Depression Treatment Advancements
While effective treatments for depression are available however, researchers are developing new and better ways to treat the disorder. This special Research in Context feature will explore some of these depression treatment advancements.
Psychotherapy helps alleviate depression symptoms by teaching people how to deal with negative thoughts and emotions. Talk therapy can take place in groups or one-on-1, with a mental healthcare professional.
Precision mental healthcare
The term "precision" refers to bringing more exactness or accuracy to the prevention, diagnosis and treatment methods. In the realm of mental health, it can encompass a variety of strategies that range from psychotherapy to medication. However, many of these strategies tend to focus on the consequences of the disorder instead of its root causes. This can lead to treatments that do nothing more than ease symptoms but do not tackle the root causes that cause mental illness in the first place.
The precision of mental health is rapidly advancing. It's akin to the methods that is used in other areas which includes continuous monitoring of vital indicators (e.g. fever or blood pressure) into the clinical practice. It also involves combining several data sets and using machine learning to help doctors recognize the unique requirements of each patient and develop more efficient treatments.
One example of precision psychiatry is using EEG to monitor brain activity and help doctors assess a person's ability to engage in cognitive behavioral therapy. A new class of drugs known as NMDA receptor inhibitors can reduce depression symptoms by preventing the neurotransmitter glutamate from reaching certain brain cell. Another potential advance is the use of pharmacogenetic testing to determine interactions between genes and drugs and prevent undesirable side effects.
Many companies are also experimenting with digital precision medicine, which utilizes objective digital technology to monitor patients remotely and collect real-time data that can help guide their treatment. For example, one company is using artificial intelligence to monitor compliance and optimize medication dosages for their depression patients. These types of solutions are likely to dramatically increase accessibility and effectiveness of mental health services and increase adherence to treatment.
Additionally Digital precision psychiatry could help overcome barriers to treatment for people living with mental illness, particularly those who are employed. Johnson & Johnson, for example, is partnering with organizations in Singapore to aid in the reintegration of people recovering from depression back into their jobs. This can help them keep their jobs, which are crucial for mental recovery.
Medication
Many people suffering from depression discover that medication helps ease their symptoms. This is particularly true if the symptoms are intense or incapacitating. Antidepressants restore the balance of neurotransmitters in the brain, which are chemical messengers that regulate mood and emotional state. The majority of antidepressants today focus on one of these neurotransmitters by increasing levels of serotonin. Selective serotonin Reuptake inhibitors (SSRIs) like Prozac and Zoloft, boost the level of serotonin's chemical in the brain. SNRIs, like Cymbalta and Effexor which are able to target both dopamine and norepinephrine and monoamine oxidase inhibiters like Wellbutrin and Effexor, focus on only norepinephrine and dopamine.
antidepressant medication www.iampsychiatry.com of doctors prescribe antidepressants to treat depression as a first treatment, along with talk therapy. Some of these therapies include cognitive behavioural therapy, which helps improve the quality of your thoughts and feelings by teaching specific skills, or interpersonal psychotherapy, which focuses on improving relationships. Other therapies such as electroconvulsive (ECT) therapy and transcranial magnetic stimulation (TMS) have also proven to be effective at treating depression.
Some people, however, don't respond to the initial medication that doctors prescribe. Up to one-third of depressed patients do not receive relief from the first medication they take and 40 percent of people who start taking antidepressants discontinue them within three months. The good news is that recent research has helped doctors predict which type of medication will be most effective for each patient, using blood or MRI tests to determine which receptors are the most affected by the depression.
In recent years, medication has improved with better options and dosages to reduce adverse effects. Newer antidepressants like esketamine, brexanolone and nefazodone work to quickly alleviate depression symptoms.
Other medications are in clinical trials that could alter the method of their use. A drug called vorapaxar, that is currently being tested in humans, targets a different part of the brain that's associated with depression by blocking NMDA receptors. It's expected to become available by 2024. A combination of ketamine and bupropion also has shown potential. It may be more effective at treating depression that is resistant to treatment.
Psychotherapy
Psychologists have been able to pinpoint certain elements that contribute to depression, for instance, imbalances in the neurotransmitters serotonin as well as norepinephrine. These chemicals are vital in managing mood and emotions, as well as the overall function of the brain. Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors are the main treatment options. They can alleviate many symptoms of depression including depressed mood, fatigue and sleep issues. However, they can have adverse effects that can cause them to be unsuitable for certain people.
Psychotherapy can help address the root causes and assist people to manage depression. Cognitive therapy for behavioral disorders and ketamine therapy are two kinds of therapy that have been proven to lessen the symptoms of depression. In addition, psychotherapy can aid people in developing a healthy way of coping and to manage stressors. Cost, scheduling restrictions and a shortage of mental health professionals can hinder access to psychotherapy. Telehealth services have made it easier for many people.
The difficulty in beating depression is finding the best combination of treatment. The use of medication alone isn't enough to alleviate all your symptoms. It may take between 6 and 12 weeks before you know whether a medication is working. There are a variety of nonpharmacologic treatment options, including repetitive transcranial magnet stimulation and vagus nerve stimulation. These therapies use electromagnetic fields to stimulate the brain's natural chemistry and enhance mood.
Whether you're interested in trying psychotherapy or medication, it's essential to collaborate with your therapist. Discuss your feelings and thoughts, and discuss the advantages, risks, and side effects of each option. If you have a hard time establishing a trusting relationship with your therapist or doctor Try to find a provider who can meet your needs. A provider who offers a free trial period could be a great option, since it gives you the chance to try different options before making a commitment. Eventually, you'll find a treatment that works best for you and helps you feel and look your best.
Brain stimulation
In just a few years scientists have found new methods to target specific brain regions and alter their function rapidly. These techniques can also be used to treat physical ailments and certain mental disorders.
rTMS is a technique which employs electromagnetic pulses to stimulate brain activity. It is similar to the magnetic pulses that are used in MRIs, but not powerful enough to cause seizures. The method is based on stimulating a specific area of the brain with an uninvolved magnet. The pulses change the way that your brain processes and allow you to feel better. The treatment only takes 3.5 minutes and does not interfere with your normal routine. You may experience a slight headache afterward.
Another treatment involves putting electrodes in the brain to send painless electrical zaps. This procedure is also referred to as deep transcranial magnetic stimulation (deep TMS), and it's been used for OCD and to quit smoking. Recent studies suggest that it may alleviate depression symptoms in certain people. It's not clear what the effect of this treatment is, however, it seems to alter the balance of certain neurotransmitters.
Other forms of noninvasive brain stimulation are also advancing, too. In a recent study, patients suffering from severe depression and intolerance to antidepressants responded well to a magnetic therapy known as SAINT. It is individualized to each patient's brain anatomy and relies on high-dose patterns of magnetic pulses. The treatment can be completed in just a few hours unlike previous treatments that required daily sessions over months or weeks.
Researchers employed fMRI technology to pinpoint the exact brain region that was being stimulated by each patient. They also analyzed minute differences in the way that the brain's different regions were activated which allowed them to determine the direction of signals. They found that in depressed people the brain's anterior cortex cortex sent signals to an area known as the subgenual cingulate cortex. These messages were often misdirected. The more severe depression the more signals were directed in the wrong direction.