This blog post deals with a very important topic: treating depression with tDCS. If you know anything at all about transcranial direct current stimulation (tDCS), you surely know that it has been shown in studies and anecdotal reports to have very positive effect on many depression patients – ranging from those with dysthymia to persons with severe, debilitating, drug resistant depression. It does not work for everyone, but what treatment does?
The beauty of tDCS is that it is incredibly simple, has a spotless safety record, has no significant side-effects, and with a little training can be used by a depression sufferer at home or wherever convenient.
Lets review some sobering facts: depression is a worldwide epidemic. In the US alone, over 14 MILLION people suffer with some form of a major depressive disorder. About 1 in 10 adults now use some form of an antidepressant. Further, about 40,000 people per year commit suicide. (CDC)
What the numbers don’t tell you is that many suffering with depression don’t receive effective treatment – either because they don’t have access, can’t afford it, or commonly, are afraid of the public stigma of having to deal with a brain disorder. And lets be clear depression is a brain disorder. For some, it can be treated effectively with “talk” therapy. But for many, depression is rooted in a brain physiology and chemistry problem and needs to be recognized and treated as such.
It really bothers me that mental health professionals are still mostly oblivious to the existence of tDCS and its potential benefits for the depressed. Every mental health professional should be aware of tDCS and use it when it seems appropriate – perhaps before or in conjunction with drug therapy.
Three Examples of tDCS Depression Treatment Montages
tDCS involves placing electrodes on the head and passing a very tiny direct current through them in order to achieve a desired effect. Because the causes of depression are individualized, an electrode placement that works for one individual may not work for another. Current level may also need to be adjusted. It’s important that a depression patient being treated with tDCS be monitored to make sure progress is being made as treatments continue. If no improvement is detected after a few treatments, it may be time to try one of the other depression montages.
A normal depression treatment protocol is for 20 – 25 minutes of tDCS at 1, 1.5, or 2 mA at least 5 days per week for 30 days. Treatment is sometimes continued for an additional 30 days for maximum result. “Booster” treatments can be administered at anytime in the future as needed if depression symptoms begin to reappear. Some individuals are unable to tolerate 2 mA tDCS due to skin irritation.
Depression Montage #1
The anode (+ lead) electrode is placed high on the left forehead while the cathode (- lead) electrode is placed on the right forehead. This is the most commonly used depression montage.
Depression Montage #2
The anode (+ lead) electrode is placed over the right temple while the cathode (- lead) electrode is placed over the left temple. This montage is interesting because not only can it alleviate depression, it is associated with improvements in intuitive thinking.
Depression Montage #3
The anode (+ lead) electrode is placed over the left forehead (supraorbital region) and the cathode ( – lead) is placed over the occipital region (middle of the back of the head, about even with the ears.) This is a recently published montage that showed very promising results in a small study.
If you are new to tDCS, may I suggest you at least examine the below:
4. www.pubmed.gov (search for tDCS)
tDCS devices are entering the marketplace with increasing frequency. Here are some suggested consumer level devices to examine (in no particular order):
1. www.foc.us (buy with accessory kit)
There are many more tDCS devices in the market, including impressive, expensive, professional models.
Its time for mental health professionals to get serious about helping their patients needing more than talk therapy with something other than a prescription drug. There is plenty of evidence and anecdote that tDCS can help many depression patients at the same level or better than medications – without all the side-effects and expense. Do some research, attend a conference, speak to doctors now using tDCS and help end the epidemic of depression.