a possibility for some dismal side effects and a chance the relief won’t be long-lasting.
Experts are still gathering data before deeming deep brain stimulation as one of the most effective procedures for treatment-resistant depression. A current point of focus for researchers is patient-specific variations to electrode placement. This speaks to the goal of shaping deep brain stimulation into a unique and precise treatment with lasting effects.
In summary, living with persistent depressive symptoms can be a tiring and frustrating experience. If you’re finding yourself struggling with depression, first seek out a licensed professional for further support. Developing an integrative team consisting of a psychotherapist, psychiatrist, and primary care doctor is ideal.
I hope you find this article helpful as well as interesting.
