At times, chronically depressed patients do not respond to treatments. Anti-depressants and psychotherapy seem to have no effect on them. These patients have to put up with intense suffering and misery. They often become suicidal due to feelings of isolation, hopelessness, desperation, unemployment and frequent visits to psychiatric hospitals. Now, brain stimulation therapies are being tried on such patients. Though these treatment procedures are effective, they come with their own risks.

Highlights of Electroconvulsive Therapy (ECT)
a. The procedure is common among patients who have Treatment resistant depression.
b. It is highly effective.
c. It involves the use of general anesthesia.

Disadvantages
a. It might lead to confusion about recent happenings.
b. It might damage the brain.
c. This treatment procedure has a high incidence of relapses.

Highlights of Repetitive Transcranial Magnetic Stimulation
a. This is a new treatment procedure.
b. It involves the use of an intense magnetic field to stimulate the brain.
c. This stimulation is administered every day over several weeks.
d. It stimulates brain cells without causing a seizure.
e. This magnetic field is targeted on the prefrontal region of the brain.
f. It depolarizes the neurons and generates pulses of electrical activity.
g. These short pulses are targeted at the limbic system structures that control mood.
h. These structures are reached through the left prefrontal cortex.
i. The magnetic energy easily reaches the brain without being distorted.
j. It is precise procedure.
k. The patient does not feel any discomfort during this procedure.
l. This treatment is carried on over twenty 30-60 minute sessions over 4 weeks.

Disadvantages
a. The device used for administering this treatment is not FDA approved.
b. It is less effective than ECT.
c. It might lead to seizures if the magnetic fields are too intense too fast or is applied for too long.
d. It might cause headaches, facial muscle twitching and tinnitus.

Highlights of Vagus Nerve Stimulation
a. This is an outpatient procedure.
b. A small electrical device is implanted in the chest underneath the skin.
c. Two thin wires connected to the device is wrapped around the vagus nerve in the neck.
d. This sends regular electrical pulse energy to the brain.
e. The dosage can be controlled according to patient's needs.
f. This treatment affects the activity of the mood-regulating brain sites like the orbital frontal cortex, insula, thalamus, hypothalamus, cingulated and hippocampus.
g. This has been approved by the FDA for use on patients above 18 years of age.
h. The implant surgery costs around $15.000.
i. The battery of the device lasts for 6 to 9 years.

Disadvantages
a. It might cause depressed patients to become manic.
b. Patients might experience voice alteration, hoarseness, cough, shortness of breath, prickling sensation on the skin or tickling in the throat.