Depression Treatment Advancements
Researchers are constantly working to improve the treatment for depression. This special Research in Context will explore some of the depression treatment advances.
Psychotherapy helps alleviate depression symptoms by teaching people the skills to deal with negative thoughts and emotions. Talk therapy can be conducted in a one-on-one session with a mental health professional or in group settings.
Precision mental healthcare
The term "precision" refers to the ability to bring greater precision or accuracy to diagnosis, prevention and treatment methods. In the context of mental health, it can comprise a variety of methods that range from psychotherapy to medication. A lot of these strategies concentrate on the symptoms of the disorder instead of the root cause. This can lead to treatments that do nothing more than ease symptoms but do not address the underlying factors that lead to mental illness in the first place.
Fortunately, precision mental healthcare is rapidly developing. It's similar to the method that is used in other areas which includes continuous monitoring of key indicators (e.g. fever or blood pressure) into the clinical practice. It also involves combining multiple data sets and using machine-learning to help physicians better recognize the unique requirements of each patient and develop more effective treatments.
One example of precision psychiatry is using EEG to determine brain activity and help doctors assess a person's ability to engage in cognitive behavior therapy. A new class of drugs referred to as NMDA receptor inhibitors may reduce symptoms of depression by preventing the neurotransmitter, glutamate, from reaching specific brain cells. Another potential advance is the use of pharmacogenetic tests to determine interactions between genes and drugs and avoid unfavorable side effects.
A number of companies are also looking into digital precision medicine, which uses 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 patients suffering from depression. These technologies have the potential of enhancing accessibility and efficiency in mental healthcare and also enhancing the patient's adherence to treatment.
Moreover, digital precision psychiatry can assist in overcoming the obstacles to treatment for those living with mental illness, especially those who are employed. For instance 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. depression treatment modalities can help them maintain their jobs, which is crucial to recovery from mental illness.
Medication
Many people with depression discover that medication can alleviate their symptoms, particularly when they're suffering from extreme or debilitating symptoms. Antidepressants restore the balance of neurotransmitters in the brain which are chemical messengers that regulate mood and emotions. 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 of the chemical serotonin in the brain; SNRIs, like Cymbalta and Effexor are able to focus on both dopamine and norepinephrine; and monoamine oxidase inhibitors such as Wellbutrin, target only dopamine and norepinephrine.
The majority of doctors recommend antidepressants as an initial treatment for depression, as well as some kind of talk therapy. Some of these therapies include cognitive behavioral therapy, which can help improve the quality of your thoughts and feelings by teaching specific skills, or interpersonal psychotherapy that concentrates on improving relationships. Other treatments, like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are also known to have been proven to be effective in treating depression.
However, some people do not respond to the first medication prescribed by doctors. Up to one-third of patients suffering from depression don't feel relief from the initial medication they take and 40 percent of those who begin taking antidepressants discontinue them within three months. The good news is that research has helped doctors determine which type of medication is most effective for each individual, utilizing blood or MRI tests to identify which receptors are most affected by depression.
The quality of medication has improved in recent years, with a wider range of options and higher doses to help minimize side effects. Newer antidepressants like esketamine, brexanolone and nefazodone work to quickly alleviate depression symptoms.
Clinical trials are currently being conducted on other medications that could change the method of their use. Vorapaxar, a drug which is currently being tested in humans, targets a specific part of the brain that's associated with depression by blocking NMDA receptors. It's expected to be available by 2024. Another medication that has demonstrated potential is a combination of ketamine and bupropion, which could be more effective at treating depression that is resistant to treatment.
Psychotherapy
Psychologists have discovered certain elements that can contribute to depression. These include imbalances of the neurotransmitters norepinephrine and serotonin. These chemicals are vital in controlling mood and emotions, as in 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 such as depressed mood, fatigue and sleep issues. They are not without adverse effects, which could make them unsuitable to some people.
Psychotherapy can address the root causes of depression and help people cope with depression. Cognitive therapy for behavioral disorders and ketonamine therapy are two forms of therapy that have been found to lessen the symptoms of depression. In addition, psychotherapy can aid people in developing a healthy way of coping and to manage stressors. However access to psychotherapy may be restricted by costs and scheduling limitations as well as a shortage of mental health professionals. The recent increase in Telehealth services has made it easier for some individuals.
The challenge with overcoming depression is finding the right combination of treatment. It could take up to 12 weeks to determine if your medication is working. The use of medication alone may not be enough to alleviate all of your symptoms. There are a variety of nonpharmacologic treatment options, including transcranial magnetic stimulation that is repeated and vagus nervous stimulation. These therapies use electromagnetic fields to stimulate the brain's natural chemical and improve mood.
If you're considering medication or psychotherapy, it's essential to collaborate with your healthcare provider. Discuss your feelings and thoughts as well as the potential risks and adverse consequences that are associated with each. If you're having a difficult getting a good rapport with your doctor or therapist Try to find an individual who can meet your requirements. A clinic that provides a trial period free of charge could be a great option, since it gives you the chance to try different methods before committing. You'll eventually find a treatment that works best for you and helps you feel and look your most 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 function rapidly. These methods can be used to treat depression and other mental disorders as well as some physical diseases.
One approach is called rTMS, which uses electromagnetic pulses to stimulate the brain. It's similar to magnetic pulses used in MRIs, but not sufficient to trigger seizures. The technique works by stimulating a precise area of the brain with an uninvolved magnet. The pulses affect the way the brain signals which allows you to feel better. The therapy takes only 3.5 minutes, and will not interfere with your daily routine. It is possible to experience a mild headache afterward.
Another treatment involves implanting electrodes into the brain to send electrical zaps. Deep transcranial stimulation (deep-TMS) is an option that has been used to treat OCD and quit smoking. Recent research suggests that it can help reduce symptoms of depression in certain individuals. It's not known what the effect of this treatment is, however, it seems to alter the balance of certain Neurotransmitters.
Other forms of noninvasive brain stimulation are advancing as well. For instance, a recent study found that patients with severe depression who were intolerant to antidepressants, responded to the treatment with magnetic pulses called SAINT. It is individualized to each patient's brain anatomy and utilizes high-dose patterns of magnetic pulses. The treatment can be delivered in a few hours, whereas previous treatments required daily 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 the different brain regions, which helped determine the direction of the signals. They discovered that in depressed people the brain's anterior cortex cortex sent signals to an area called the subgenual cingulate cortex. These messages were often not directed correctly. The more severe the depression the more signals were directed in the wrong direction.