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Depression Treatment Advancements

While effective treatments for depression are available, researchers are working on innovative and more effective methods to treat the disorder. This special Research in Context feature will examine some of these breakthroughs in treatment for depression.

Psychotherapy can help ease depression symptoms by educating the person how to manage negative feelings and thoughts. Talk therapy can be performed one-on-one with a health professional or in group settings.

Precision mental healthcare

The term "precision" refers to bringing greater precision or accuracy to the prevention, diagnosis and treatment methods. For mental health, this can mean various approaches ranging from psychotherapy to medications. However, many of these strategies tend to focus on the effects 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 contribute to mental illness in the beginning.

Fortunately, the field of precision mental health is rapidly evolving. It's a similar approach to that that's been taken in other healthcare areas that include continuous monitoring of important indicators into the clinical practice (e.g. fever, ailment or blood pressure). It also involves combining multiple data sources and utilizing machine learning to assist physicians better understand a patient's specific needs and create more efficient treatment plans.

Precision psychiatry employs EEG to measure brain function and assess a patient's ability to engage cognitive behavioral therapy. Another example is a brand new class of drugs called NMDA receptor antagonists. These can block the neurotransmitter glutamate from reaching certain brain cells and reduce symptoms of depression. The testing of pharmacogenetics can also be used to determine interactions between drugs and genes, as well as to avoid negative effects.

A number of companies are also experimenting with digital precision medicine, which utilizes objective digital technology to monitor patients remotely, and collect real-time information that helps guide their care. One company, for example utilizes artificial intelligence to monitor the adherence of medication and optimize dosages for depression patients. These types of solutions have the potential to dramatically improve accessibility and effectiveness of mental health services, as well as increase patients' adherence to treatment.

Digital precision psychiatry, specifically, can help people with mental illness overcome obstacles to treatment, particularly those who are working. Johnson & Johnson, for instance, is working with organizations in Singapore to aid in the reintegration of people recovering from depression treatment goals back into their work. This can help them keep their jobs, which are essential to a successful recovery.

Medication

Many people with depression find that medication helps relieve their symptoms, especially those who are suffering from extreme or debilitating symptoms. Antidepressants aid in restoring the balance of neurotransmitters which are chemical messengers in the brain that regulate mood and emotions. The majority of antidepressants today target one of these neurotransmitters, increasing levels of serotonin, norepinephrine and dopamine. Selective serotonin reuptake inhibitors (SSRIs), like Prozac and Zoloft increase the amount of serotonin in the brain. These SNRIs, such as Cymbalta, Effexor and Cymbalta focus on both norepinephrine as well as dopamine. Monoamine oxidase inhibitors such as Wellbutrin target only dopamine and norepinephrine.

The majority of doctors prescribe antidepressants to treat depression as a first treatment, as well as 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 is focused on improving relationships). Other therapies, such as electroconvulsive therapy (ect for treatment resistant depression) and transcranial magnetic stimulation (TMS) have also been proven to be effective in treating depression.

Some people, however, don't respond to the initial medication that doctors prescribe. About one-third of depressed patients do not receive relief from the first medication they take and 40% of those who begin taking antidepressants discontinue them within three months. The good news is that recent research has helped doctors determine which type of medication is most effective for each patient, using blood or MRI tests to identify which receptors are most affected by the depression.

Medication has improved in recent years with more options and better dosages that help reduce side effects. Newer antidepressants like esketamine, brexanolone and Nefazodone help to reduce depression symptoms.

Other medications are currently in clinical trials that could alter the way they're used. A drug called vorapaxar that is currently being tested in humans, targets a different brain region that's associated with depression, by blocking NMDA receptors. It's expected to be available by 2024. The combination of ketamine and bupropion has also demonstrated promise. It may be more effective at treating depression resistant to treatment.

Psychotherapy

Psychologists have discovered certain elements that can contribute to depression. These include imbalances of the neurotransmitters serotonin as well as norepinephrine. These chemicals play a vital role in controlling mood emotions, moods, and overall brain function. Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors are the main treatment options. They can ease many of the symptoms of depression that include depressed moods and fatigue, and improve appetite, sleep and energy levels. However, they do have side effects that can cause them to be unsuitable for certain people.

Psychotherapy can be used to tackle the causes of depression and help people manage their herbal depression treatments better. Different types of therapy have been proven to decrease symptoms, such as cognitive behavioral therapy and ketamine infusion therapy. Psychotherapy can also help patients to develop a healthier way of coping and better manage stressors. However access to psychotherapy may be limited by cost or scheduling restrictions, as well as the lack of mental health providers. Telehealth services have increased accessibility for many people.

The biggest challenge in overcoming depression is finding the right combination of treatment. It may take up to 12 weeks to determine whether your medication is effective. A single dose of medication may not be enough to relieve all your symptoms. There are many nonpharmacologic treatments that are available, such as repetitive transcranial magnetic stimulation as well as vagus nerve stimulation. These therapies use electromagnetic fields to stimulate the brain's natural chemical and enhance mood.

It's crucial to collaborate closely with your doctor, regardless of whether you're interested trying medication or therapy. Discuss your thoughts and feelings as well as the risks and side effects associated with each option. If you're having a difficult to establish a trusting relationship with your doctor or therapist Try to find the right person to meet your needs. A provider who provides a trial period free of charge can also be a good option, as it offers you the chance to test different options before making a commitment. In the end, you'll discover a treatment that works best way to treat depression for you and makes you feel at your best.

Brain stimulation

In the span of just a few years, scientists have discovered new ways to target specific brain areas and change their functions quickly. These techniques can also be used to treat physical ailments as well as certain mental disorders.

rTMS is a technique which employs electromagnetic pulses to stimulate brain activity. It's similar to magnetic impulses used in an MRI, but isn't powerful enough to trigger seizures. The method works by stimulating a precise area of the brain with an uninvolved magnet. The pulses change the way your brain communicates and help you feel better. The therapy can take just 3.5 minutes and isn't a problem with your normal activities. You might experience a mild headache afterwards.

Another option is to implant electrodes into the brain to send painless electrical pulses. This treatment is also referred to as deep transcranial magnetic stimulation (deep TMS) and is utilized to treat OCD and to quit smoking cigarettes. Recent studies suggest that it may help reduce symptoms of depression in certain individuals. It's not known how to treat anxiety and depression without medication this treatment works but it appears to alter the balance of certain Neurotransmitters.

Other methods of brain stimulation that are not invasive are also getting better. In a recent study patients suffering from severe seasonal depression treatment and intolerance to antidepressants reacted well to a treatment using magnetics called SAINT. It is personalized for each patient's brain anatomy, and uses high-dose magnetic pulse patterns. The treatment can be delivered in just a few hours, whereas previous treatments needed regular sessions for weeks or months.

Researchers used fMRI to pinpoint exactly the region of the brain that was being stimulated in each patient. They also studied the tiny variations in the way that brain's different regions activated, which helped them discern the directional flow of signals. They found that in depressed people the brain's anterior cingulate cortex was sending 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 incorrect signals were.