The first time I heard about someone using brain stimulation therapy was when I was sitting in a crowded waiting room. I saw an older gentleman enter, and he sat in the chair next to me as I flipped through a magazine. His wife came in and sat on the other side of him. They were discussing “his ECT treatment”, and this brought me back to sophomore year of college.
I must have missed the part of class where the Professor explained that we still give “shock” treatment. All I remember is how controversial it was, and how it was used in “conversion therapy”.
I interjected because I was so curious about this. I said, “I hate to interrupt, but I couldn’t help but overhear. Are you referring to electroconvulsive therapy?”
He nodded his head and began to explain how he was determined to change his life. He had been battling with a deep depression for a long time, and the traditional therapy and medications weren’t having a strong enough effect. That’s when his doctor recommended taking a chance on brain stimulation therapy.
Here are five brain stimulation therapies that we still practice today to treat mental illness.
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What Is Brain Stimulation Therapy?
Brain stimulation therapy generally comprises of electric or magnetic currents sent to activate parts of the brain linked to physiological areas that contribute to mental illness.
Outside of neurological diseases, the most common reason for using brain stimulation therapies is “treatment-resistant depression” (TRD). According to this study, TRD is “generally applied to patients who fail to respond to at least two adequate trials of antidepressants from different drug classes”.
Repetitive Transcranial Magnetic Stimulation (rTMS)
Used for: Depression, Anxiety
rTMS is a fairly new, non-invasive treatment and includes an electromagnetic coil that is placed on a patients forehead. The coil sends magnetic pulses to the prefrontal cortex.
For those who are unfamiliar with brain anatomy, the prefrontal cortex is located just behind the forehead, and is known for it’s relation with emotional responses, decision-making, and personality.
rTMS does not require anesthesia, and patients can go about their normal routines within hours. TMS therapy sessions are usually administered five times a week for 3-4 weeks.
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Magnetic Seizure Therapy (MST)
Used for: Depression
Similar to rTMS, Magnetic Seizure Therapy uses magnetic currents to stimulate specific parts of the brain. MST uses a higher intensity of magnetic field pulses than rTMS, and will put patients into a controlled seizure.
Due to the induced seizure, patients are put under anesthesia.
Right now, MST is only available through participation in clinical trials, and is not FDA approved. However, due to the ability to target specific parts of the brain, it is expected to have fewer side effects than electroconvulsive therapy.
Electroconvulsive Therapy (ECT)
Used for: Treatment Resistant Depression, Depression with Psychosis
Commonly known as “shock therapy”, ECT has been around for decades. The procedure involves sending electric currents through the brain which cause short, controlled seizures.
ECT patients are under general anesthesia, and feel no pain during the process.
This therapy is only referred by doctors after other treatments, such as psychotherapy and medication, have been unsuccessful. It is an option for people with severe or life-threatening depression.
Vagus Nerve Stimulation (VNS)
Used for: Seizures and Epilepsy, Depression
VNS is a minimally invasive therapy which includes a control system implanted under the collar bone with threads of electrodes connected to the left vagus nerve.
The control system sends mild electrical currents to through the electrical wires to the vagus nerve to stimulate which is said to effect the production of neurotransmitters.
Depression has been linked to an imbalance in neurotransmitters, such as serotonin and dopamine.
The implantation is completed by a neurosurgeon on an outpatient basis. The patient will receive anesthesia before the procedure, but will be able to go home shortly after surgery.
Deep Brain Stimulation (DBS)
Used for: Parkinson’s Disease, Dystonia, Multiple Sclerosis, Anxiety, Obsessive Compulsive Disorder, Depression
Of these four brain stimulation therapies, DBS is the most invasive. It involves implanting electrodes in the brain as well as a controllable “pacemaker” in the chest.
The electrodes send impulses into the brain that are used to “override” abnormal impulses caused by a neurological disease.
After the brain and chest surgery, a doctor will be able to control the impulses using a remote outside of the body. The intensity can be customized based on the person’s severity of disease.
Brain stimulation therapy has been around for many years beginning with ECT treatments. The success of this therapy to treat symptoms of severe depression has led to the development of alternative treatments that are sometimes used to treat other forms of mental illness.
While brain stimulation therapies are usually a last resort, they can be highly effective and help people to be less resistant to traditional psychotherapy and medication.
There is still a lot to learn about how the brain operates, but this type of treatment is a sign that scientists are on the right path to having better treatments for mental illness.