Depression: A New Frontier in It's Treatment

Allan N. Schwartz, LCSW, Ph.D. Updated: May 27th 2008

It remains experimental. All the facts and information is not in as yet. The possibilities are wonderful and exciting. It's called DBS and that stands for Deep Brain Stimulation. In effect, what DBS really means is that Brain Pacemakers might be used to cure people of the most intractable and resistant types of depression.

During the many years of my experience in mental health I came across patients for whom all the newest and oldest types of treatment for depression were unsuccessful. For these unfortunate few neither traditional psychotherapy, cognitive behavioral therapy nor medication therapy worked to reduce the symptoms of depression. These were people who became actively suicidal despite all that was done for them both inside and outside of the hospital. In some of the worst cases ECT or Electro Convulsive Therapy were used to reduce symptoms. In many cases this succeeded for a while but even these patients elapsed into depression and suicidal behavior after a certain amount of time.

Vanderbilt University Medical Center in Nashville, Tennessee, has been experimenting with Deep Brain Stimulation as a way to relieve the most serious types of depression. While it may seem unique that such a method be used there is a lot of precedence for this. Deep brain stimulation and the insertion of electrodes or pacemakers into the brain, have been used to relieve the symptoms of such illnesses as Parkinson's and related diseases.

Thus far, six of seventeen severely depressed patients remained free of depression after one year of treatment as reported by the Cleveland Clinic.

However, the treatment remains highly experimental for several reasons:

1. The procedure is highly risky because of the danger of the surgery creating uncontrolled bleeding into the brain.
2. The danger of brain infection from the implanted equipment remains a serious challenge to researchers.
3. The statistics on recovery from depression as a result of the treatment are encouraging but not definitive. In some cases fifty percent of patients treated this way improved and remained free of depression.

One of the many challenges presented by this new procedure is that medical scientists do not understand how and why deep brain stimulation works. There is a sense that the brain is being re-wired but how is not yet understood.

Yet, researchers know where to place the electrode for Parkinson's disease and that is in the part of the brain called the Thalamus. With regard to depression, scientists are focusing on parts of the brain that control emotions in order to reduce depression. These parts of the brain are called the Ventral Striatum and the Brodmann Area 25. Those interested can do a search on the Internet to learn more about these two brain areas.

Even though the research is far from complete, the possibilities are very exciting for relieving suffers of the worst types of depression. This research, along with others, could help us foresee the time when depression and it's associated illness, such as OCD, will be things of the past.

What are your comments?

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

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