Sometimes Depression Treatment Must Go Beyond Talk and Medication
> 9/11/2006 12:54:28 PM

Technological advances have helped us gain a better understanding of depression and other diseases of the mind. Where we once were limited in our options, there are now many tools and avenues available to doctors, therapists and patients for depression treatment. One of these, which predates almost all psychopharmacological treatments, is electroconvulsive therapy or ECT.

Perhaps no modern medical procedure has been as maligned or as slandered as electroconvulsive therapy. This isn't hard to understand; the treatment involves passing electrical currents through the brain thus generating a seizure, an act that can appear barbaric when taken out of context. While the technique has been improved upon over the last half-century to cut down on the negatives and heightened the positive effects, ECT continues to be maligned for its memory related side-effects.

In this week's Newsweek, Kitty Dukakis, wife of the former presidential candidate Michael Dukakis, speaks about her battle with depression and how she credits electroconvulsive therapy with giving her life back to her. She addresses the oft-repeated criticisms, but rationally explains what may be the most prominent argument in favor of the treatment: for some, it is the only treatment that can help.

Down a similar road of uncommon depression treatment, yesterday's New York Times covered what some consider to be the most prominent lead in helping those with the most severe cases of depression. Called treatment resistant depression or TRD, those who suffer from this affliction have responded to none of the depression medications and have often even tried electroconvulsive therapy with little success. There is some evidence that for these cases vagus nerve stimulation may prove a miracle cure.

Originally designed as a treatment for epilepsy, vagus nerve stimulation or VNS has received approval by the FDA, but that decision and indeed the entire company that produces the device, Cyberonics, are under suspicion by the SEC. VNS requires the implanting of a device in the patient's chest cavity that sends a pulse to the vagus nerve, which is located in the neck. Because of its highly invasive nature and dubious lack of objective study support, the procedure should really only be discussed after all other avenues have been exhausted.

If you or someone you know has been effected by depression, especially major depression, both of these treatments should at least be on your radar. Knowing about the options that exist, and staying informed about what different treatments entail, should be an integral part of knowing and facing an illness. An educated health care consumer sets him or herself up for improved outcomes as well as more cost efficient care.

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