In Russia, deep brain stimulation (DBS) for depression is not used due to safety concerns, according to a leading psychiatrist who heads the emotional states department at a prominent mental health research institute within a national medical research center. He notes that DBS involves implanting very fine microelectrodes into brain regions tied to emotional regulation. While such invasive procedures are adopted in a few countries to treat resistant depression, they are not routinely performed in Russia.
There are several reasons for this cautious stance. On one hand, these operations have shown potential for significant improvement in some patients. On the other hand, they carry risks that can be serious. During surgery, a blood vessel in the brain could be damaged, bleeding might start, and surrounding brain tissue could be harmed. Micro-damage to critical brain areas may trigger epileptic seizures, and those damaged structures could become seizure-prone. The specialist emphasizes that DBS is considered only in a small fraction of cases where multiple treatments have failed and every possible risk has been thoroughly evaluated.
In Russia, clinicians rely on alternative approaches to help those with treatment-resistant depression. Vagus nerve stimulation, a technique that delivers targeted electrical impulses to the vagus nerve through a small device implanted in the chest, is among the prominent options. This method engages a broad nervous-system network that links to brain regions involved in mood regulation, enabling modulation of emotional states through a less invasive route compared with brain implants. The aim is to influence the brain’s emotional circuitry by exciting pathways that intersect with areas responsible for regulation of mood and thought patterns.
Understanding the differences among depression subtypes is essential, since not all forms respond to the same treatments. The ongoing exploration of new therapies, both within the country and globally, prompts clinicians to distinguish simple sadness from a psychiatric condition that warrants professional care. For individuals experiencing persistent low mood, loss of interest, sleep disturbances, or changes in appetite that endure beyond typical mood fluctuations, seeking a medical assessment is advised. When symptoms interfere with daily functioning or safety, medical guidance becomes particularly important for choosing an appropriate treatment strategy. This discussion reflects a broader conversation about managing depression in modern clinical practice and highlights the importance of individualized care in achieving meaningful outcomes.