How Deep Brain Stimulation Is Used to Treat 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.  

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. 

Treatment typically consists of psychotherapy and medication. But, as explained earlier, that isn’t a fit for everyone. 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 where 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.

How Deep Brain Stimulation Can Reduce Depression Symptoms

Deep brain stimulation specifically targets the nucleus accumbens aka NAc. This is the 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.

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 the electrode placement. This speaks to the goal of shaping deep brain stimulation into a unique and precise treatment with lasting effects. 

A Word From Verywell

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.