Innovative Depression Treatments
Many people suffering from depression struggle to find a treatment that works for them. Some sufferers have a low response to medication or have inexplicably negative side effects.
The health benefits that come from increased coverage of effective treatment are estimated to be substantial (table 2). The discounted value for depression is $399 billion, and for anxiety disorders $169 billion.
Transcranial Magnetic Stimulation (TMS)
TMS uses an electric field to deliver short pulses of electric current to specific brain areas that are overactive in patients suffering from depression. The therapy is noninvasive and doesn't require anesthesia. It is also highly efficient and well-tolerated in comparison to antidepressant medication.
A person receives TMS by sitting in a chair similar to the chair used by dentists. A trained technician will place a device with a coil of magnetic material against the frontal portion of the head. The coil's pulses are quick and one may hear a click or feel a tapping sensation on the scalp. Each magnetic pulse (measured in hertz or Hz) is referred to as a "pulse”. The frequency of the pulses can vary from low (1 pulse every second) to high (10 per second).
The treatment is not painful but the magnetic field affects the cells that are located in the outer layer. It depolarizes cortical neurons and the transynaptic effects can affect deeper regions of brain that are involved in mood. For instance, a higher-frequency TMS over the left dorsolateral frontal cortex (DLPFC) can increase mesolimbic neurocircuits, which regulate emotional responses.
TMS can be used as an alternative to psychiatric medication and certain insurance plans will cover the treatment. You should consult with your insurance provider to see what your plan covers.
In clinical trials, TMS produced significant and sustained improvements in depression symptoms when compared to an placebo. During a TMS treatment program, a patient may undergo up to 30 sessions over a few weeks. Patients suffering from severe depression may require a longer course of treatment.
Certain modern treatments of TMS utilize a lower frequency pulse that is less likely to cause side effects such as seizures. While the method is still in the early stages of development but it's an effective treatment alternative for patients who are not responding to psychotherapy or antidepressants.
Electroconvulsive Therapy (ECT)
ECT helps to restore the brain's natural chemical balance. It is among the most safe and effective treatments for depression. It can also be used to treat other mental health issues like schizophrenia.
The ECT procedure is performed by medical professionals and occurs in a separate room at the hospital, or an outpatient treatment center. A general anaesthetic is given prior to the procedure, meaning you won't feel any discomfort. The ECT team will utilize monitoring equipment to measure your heart rate, blood-pressure, oxygen levels, and brain waves. You will be given a muscle relaxant that will keep you calm, as well as a mouth guard to protect your teeth. depression treatment resources I Am Psychiatry of metal are placed on the head, one each side or inside your forehead. The anaesthetist then gives you an injection of a medication that puts you to sleep.
You will be woken up in the ECT suite and a member of the ECT team will meet with you and answer any questions you may have. Before you can receive the treatment you will be required to sign an authorization form. It is a good idea to have a friend or relative with you while you are learning about ECT, as it can be difficult to absorb all the information in one go. You should be given at minimum 24 hours to consider the treatment prior to having to make a decision.
During the procedure you will experience brief fits or seizures lasting between 40 seconds and 2 min. The ECT doctor will adjust the number of electrical pulses you receive according to your response. You will probably have short sessions of ECT typically 6-12 sessions twice per week.
There isn't a single theory of how ECT works however, it does cause the release of certain chemicals that aid your brain cells communicate with each with each other. It also appears to alter how brain cells develop.
ECT is very effective in treating severe depression, suicidal thoughts and catatonia that is secondary to depression and other mental health disorders. Studies show that half of people who receive ECT improve and remain well for one year or more. It is particularly beneficial for those who have not had a positive response to medication or other psychosocial treatments.
Deep brain stimulation (DBS)
Deep brain stimulation (DBS) is an operation that involves the placement of electrodes into the brain. The electrodes are connected to tiny devices that send electric pulses into the area of your brain that regulates symptoms. The pulses could help reduce your symptoms and increase the quality of your life. DBS can treat a variety of conditions that include movement disorders like essential tremor and Parkinson's disease, and psychiatric disorders such as depression and obsessive-compulsive disorder. It also helps reduce seizures for people with epilepsy. It can also help treat extreme pain caused by brain and nerve conditions.
DBS is a successful treatment for many patients with TRD and can be combined with other treatments like ECT. It is important to keep in mind that not all patients will benefit from DBS. Some patients may not experience any improvement in symptoms, while others may experience a worsening of depression. This non-response may be caused by a combination factors that include patient-related factors, like personality traits or psychiatric co-morbidity and also clinical factors like a misdiagnose or a suboptimal DBS goal.
Researchers utilized a machine learning algorithm to classify changes in LFPs observed during intraoperative DBS. The results indicated that a decrease in depression symptoms was correlated with changes in beta power. These findings suggest DBS can be used as a predictor of antidepressant effects. This hypothesis must be further tested through research.
While DBS is a proven treatment for movement disorders and a growing number of psychiatric conditions, it is not well recognized as a successful depression treatment. The FDA has approved DBS for reducing seizures in some patients suffering from epilepsy that is difficult to treat. Studies are underway to determine whether DBS can be used to treat depression.
You should discuss the DBS procedure with a neurologist prior to undergoing it. Your neurologist will evaluate you and recommend the most appropriate treatment option for you. They will also inform you of the risks and benefits of DBS. In addition, you should ask about any tests or preparations you may need before the procedure. You may require a blood test, imaging and other tests prior to the procedure.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy is one of the most popular types of psychotherapy that has been found to be effective in a variety of different outcome studies. It is typically used as an independent treatment, but it may be combined with medication in certain instances. CBT is a form of psychotherapy that helps you overcome negative attitudes and thoughts that are contributing to depression. It is based on the idea that how you perceive and respond to situations is more important than the situation itself. It is an active type of psychotherapy which focuses on problem-solving, identifying and changing unhelpful thinking patterns and identifying maladaptive thought patterns.
The goal of CBT therapy is to help you be your own therapy. It does this by assisting you to change the way you think and behave. It employs exercises and home sessions as well as outside of sessions to teach new techniques. CBT is focused on current issues and issues, not past experiences and their root causes. It does require some information about your life experience to be able to deal with and understand problems that you face in the present.
CBT is usually an in-depth treatment that lasts between 6-20 sessions. It is an empirically-based therapy and its duration is determined by the extent to which you reach the goals established at the beginning of therapy. It is an active therapy and requires a lot of commitment and dedication on your part.
There are a variety of other types of cognitive behavioral therapies that could be beneficial for you, such as acceptance and commitment therapy, which teaches you to engage in positive behaviors even when you are experiencing negative thoughts or emotions and dialectical behavior therapy designed to tackle self-injury and suicidal thinking and interpersonal psychotherapy, which is aimed at resolving issues with relationships that contribute to depression.
There are a variety of exciting new treatments that could bring revolutionary results for those suffering from depression. Some treatments are already available. For example deep brain stimulation. A surgeon implants electrodes into your brain to send zaps that alter the electrical activity contributing to your symptoms. There are many other advances in the research phase, like customized medication for depression. This could reduce the need for trial and error to determine what works for you.