Vagal Nerve Stimulation – Placebo or Alternative Cure for Depression?

Depression knows no barriers. It can strike anyone, anywhere and anytime. While the standard treatment for depression is medications, including depressants, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), as well as therapies, such as cognitive behavioral therapy (CBT), talk therapy and group therapy, sometimes, a patient doesn’t respond to the treatment.

Under severe mental strain, the depressed individual then takes recourse to electroconvulsive therapy (ECT) where electric signals are sent through the brain. These help to sort out chemical imbalances that caused the mental health condition. But under extreme circumstances, even ECT provides no relief or only temporary respite and may result in a relapse. Vagal nerve stimulation (VNS) therapy, primarily used in controlling epileptic seizures, is fast proving to be a sought-after treatment for those who do not respond to the traditional mechanisms.

Understanding VNS therapy

The premise of VNS is simple. It works on the vagus nerve, which is the longest cranial nerve in the human body passing from the neck to the thorax and the abdomen. This nerve plays a crucial role in monitoring key functions in the human body. In case there are variations such as increased breathing, the vagus nerve relays messages to the brain regarding how to respond. During VNS therapy, the care giver inserts a small gadget similar to a pacemaker below the neck which activates the nerve.

Skepticism regarding the benefits of the therapy has remained among the medical fraternity, though its function as a placebo has been disapproved by psychiatrist Prof. Hamish McAllister-Williams from Newcastle University. Though he admits that not much is known about its efficacy in cases of severe depression that remain unresponsive to traditional treatments, he is sure that the impact of VNS is not akin to a placebo. Placebo is immediately activated and ends quickly, whereas VNS takes six months before its impact can be felt.

In a 2013 study on depressed patients who were resistant to treatment, it was observed that those who were provided adjunct VNS along with routine treatment for depression, the response rates were higher than when one only depended on treatment as usual (TAU). Another study by psychiatrist Scott Aaronson also revealed that VNS when used with TAU had better long-term outcomes than in case of only TAU.

Commenting on the study outcome, Aaronson said, “The tolerability of the device is terrific. The main side effect is hoarseness because the recurrent laryngeal nerve [that supplies the voice box] comes off the vagus nerve.” He suggested that the side effects could be controlled by temporarily turning off the device by holding a magnet over it.

Apart from hoarseness in the voice, the therapy also causes frequent coughs, breathing difficulties and changes in heart rhythm. It may also result in one’s depression or mania getting aggravated. Therefore, it is necessary to exercise caution before recommending bioelectric therapies for depression.

Alternative treatments for depression

There are many novel therapies for combatting depression. Their use with standard treatments is extremely effective for keeping the condition under check. Three such therapies that engage one’s thoughts constructively while keeping negative thoughts at bay are as below:

  • Art therapy: One can engage in creative arts even without having a prior experience in dance or drama. These activities open the body and mind to a different experience and help one connect to him/her self. They help release all negativity and boost confidence thereby reducing symptoms of persistent sadness and low mood, characteristics of depression.
  • Mindfulness therapy: Both mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) promote emotional well-being and awaken positivity. Such therapies focus on being in the present without worrying about the past or future. They encourage a person to get attuned to one’s senses and gain better understanding and control of their thoughts and behaviors.
  • Eco therapy: As the name implies, eco therapy helps one connect with nature. Whether it is through walks in the nature or horticulture, it relies on the potential of the nature to heal, soothe and calm.

Do not let depression mar your life

The World Health organization (WHO) reports that  is the number one cause of disability worldwide affecting more women than men. However, with proper medication and treatment, one can lead a quality life. It is important to seek advice from a certified mental health practitioner who can diagnose the condition in time and suggest appropriate treatment.