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Major depression is the leading cause of disability in the U.S. and worldwide. Depressive disorders affect an estimated 9.5 percent of adult Americans over the age of 18 in a given year, or approximately 18.8 million people. Symptoms of depression can include a persistent depressed mood, loss of interest in regular activities, feelings of hopelessness and helplessness, sleep disturbances, increased or decreased appetite and decreased energy. When seeking treatment for depression, it is important to obtain a medical examination, as many symptoms of depression can be caused by medications and other medical conditions. A variety of antidepressant medications and psychotherapies can be used to treat depression. Medications for depression typically include the selective serotonin reuptake inhibitors (SSRIs), tricyclics, and monoamine oxidase inhibitors (MAOIs). Electroconvulsive therapy (ECT) is also sometimes used for people who do not respond to more conventional methods of treatment like medication. Two other forms of treatment are currently being tested for people with treatment-resistant depression--rapid Transcranial Magnetic Stimulation (rTMS) and Vagus Nerve Stimulation (VNS).