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7 Articles in Volume 5, Issue #5
Effective Non-Drug Treatment of Depression
First Line Treatment of Musculoskeletal and Neuropathic Pain
Pain Drug Use Policy
Targeted Peripheral Analgesics in Chronic Pain Syndromes
Therapeutic Drug Monitoring
Tiredness and Chronic Pain Management
TMD/Facial Pain and Forward Head Posture

Effective Non-Drug Treatment of Depression

A review of the evolution in electrical and photo stimulation for effectively treating depression in chronic pain patients.

In 1965, the author introduced the concept of electrical stimulation of the dorsal column of the spinal cord for management of intractable, chronic benign pain.1,2 In 1972 after sub-specializing in the management of chronic pain, the author began to see about 400 patients a year referred for implanted spinal cord stimulation and was finding that at most only 6% of those patients qualified for the procedure. It became obvious that other methods of managing these complicated and difficult patients should be found.

Evolution of Electro Therapy

Initially the author used behavioral modification along with a very crude, ancient electrical stimulator, the Electreat®, together with acupuncture. After the first year, the author was introduced to the concept of biofeedback and continued that with other forms of behavioral modification.3,4 From the beginning, the old Electreat® was one of the most successful tools utilized for managing chronic pain.5 Manufacturers initially had been uninterested in developing a modern solid-state device. However in the early 1970s, both Stimulation Technology and Medtronic came out with modern solid-state devices.

In 1975, Saul Liss introduced the author to his device, the Pain Suppressor® (subsequently referred to as the Liss Stimulator), which was quite different from the other modern TENS devices. He stated that it only needed 1 to 2 milliamps of current at 15,000 Hz to be effective. Initially, the author wasn’t at all certain that it had any major benefit when applied on either side or above and below pain but serendipitously, happened to place one of the electrodes on the forehead and saw a visual flicker. A few months later, trying it transcranially for one hour, the author demonstrated that it strikingly increased serotonin production. Since virtually all chronic pain patients had quite significant depression, the author began using this device transcranially with remarkably good results.

Stimulating Normalization of Neurochemicals

The author’s earliest studies revealed that 24 hour output of 5-hydroxyindoleacetic acid, the metabolic byproduct of serotonin, was elevated in 40% of patients, below normal in 40% of patients and had an average normal production in 20% of patients. Interestingly, after two weeks of applying the Liss Stimulator transcranially, both those with initially elevated levels of serotonin production and those with deficient levels of serotonin production normalized. Even more interesting, none of the 20% of individuals who had a normal production of serotonin responded to any of the multi-modal approaches that the author was using for treatment of chronic pain at that time.6

Over the next few years, the Liss device evolved to use both 15,000 Hz, as well as modulations of 15 Hz and 500 Hz. By the 1980s, the author was able to demonstrate that the Liss device, used transcranially, raised not only serotonin but also beta endorphin levels. Later experiments proved that it increased these neurochemicals in cerebral spinal fluid, as well as in blood.7,8

Meanwhile, the author had begun using a 1975 photostimulator between 3 and 12 Hz frequency as an adjunct to help chronic pain patients with depression and anxiety to relax. In later experiments, the author demonstrated that 29 out of 50 patients with depression improved using nothing but the photostimulation.9,10

Multi-Modal Therapies

By 1988, the author was using only the Liss Cranial Stimulator, Shealy Series, for an hour every morning, the photostimulator for an hour sometime during the day and, in the author’s earliest research on some 400 patients, found that 85% were out of depression within two weeks using this approach. Since 1975, the author has treated 30,000 patients with depression of which approximately 25,000 had chronic pain. Using the Zung Test for Depression and, in many cases, also the MMPI, the author has routinely seen that around 85% of patients come out of depression within two weeks utilizing these protocols.11,12

Through the years, the author has continued using a wide variety of therapeutic approaches including acupuncture, massage, individual psychotherapy, physical exercise, education, biofeedback, and autogenic training as adjuncts to overcome both pain and depression, along with the Liss Stimulator, Shealy Series, and the photostimulator, which later became the Shealy RelaxMate II™.13 Also, in 1993, the author introduced a self-directed form of psychotherapy through a three month home program to assist patients in maintaining their freedom from depression.14

Other experiments demonstrated that these chronic pain and chronically depressed individuals had a deficiency of intracellular magnesium 100% of the time; deficiency of the essential amino acid, taurine, 86% of the time; and deficiencies in 1 to 7 essential amino acids, 92% of the time.15 Therapies should therefore include magnesium lotion and a good multivitamin/mineral supplement.

Validation Testing

In 2004, in order validate the therapeutic effectiveness of the Liss Stimulator and RelaxMate II™—exclusive of the multi-modal interventions taking place simultaneously in the more intense treatment protocols—the author treated 200 patients having unequivocal depression as demonstrated both by the Zung Test for Depression and the MMPI.16 The patients were evaluated and screened by a nurse practitioner and instructed in the use of the Liss Cranial Stimulator, Shealy Series, and the Shealy RelaxMateII™ by a trained technician. They were given this equipment to use at home, along with the 90 Days to Stress-Free Living book,17 a single autogenic training tape, and encouragement to use transdermal magnesium lotion and a good B complex multivitamin. The patients were seen in follow up at one month, three months, and six months. One hundred sixty-eight of these 200 patients (84%) came out of depression, usually by the first follow up at one month, and remained out of depression at the follow up at three months and six months. Most of the failures actually dropped out during the first month of the program. This 84% success rate is approximately twice as good as the best antidepressant drug—and without complications. According to the Physicians’ Desk Reference (referencing treatment of a comparable 207 patients), Paxil has a 25% success rate at a 20 mg. dose, a 42% success rate at a 40 mg. dose and a 44% success rate at a 60 mg. dose. The stated side effects included nausea in 26% of patients, somnolence in 23% of patients; dry mouth in 18% of patients; constipation in 14%; diarrhea in 12%; dizziness in 13%; insomnia in 13%; male genital disorders, including ejaculatory problems, in 23%; asthenia in 15%; and headache in 18%. Similar results were found with Prozac and Effexor.


This simple, non-pharmaceutical protocol for depression appears to be safe, essentially free of complications or side effects, and twice as effective as the best antidepressant drugs. The protocol consists of the use of

  • The Liss Cranial Electrical Stimulator, Shealy Series™, one hour each morning
  • The Shealy RelaxMate II™ for one hour sometime each day
  • A self-directed, psychotherapeutic program, 90 Days to Stress-Free Living17
  • Transdermal magnesium lotion and a good multivitamin/mineral supplement.

Results with this simple, effective, and inexpensive therapy—applied alone with no other interventions—have been as effective as including this program with many other multimodal interventions. Staff at three hospitals have now been trained to carry out this protocol. It appears equally effective whether one does it in a major hospital setting or in a stand-alone clinic managed only by a nurse practitioner and a technical assistant. Since depression is a major component of all chronic pain, this approach may be one of the most effective adjuncts for pain management. In the author’s clinical experience, migraine and fibromyalgia also respond well to this same protocol. For those patients having significant depression, whether chronic pain patients or not, the author has found that this protocol alone often provides successful treatment of depression.

Last updated on: January 28, 2012
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