Question: I am a 62-year-old man, and I have suffered with moderate to severe depression for about 12 years. I have been under psychiatric care during this time, and I have undergone ECT, magnetic treatments, and medications. Is there any future hope for patients like me?

Dr. Hibberd's Answer:

We now understand that depression is caused by biological imbalances of neurotransmitter substances in our brains. Most modern treatments of depression capitalize on this discovery, and we now have a vast array of very useful medications that are very effective in most people.

Sometimes, the depression is so severe that immediate relief of depression is demanded. This is where electroconvulsive therapy (ECT) has had its role.

Unfortunately, ECT also has drawbacks that include memory loss, even with the newer ways of administering it (one-sided is almost always used now instead of the old method of bilateral stimulation). Suffice to say that if severe enough, ECT can be justified in selective cases or in cases which are slow to respond or are resistant to response.

ECT appears to work like resetting or rebooting your home computer. Although most patients never need this form of aggressive treatment, some respond very well to it.

Remember that depression may be related to underlying disease, hormonal imbalance, or even malignancy. Always obtain full physical clearance before simply accepting that an imbalance in neurotransmitters is causing your depression.

Unfortunately, magnetic treatments have not shown much promise. New hopes for depression still seem to relate to neurotransmitter manipulation by drug therapy. Note that many patients can enroll in a form of therapy called CBT (cognitive behavioral therapy), and have managed to become drug-free.