Depression, MH@H Books

Somatic Treatments for Depression

list of somatic treatments for depression, taken from Managing the Depression Puzzle

One of the chapters in my new book Managing the Depression Puzzle is focused on somatic treatments for depression, which involve the application of energy to the brain.  These types of treatment are used less commonly than medications or therapy, but they do have a role to play, particularly when it comes to treatment-resistant depression.

Electroconvulsive therapy

Out of this group of treatment, electroconvulsive therapy (ECT) is probably the most recognized.  It involves the application of an electrical stimulus to induce a seizure.  This is done under anaesthetic, and a muscle relaxant so there’s no visible seizure activity.  ECT is very effective, and it starts to work much faster than antidepressants do.   

The most problematic side effect is memory loss.  Some people receiving ECT have no memory loss, while for others it can be quite significant.

I did a guest post recently on Renard’s World that went into greater depth about ECT.

Transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) involves applying a magnetic field across the brain to stimulate certain structures under the surface.  It has been growing in popularity in recent years.  It has demonstrated effectiveness in both bipolar and unipolar depression.  It’s considered to be less effective than ECT.

Treatments are done 5 days a week for a period of 6 weeks.  Unlike ECT, no anaesthetic is required, so there are no restrictions in activity following the treatment.

Deep brain stimulation

Deep brain stimulation (DBS) is done using electrodes that are surgically implanted into the brain and connected to a stimulator device implanted below the collarbone. DBS is most often used in Parkinson’s disease, and while there is some evidence of benefits in depression, it hasn’t been used enough to get a really clear picture of its effectiveness.

Transcranial direct current stimulation

In transcranial direct current stimulation (tDCS), electrical current is passed through electrodes placed on the scalp.  Treatments are performed daily over a period of several weeks.  It’s been used in a number of conditions in addition to depression, but overall there hasn’t been a lot of research, and results have been mixed in depression,.

Vagus nerve stimulation

The vagus nerve is a major nerve that runs through the neck (but not the spine).  Vagus nerve stimulation is done by connecting lead wires to the vagus nerve in the neck.  Those lead wires are connected to an impulse generator that’s implanted below the collarbone.  It takes months to see a therapeutic effect, and side effects are common, so understandably it’s not used very commonly.

While none of these somatic treatments are going to be a go-to right out of the gate, they do provide some extra options to consider.  TMS is something I’m guessing will continue to grow in popularity.  Where I live, TMS isn’t covered by the provincial medical plan or most extended health insurance plans.  Hopefully, that will change in the near future, as it really should be more widely available.

Do you have experience with any of these treatments?

Book cover: Managing the Depression Puzzle, 2nd ed., by Ashely L. Peterson

Managing the Depression Puzzle takes a holistic look at the different potential pieces that might fit into your unique depression puzzle. The revised and expanded 2nd edition is now available on Amazon.

This post contains affiliate links that let you support MH@H at no extra cost to you.

23 thoughts on “Somatic Treatments for Depression”

  1. I wish ECT was more frequently used. I think it gets a bad rap. It could be better than antidepressants, that have side effects and such. And it’s a simple procedure, from what you’ve told us. It’s too bad it’s not more readily available!! ๐Ÿ˜ฎ

  2. I think it is good that those treatments are being looked into besides other therapies. Would you consider TMS or do you have any experience with it?

      1. I don’t really know enough of it to understand the difference in effect between let’s say ECT and TMS. I guess I need to start reading a certain book instead of blogging and moving boxes all the time ๐Ÿ˜‰
        The cost is certainly an important point of consideration, especially when you’re not convinced it would work well for you.

        1. TMS doesn’t work as well as ECT, and for psychomotor retardation in particular it doesn’t sound like TMS is that impressive. And ECT has never gotten me into remission when I’ve had it in the past, so I’ve got my doubts about TMS.

  3. Proud mummy moment – my son was involved in lots of studies of TMS for depression and Direction of TDCS current flow in human sensorimotor cortex influences behavioural learning. Ricci Hannah.

    I agree with you and Meg where ECT should be more widely promoted as it’s said to be most effective on treatment resistant chronic depressions. And yes, lots of people are too scared to try it. I know my mum had two courses of ECT over the years – once, back in the 60’s and later in late 70’s and she suffered no terrible side effects.

  4. When I first started reading I thought you were referring to spiritual energy, haha! I canโ€™t say Iโ€™ve had any experience with these methods but I enjoyed reading about them ๐Ÿ™‚

  5. Informative article! I have not had to have any treatments for my depression on this scale, but it was recommended at one point. It’s a long, difficult road to feeling well. And, then it can get tripped up too. As always, one day at a time.

  6. I don’t have experience with any of these, but did you know TMS can also help a rare neurodegenerative condition called guillain barre syndrome? ๐Ÿ˜€

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