This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.

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Treatment option 10: Undergoing Cranial Electrotherapy Stimulation (CES) or Transcranial Magnetic Stimulation (TMS)

Cranial electrotherapy stimulation (CES) is a therapeutic treatment in which a handheld electric pulse generator is connected to the scalp. Painless, low-level currents stimulate electrical movements in the brain, which possibly help alter existing neural pathways. Patients are prescribed the device, then use it at home for a few minutes a day. Side effects are few, but the efficacy of these devices for depression is not yet proven.

Transcranial magnetic stimulation (TMS) is the in-office version of CES. Due to the effectiveness of this treatment, in recent years, TMS clinics have been established in many areas. TMS is more intense than CES, and memory loss has been reported. 

Related but less often prescribed treatments are electroconvulsive therapy (ECT) and deep brain stimulation, both of which might have greater side effects than TMS or CES.

People with severe, treatment-resistant depression might want to consider one of these therapies. Just do your research first, both on the treatment of choice and on providers in your area.

For a thoughtful, thorough account of these treatments, read the relevant sections in The Noonday Demon: An Atlas of Depression by Andrew Solomon. Just keep in mind that his account was published in 2015, and might be somewhat outdated due to changes in technology.

If desired, add “consider undergoing CES or TMS” to your depression treatment plan. Then decide on next steps, such as finding a provider, and write them on your short-term and/or long-term to-do list.

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