Dealing with treatment-resistant major depression – 4: Vagus nerve stimulation

Dealing with treatment-resistant major depression – 4: Vagus nerve stimulation

Depression is a serious mental disorder characterized by the feelings of persistent sadness, hopelessness, irritability, and even suicidal tendencies. When undetected or untreated, depression can prove to be highly devastating, often leading to longer episodes of depressive symptoms as well as aggravating other medical conditions. Clearly, depression is way beyond the normal feelings of sadness and gloom, and this is the reason why its symptoms do not go away naturally.

Depending on the intensity and duration of the symptoms, depression can be categorized into several distinct disorders, with most common being major depressive disorder characterized by a constant sense of hopelessness and despair. According to the 2016 report by the National Institute of Mental Health (NIMH), major depression affects nearly 6.7 percent of Americans aged above 18 years. Overall, between 20 percent and 25 percent of adults are at the risk of developing major depression at some point during their lifetime, observed NIMH.

Depression can be highly devastating due to its detrimental impact on day-to-day activities. Fortunately, there are a range of therapies and medications available today that can effectively treat the mental health condition. However, in some cases, depression cannot be treated with the regular treatment strategy, and is thus, referred to as treatment-resistant major depression disorder (TR-MDD). However, studies have shown that even TR-MDD can be effectively treated by using certain specialized techniques such as vagus nerve stimulation (VNS).

VNS can greatly reduce symptoms of  TR-MDD

When talking about out of the box methods to treat TR-MDD, VNS surely grabs the attention. Unlike the usual procedures that involve therapies and counseling, VNS is a surgical process used to treat the condition. During the treatment procedure, a pacemaker-like device is implanted to the stimulating wire that is threaded along a nerve called the vagus nerve. This nerve travels up from the neck to the brain and connects with the area responsible for regulating mood.

The device (about the size of a silver dollar) is implanted into the chest and works the same way as the pacemaker. Meanwhile, another incision is made on the left side of the neck. A thin wire is, then, placed under the skin, which runs from the device to the large vagus nerve in the neck. Once placed in the body, the device sends electric pulses to the nerve, which further reaches the brain, thereby relieving the depressive symptoms. The settings of the device can be changed by doctors, when necessary, using a special magnet. However, it may take several months before a patient can actually feel the effects.

Pros and cons of VNS

Although VNS is often regarded as a safe option to cure TR-MDD, it has certain side effects that cannot be ignored. Since the process primarily includes the neck area, the patient can experience temporary hoarseness, cough and shortness of breath during the 30 seconds when the stimulator is on. VNS also carries a significant risk of infection as it is surgically implanted. Just as a pacemaker, even VNS requires a regular replacement of the battery. Besides, the process may also demand additional surgery prior to replacing the battery, in case of any damage done to the device.

While the implantation of VNS can interfere with mammograms, procedures such as ultrasound can also damage the implanted device. Notably, special precaution is required while conducting MRIs.

Recovery road map

While a depression can turn into TR-MDD due to several reasons, delay in diagnosis and treatment is one of the prime reasons for the development of the mental health condition. Hence, if you or your loved one is struggling with depression, contact the Depression Treatment Helpline to find the top depression recovery centers in the U.S. Call at our 24/7 helpline number 866-619-7729 or chat online with our counselors to find the best rehabilitation centers for depression in your area.

Read the other articles of the series “Dealing with treatment-resistant major depression:”

  1. Using tianeptine
  2. Using Dalhousie serotonin cocktail
  3. Using electroconvulsive therapy