Depression Treatment Advancements
While effective treatments for depression are available Researchers are developing innovative and more effective methods to treat the disorder. This special Research in Context will explore some of the depression treatment advances.
Psychotherapy can help ease depression symptoms by teaching the person how to deal with negative feelings and thoughts. Talk therapy can be conducted one-on-one with a mental health professional or in group settings.
Precision mental healthcare
Precision is the ability to be more precise or accurate in diagnosis, prevention and treatment strategies. In the realm of mental health, it could encompass a variety of strategies that range from psychotherapy to medication. However, many of these strategies tend to focus on the repercussions of the disorder rather than its roots. This can lead to treatments that do little more than ease symptoms but don't address the underlying factors that contribute to mental illness in the beginning.
The precision of mental health is rapidly improving. It's similar to the method taken in other areas that include continuous monitoring of important indicators (e.g. fever or blood pressure) into clinical practice. It also involves combining multiple data sets and utilizing machine learning to help doctors understand the unique requirements of each patient and to develop more effective treatments.
One example of precision psychiatry is using EEG to measure brain activity and assist doctors determine whether a patient is able to participate in cognitive behavioral therapy. A new class of drugs referred to as NMDA receptor inhibitors could reduce symptoms of depression by preventing the neurotransmitter glutamate from reaching certain brain cells. Another possibility is the use of pharmacogenetic testing to identify drug-gene interactions and to avoid adverse side effects.
In addition, a number of companies are looking into digital precision psychiatry, which uses objective digital technology to monitor patients remotely and gather real-time information that can guide the care they receive. One company, for instance, uses artificial intelligence to monitor medication adherence and optimize dosages for patients suffering from depression. These solutions have the possibility of improving accessibility and effectiveness in mental health care and also enhancing the adherence to treatment.
Moreover, digital precision psychiatry can help overcome barriers to treatment for people who suffer from mental illness, especially those who are employed. For example an Johnson & Johnson initiative in Singapore has partnered with several organizations to aid in the reintegration of those recovering from depression back into their work and communities. This will help them keep their jobs, which is essential to recovery from mental illness.
Medication
Many people who suffer from depression find that medication can help ease their symptoms, especially if they're experiencing severe or disabling symptoms. Antidepressants help restore the balance of neurotransmitters within the brain that are chemical messengers that regulate mood and emotion. Most current antidepressants target one of these neurotransmitters, boosting levels of serotonin, norepinephrine and dopamine. Selective serotonin reuptake inhibitors (SSRIs), like Prozac and Zoloft boost the level serotonin, a chemical in the brain. These SNRIs, such as Cymbalta, Effexor and Cymbalta target both dopamine and norepinephrine. Monoamine oxidase inhibitors like Wellbutrin focus on only dopamine and norepinephrine.
Most doctors prescribe antidepressants in order to combat depression as a primary treatment, in addition to talk therapy. Some of these therapies are cognitive behavioural therapy (CBT) which helps improve the quality of your thoughts and feelings by teaching specific techniques or psychotherapy for interpersonal relations (which focuses on improving relationships). Other therapies, like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS), have also been proven to be effective in treating depression.
However, some people do not respond to the initial medication prescribed by doctors. Up to comprehensive depression treatment -third of people suffering from depression do not receive relief from the first medication they take, and 40 percent of those who begin taking antidepressants discontinue them within three months. Recent research has allowed doctors to predict which medication is the most effective for a patient by using blood or MRI testing to identify which receptors are most affected by depression.
Medication has improved in recent years with a wider range of options and higher dosages to minimize adverse effects. Modern antidepressants, such as esketamine, brexanolone and Nefazodone are effective in reducing depression symptoms.
Other medications are in clinical trials that could alter the method of their use. A drug known as Vorapaxar is being tested on humans. It targets a distinct part of the brain that is associated with depression, by blocking NMDA receptors. It's expected to be available by 2024. Another drug that has shown promise is a combination of bupropion and ketamine, which may be more effective in treating depression that is resistant to treatment.
Psychotherapy
Psychologists have discovered certain factors that can contribute to depression. These include imbalances in the neurotransmitters serotonin as well as norepinephrine. These chemicals play a vital role in controlling mood emotions, mood and brain function in general. Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors are the main treatment options. They can relieve many symptoms of depression such as depressed mood, fatigue and sleep issues. They can also cause adverse effects, which could make them unsuitable to some people.
Psychotherapy can be used to address the primary causes of depression and assist people to cope with depression better. Several types of therapy have been proven to decrease symptoms, including cognitive behavior therapy and ketamine infusion therapy. Additionally, psychotherapy can help people develop a more healthy way of coping and to manage stressors. However, access to psychotherapy can be limited by cost or scheduling restrictions, as well as a shortage of mental health professionals. The recent rise of Telehealth services has made it easier to some people.
Finding the best treatment combination is essential to overcome depression. A single medication may not be enough to eliminate all your symptoms. It could take anywhere from 6 to 12 weeks before you know whether a medication is effective. There are a variety of nonpharmacologic treatments available like transcranial magnetic stimulation as well as vagus nerve stimulation. These therapies use electromagnetic fields to boost mood and stimulate the brain's chemical.
It is essential to collaborate closely with your provider, whether you're interested trying medication or therapy. Discuss your feelings and thoughts and discuss the advantages as well as the risks and consequences of each choice. If you're having a hard getting a good rapport with your therapist or doctor, try to find the right person to meet your requirements. You can also choose one that offers an opportunity to try a trial for no cost. This allows you to test different methods before committing. In the end, you'll discover the best treatment for you and helps you feel your most at your best.
Brain stimulation
In just a few short years, scientists have developed new techniques to target specific areas of the brain, and rapidly alter their functioning. These techniques can also be used to treat physical ailments as well as certain mental disorders.
rTMS is a technique that uses electromagnetic pulses to stimulate brain activity. It is similar to magnetic pulses that are used in MRIs, but not powerful enough to cause a seizures. The technique works by stimulating a precise area of the brain with a painless magnet. The pulses change the way your brain signals and help you feel better. The therapy takes only 3.5 minutes and does not interfere with your normal routine. You may feel a slight headache following the treatment.
Another treatment involves putting electrodes in the brain to send electrical sparks. This treatment is also known as deep transcranial magnetic stimulation (deep TMS) and is utilized to treat OCD and to quit smoking. It's still being researched for depression, but early research suggest it can reduce depressive symptoms in certain people. The mechanism behind this treatment isn't completely clear, but it seems to work by altering the balance of certain neurotransmitters.
Other techniques for brain stimulation that are noninvasive are also getting better. For instance, a recent study found that patients suffering from severe depression who were intolerant to antidepressants benefited from an electromagnet treatment known as SAINT. It is personalized to each patient's specific brain anatomy and employs high-dose magnetic pulse patterns. The treatment can be administered within a couple of hours, prior treatments required regular sessions for weeks or months.
The researchers used FMRI to identify the precise region of the brain being stimulated in each patient. They also examined the tiny variations in the activation of different brain regions, which helped them determine the direction of signals. They discovered that in people who suffer from depression the brain's anterior cingulate cortex sent signals to an area called the subgenual cingulate cortex. However, these signals were often misdirected, and the more severe the depression, the greater number of these signals that were not directed in the right direction were.