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Unexplained sadness, loss of interest in work, feelings of guilt or low self-worth, sleeping too much or too less, loss or increase in appetite, feelings tired most of the time, and poor concentration- as you are reading all these symptoms, which are of depression, it is quite likely that you identify a few or most of these with someone around you. This may take you by surprise, but depression is actually one of the most common medical conditions.
Affecting 350 million people across the globe, depression is probably the most common problem which swiftly changing lifestyle has in offering. Moreover, depression is just not rising at an alarming rate, it is catching us young!
Increasing work pressure, rising ambitions, challenges of day to day life and promptly changing personal and professionals priorities are pushing people towards extreme stress and depression. Starting from unexplained sadness and mood swings, depression could reduce productivity and performance in every sphere of life, if left untreated. At its worst, depression can lead to suicide. It is estimated that 1 million deaths every year accounts for depression.
"Treatments of depression conventionally include counselling and antidepressants but patients who do not respond to these medications, are advised for electroconvulsive therapy (ECT) or trans-cranial magnetic stimulation (TMS). Sometimes, however, in case of major depressive disorder, all these prove to be of little help," says Dr Paresh Doshi, Director of Functional Neurosurgery, Jaslok Hospital.
MDD is the considered the leading cause of years lost due to disability worldwide and the third overall contributor to the global burden of disease and projected to be the largest contributor by 2030. Fortunately with advancement in medical technology, now we have surgical options for such patients.
"For patients suffering from severe grade depression, who do not respond to medication and even therapies, we have an advanced medical modality called Deep Brain Stimulation treatment, presently being done in a few selected centers all over the world. The results of the treatment nothing short of miraculous," says Dr Paresh Doshi.
In recent times, patients from advanced countries have also started coming to India to avail of this new advent in medical technology. Mr. Benjamin Ward, a 26 year old missionary from Sydney, Australia, who was suffering from severe depression with suicidal thoughts, has successfully undergone Deep Brain Stimulation (DBS) surgery at Jaslok Hospital, Mumbai, on 25th September 2013 and is reported to be recovering well.
"As a matter of fact, certain biochemical disturbances in brain chemicals called neurotransmitters (mainly serotonin) are primarily responsible for major depressive disorder (MDD). Sometimes, as in case of severe depression, these neurotransmitters could not be managed with drugs and conventional therapies. In such conditions DBS can be very effective," explains Dr Paresh Doshi.
DBS directly stimulates brain regions through insertion of a device within the skull to target particular symptoms. Electrodes or leads are placed in the skull, which are connected by wires to a type of pacemaker device (called an impulse generator, or IPG) implanted under the skin of the chest, below the collarbone. Once activated, the device sends continuous electrical pulses to the target areas in the brain. Thus, the pacemaker delivers continuous stimulation to the brain, and as days progress, the effect of the stimulation builds up and improves patients' mood.
According to a study published in the journal Neurosurgical Focus in 2008, surgical intervention for treatment-resistant depression, in the form of DBS is emerging as a viable treatment alternative to existing modalities.
Such treatment options could be even more beneficial for a country like India where 36 percent of the population is estimated to be suffering from major depressive episodes (MDE).
So, all those who are suffering from drug-resistant depression and are not responding too can possibly be a candidate for DBS.
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