In some people, severe clinical depression does not respond to established forms of treatment such as psychotherapy, behavioural therapy, drug treatment or electrconvulsive therapy (ECT). Such a depressive state is medically referred to as TREATMENT RESISTANT DEPRESSION (TRD).
However, there is new hope for people with TRD due to the discovery of a new, cutting -edge treatment known as DEEP BRAIN STIMULATION (DBS).
DBS is still in the relatively early stages of being researched and evaluated for efficacy but some initial studies have provided extremely promising results. At present, it is expensive and not very easy to access, but this state of affairs could, of course, change in the future.
WHAT DOES DBS TREATMENT INVOLVE?
DBS treatment involves an electrode being inserted deep within the brain ; once inserted, it sends out small pulses of current which help specific brain regions involved in contributing to symptoms of depression regain normal functioning.
WHAT DOES RESEARCH INTO THE EFFECTIVENESS OF DBS INDICATE SO FAR?
Research into the effectiveness of DBS is ongoing and is trying to ascertain the specific brain regions where electrodes should be inserted in order to produce the maximum possible benefit to the patient. This is quite a complex area of study due to the fact that several areas of the brain are involved in giving rise to symptoms of depression. Different adversely affected brain regions correspond to different symptoms (such as intense and pervasive sadness, weight fluctuations, low self-esteem, sleep problems and anhedonia – anhedonia means an ‘inability to experience feelings of pleasure’ and is one of the hall-marks of clinical depression).
Another complication is that the different regions of the brain which give rise to the different symptoms of depression are all INTERCONNNECTED so that a change in functioning of one region has knock-on effects in relation to the other brain regions to which it is connected. The main brain regions which have been focused on so far are :
– the ventral striatum
– the nucleus accumbens
– the medial forebrain bundle
THE MAIN STUDIES :
One study showed that six months after DBS treatment patients were able to recover psychologically from negative events in their lives significantly better than they were able to prior to treatment.
Another study showed that six months after treatment patients’ symptoms of depression had significantly improved.
A third study has given particularly exciting results – the region of the brain that was targeted in the study was the medial forebrain bundle, and, out of the 7 people who received the DBS treatment in the study, 6 experienced a RAPID and very significant alleviation of their depressive symptoms.
I hope you have found this post interesting.
Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).