Vagus Nerve Stimulation for Depression: Therapist-Approved Methods

Brittany Ferri, PhD, OTR/L
Occupational Therapist, Writer
November 18, 2025

Being able to manage your mental health is important, which is why treatment-resistant depression can be so difficult to live with. Individuals with this form of depression don’t see typical results from traditional treatments, which can lead them to lose hope for their condition and the future.

However, the distinct link between the vagus nerve and depression can bring these individuals symptom relief. Vagus Nerve Stimulation (VNS) is an innovative medical procedure that can help treat treatment-resistant depression, along with many other conditions. VNS gently stimulates the vagus nerve and activates certain parts of the brain to improve emotion regulation and overall cognitive function. In addition to vagus nerve stimulation for depression, individuals can benefit from SoundSory, which is a complementary program that enhances the effects of VNS by improving coordination, attention, and auditory processing.

This article offers a comprehensive look into the mechanisms behind VNS, the benefits you can expect from this medical device, and how SoundSory can further support your depression treatment.

What is Vagus Nerve Stimulation (VNS), and How Does It Help with Depression?

Vagus Nerve Stimulation is a treatment that involves sending mild electrical impulses to the vagus nerve, which is a cranial nerve responsible for many of the body’s involuntary functions. The vagus nerve is part of the parasympathetic nervous system, meaning it is tasked with bringing our body back to a calm and rested state after periods of stress. Specifically, the vagus nerve does this by lowering our heart rate, respiratory rate, and blood pressure while increasing digestion.

The impulses that someone receives from VNS help the vagus nerve work more efficiently to keep the body’s vital signs steady and stable. This has a host of benefits, including regulating our mood and allowing us to be more alert and attentive. Research explains that VNS works by stimulating the vagus nerve in the neck, which then carries impulses to the dorsal raphe nucleus and the locus ceruleus – both located in the brain stem.

The dorsal raphe nucleus regulates appetite, helps us respond to stress, controls our sleep-wake cycles, and keeps our mood balanced. The dorsal raphe nucleus does all of this by creating and releasing a neurotransmitter called serotonin, which is low in people with depression. The locus ceruleus is responsible for many of these same functions, along with helping us maintain attention and regulating many of the vital signs we discussed earlier. By stimulating both of these areas, VNS keeps many of our bodily functions running smoothly and evenly.

Another study suggests that stimulation of the vagus nerve can better balance the thalamus, along with the insular and prefrontal cortex. The thalamus helps our ability to sustain focus, process and regulate emotions, and retain information we have learned, while the insular and prefrontal cortex help with organization, judgment, planning, and decision-making. Each of these functions may be impacted by TRD, so this is yet another way that VNS comprehensively addresses the brain to better manage depressive symptoms.

Soundsory operates in a similar fashion by using sound stimulation to regulate and calm the body’s sensory processing systems. This can wonderfully complement the effects of VNS by promoting a sense of relaxation and emotional well-being.

Vagus Nerve Stimulation for Treatment-Resistant Depression (TRD)

Treatment-resistant depression, also known as TRD, is a form of depression that doesn’t respond to the usual treatments for this condition, such as medication and psychotherapy (or talk therapy). So, someone with this condition likely has tried medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) as well as individual therapy, but saw little to no results.

VNS is a treatment approved by the Food and Drug Administration (FDA) to manage treatment-resistant depression. This means there is significant evidence showing that vagus nerve stimulation for depression can bring patients significant relief from symptoms. It is important to note that VNS is not recommended as a first-line treatment for depression and is only approved for certain individuals. Individuals may receive surgical VNS if they:

• Have had depression that has lasted for at least 2 years
• Have depression that is considered recurrent or severe
• Have depression that has not been relieved by at least four different treatments
• Are 18 years or older

There is substantial evidence supporting the use of VNS for depression as long as individuals meet the above criteria. The RECOVER trial is one of the leading studies on VNS for treatment-resistant depression. This study found that, when compared to a sham treatment, VNS had more antidepressant effects as reported by healthcare providers and patients themselves. In addition, patients who received VNS displayed positive effects more quickly than those who received sham VNS. While there are some mild adverse effects associated with VNS, participants who received the treatment as part of this trial did not experience any new adverse effects.

Additional studies support the use of VNS in this population and highlight other benefits associated with this treatment. We will discuss those in the next section.

Benefits of Vagus Nerve Stimulation (VNS) for Depression

There are several benefits of using VNS for depression. One of the chief benefits of this treatment modality is better management of depression symptoms. VNS can offer individuals with treatment-resistant depression significant, long-term relief from the direct effects of depression. This means individuals who receive VNS are likely to see some of the following positive outcomes as a result of this treatment:

• A more balanced mood
• More regular sleep habits
• A more consistent approach to eating
• Fewer unexplained aches and pains
• Increased energy levels
• Improved ability to concentrate
• More clarity in decision-making
• Improved sexual function

Individuals who participate in vagus nerve stimulation may once again begin participating in preferred activities they may have lost interest in or stopped pursuing due to their condition. Overall, VNS can lead individuals with treatment-resistant depression to work more successfully, attend school, fulfill responsibilities, and engage with loved ones. As a result, this can lead to enhanced quality of life.

Research backs this statement up, as one study found that active VNS improved quality of life and psychosocial function better than sham VNS did. Another study showed that quality-of-life gains associated with VNS were clinically meaningful as well as associated with a reduction in depression symptoms. In addition, this study found that quality-of-life gains were sustained over longer periods of time.

The RECOVER trial found that VNS for depression produced the most significant functional and quality-of-life improvements when provided for 12 months and in addition to other therapies. Talk therapy is often recommended as a supplement to VNS, as this modality teaches individuals about their condition and how to make lasting positive changes for their health. SoundSory is another complementary modality to VNS, as this program can enhance the function of the vagus nerve through sound stimulation and improved brain activity. Through enhanced relaxation and improved regulation of the nervous system, SoundSory pairs very well with vagus nerve stimulation for depression.

The Surgical VNS Process: What to Expect 

Individuals who are to receive VNS for depression must first have a vagus nerve stimulation device implantation. This is done surgically, meaning doctors will give you anesthesia before they place the device under your skin. The procedure involves several steps. Firstly, doctors will place a pulse generator (which is about the size of a stopwatch) under the skin on one side of the chest. They will then connect this to a wire that will run from the pulse generator up the left side of the neck to the vagus nerve. From here, the impulses that directly stimulate the vagus nerve then travel up to the brain. Individuals who undergo this procedure are left with two small incisions: one on the left side of the chest just below the collarbone and another on the left side of the neck above the collarbone.

Because of the method by which surgical VNS is placed, there are some innate risks involved. Individuals are likely to experience some degree of pain as a result of the surgery, though this is considered tolerable compared to more major procedures. Individuals may develop surgical site infections if their incisions are not properly taken care of. 

There is also a risk of other adverse effects, including headaches, neck pain, difficulty swallowing, breathing difficulties (particularly during strenuous activities such as exercise), vomiting, nausea, hoarseness or other voice changes, sore throat, cough, and discomfort at the implantation site. There is the possibility that any of the device’s pieces may move around excessively or malfunction. If this occurs, they may need an additional procedure to readjust and secure the device.

The VNS placement procedure takes between 45 and 90 minutes and is done on an outpatient basis, meaning individuals are usually able to go home on the same day as their surgery. As with any surgery, there are some limitations in place afterwards. Individuals are expected to refrain from strenuous activity for about a week after their procedure. They will then consult with their doctor to activate the device and learn about how the impulses will work. Doctors start the VNS device on a low level and allow you to get used to it for some time. Then, they will slowly increase the intensity based on the symptoms you report and how you are tolerating the impulses so far.

Non-Invasive Alternative: Soundsory

Regardless of whether or not you take advantage of VNS for depression, you may also benefit from additional vagus nerve stimulation using the SoundSory program. SoundSory is a non-invasive alternative to traditional VNS. SoundSory similarly targets the vagus nerve, though it does so in a pain-free, easy-to-use way by sending impulses to the nerve through the ear. Its impact on the vagus nerve has many positive effects on the body, including producing a more regulated mood, lowering levels of anxiety, and enhancing overall well-being.

SoundSory is ideal for people of all ages and walks of life, and there are many advantages to this program. Its accessible and simple design makes it a perfect fit for use in any setting – from the comfort of your own home or on the go. The device has no requirement for surgery, medication, or downtime and is completely safe with no associated side effects. Our device is wearable in the form of over-ear headphones, making it much less of a commitment than some other vagus nerve technology. SoundSory’s non-invasive nature makes it much easier to integrate into your daily routine than some more complex options, which is perfect for people looking to get started right away. 

SoundSory is also fun to use! We utilize a multi-sensory approach with music and movement to encourage learning and growth. Based on the Tomatis Method, our 40-day program includes 30 daily minutes of music listening alongside exercises. There are two parts in each program, which both last 20 days. If you enjoy the program (which we’re confident you will), you can repeat it as many times as you’d like. That’s the true benefit of a non-invasive program, as you can adapt the program to your wants and needs to reap the benefits for years to come.

Frequently Asked Questions (FAQs)

What is Vagus Nerve Stimulation (VNS) for depression, and how does it work?

Vagus Nerve Stimulation is an FDA-approved medical procedure that helps manage symptoms for individuals living with depression that hasn’t responded to therapy or medication (also known as treatment-resistant depression). VNS sends gentle, comfortable electrical impulses from the vagus nerve located in the neck to various areas of the brain that control emotion, attention, memory, appetite, sleep, and vital signs. This allows someone with depression to experience a more balanced mood and consistent energy levels.

Can Vagus Nerve Stimulation (VNS) help people with severe, treatment-resistant depression who haven’t responded to medication?

Yes. In fact, VNS is designed specifically for people with significant depression who have not gotten much benefit from other treatment methods. Individuals who have just been diagnosed or are beginning to explore treatment options should look toward talk therapy (also known as psychotherapy) and medications such as SSRIs and SNRIs before trying VNS.

How does Vagus Nerve Stimulation (VNS) compare to other treatments for depression, like antidepressants or therapy?

In order to experience the intended benefits, you must take antidepressant medications as often as your doctor tells you to. Medications also come along with an adjustment period, which is the time it takes for your body to get used to the medication. When engaging in talk therapy or counseling, individuals need to play an active role in working through uncomfortable emotions, discussing the changes they are making to help their symptoms, and reporting back to their therapist regularly. With VNS, the device operates on its own and requires no effort from you. This makes it simpler, which is especially helpful for people with severe depression.

How long does it take for Vagus Nerve Stimulation (VNS) to show improvement in depression symptoms?

It typically takes between 4 and 8 months of VNS to begin seeing improvements in depressive symptoms, though it can take up to 12 months in some people. One long-term study showed that benefits are still seen up to the 5-year mark, as people who received VNS had higher remission and response rates than those who received traditional treatments. Another similar but smaller study found continued benefits up to 10 years after VNS device implantation.

Are there any side effects associated with Vagus Nerve Stimulation (VNS) for depression?

Since VNS for treatment-resistant depression is implanted via a surgical procedure, there is a risk of a postoperative infection. However, this risk is low. Side effects associated with VNS implants are mostly minor and include voice changes, paresthesias (such as numbness and tingling), cough, and voice hoarseness.

Can Vagus Nerve Stimulation (VNS) be used for other mental health conditions besides depression?

Yes. VNS has also been FDA-approved for the treatment of epilepsy, migraines, and cluster headaches. Researchers are exploring other potential uses for VNS, including stroke rehabilitation, heart failure, and the management of long COVID. However, there is not currently enough evidence to support the use of VNS for these purposes.

How does Soundsory complement Vagus Nerve Stimulation (VNS) for mental health?

SoundSory stimulates the auditory processing system, which has many of the same positive effects as vagus nerve stimulation does. Therefore, people who use VNS alongside SoundSory are likely to see even more improvements in emotion regulation, attention, and alertness.

Conclusion

There is a host of evidence supporting the use of vagus nerve stimulation for individuals with treatment-resistant depression. Through a simple surgical procedure to implant the device, individuals with this condition can unlock long-term relief from depression symptoms. As a result, VNS can lead those with TRD to experience a greater quality of life and improved functioning across all areas of their lives. When other treatments such as medication and talk therapy have not helped, vagus nerve stimulation offers hope for a more balanced mood and improved psychosocial health.

If you are interested in vagus nerve stimulation to help with treatment-resistant depression, talk to your healthcare professional today. Psychiatrists, psychologists, and mental health counselors with any background should be able to advise you on the next steps. If you want to experience added benefits alongside vagus nerve stimulation, look into SoundSory to further improve the health of your vagus nerve and encourage an even greater sense of long-term relaxation.

References:

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Brittany Ferri, PhD, OTR/L

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My areas of expertise include occupational therapy, rehabilitation medicine, telehealth, and mental health. With nearly 10 years of healthcare experience, I am also qualified to write on topics such as exercise, health insurance, nutrition, orthopedics, geriatric care, pediatric therapy, neurology, and health tech.