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 examine some of these advancements in depression treatment.
Psychotherapy helps ease depression symptoms by teaching people skills to manage negative thoughts and emotions. Talk therapy can be performed one-on-one with a mental health professional or in a group.
Precision mental healthcare
The term "precision" refers to the ability to bring more exactness or accuracy to diagnosis, prevention and treatment methods. In the context of mental health, it may encompass a variety of strategies, from medication to psychotherapy. However, many of these strategies tend to focus on the consequences of the disorder, rather than the root causes. This can lead to treatments that do little more than ease symptoms but they do not tackle the root causes that cause mental illness in the initial place.
The precision of mental health is rapidly improving. It's similar to the approach that is used in other areas which includes continuous monitoring of vital indicators (e.g. fever or blood pressure) into clinical practice. It also involves combining multiple sources of data and applying machine learning to aid doctors better understand a patient's specific needs and create more efficient treatment strategies.
Precision psychiatry employs EEG to evaluate brain function and determine a patient's ability to engage cognitive behavioral therapy. A new class of medications known as NMDA receptor inhibitors can reduce depression symptoms by preventing the neurotransmitter glutamate from reaching certain brain cell. Pharmacogenetic testing can also be used to determine interactions between genes and drugs, and to prevent undesirable effects.
A number of companies are also exploring digital precision medicine, which utilizes objective digital technology to monitor patients remotely, and gather real-time data that aids in their treatment. One example is that a company is using artificial intelligence to track adherence and optimize dosages of medication for patients suffering from depression. These kinds of solutions have the potential to dramatically improve the accessibility and effectiveness of mental health services and also increase the patients' adherence to treatment.
Digital precision psychiatry in particular it is a way to help people suffering from mental illness overcome the barriers to treatment, especially those who are working. For instance, a Johnson & Johnson initiative in Singapore has partnered with several organizations to aid in the reintegration of workers in recovery from depression into their work environments and communities. This can help them maintain their jobs, which is crucial to recovery from mental illness.
Medication
Many people with depression discover that medication can relieve their symptoms, especially those who are suffering from extreme or debilitating symptoms. Antidepressants can restore the balance of neurotransmitters within the brain, which are chemical messengers that regulate mood and emotional state. Most antidepressants focus on one of these neurotransmitters, increasing levels of serotonin and norepinephrine as well as dopamine. Selective serotonin Reuptake inhibitors (SSRIs), such as Prozac and Zoloft increase the amount of serotonin's chemical in the brain; SNRIs, like Cymbalta and Effexor which are able to target both dopamine and norepinephrine; and monoamine oxidase inhibitors, such as Wellbutrin which targets only norepinephrine and dopamine.
The majority of doctors prescribe antidepressants to combat depression as a primary treatment, in addition to talk therapy. Some of these therapies include cognitive behavioral therapy (CBT), which helps improve the quality of your thoughts and feelings by teaching specific skills, or psychotherapy for interpersonal relations (which is focused on improving relationships). Other therapies, like electroconvulsive (ECT) therapy and transcranial magnet stimulation (TMS) have also proven to be effective in treating depression.
However, some people do not respond to the initial medications prescribed by doctors. Up to one-third of people suffering from depression do not get relief from the first medication they take, and 40 percent of people who start taking antidepressants stop them after three months. Recent research has enabled doctors to predict which medications will work best for a person through blood or MRI tests 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 side effects. Newer antidepressants such as esketamine, brexanolone, and Nefazodone are effective in reducing depression symptoms.
depression treatment for women are currently being conducted on other medications that could alter the ways they are used. A drug called vorapaxar that is currently being tested in humans, targets a distinct brain region that's associated with depression, by blocking NMDA receptors. It's expected to become available in 2024. Another medication that has shown potential is a combination ketamine and bupropion, which could be more effective in treating depression resistant to treatment.
Psychotherapy
Psychologists have been able to pinpoint certain elements that contribute to depression, such as problems with the neurotransmitters serotonin as well as norepinephrine. These chemicals play a crucial role in regulating 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 depression-related symptoms such as depressed feelings and fatigue, and also increase appetite, sleep and energy levels. They do not come without adverse effects, which could cause them to be unsuitable for some people.
Psychotherapy can be used to tackle the causes of depression and help people cope better. Different types of therapy have been proven to reduce symptoms, including cognitive behavioral therapy and the ketamine infusion therapy. Psychotherapy can help people develop a more effective coping strategy and manage stressors better. However access to psychotherapy could be limited due to cost, scheduling limitations, and a shortage of mental health providers. The recent rise of Telehealth services has made it easier to some people.
Finding the best treatment combination is key to overcoming depression. Medication alone may not be enough to relieve all of your symptoms, and it may take between 6 and 12 weeks before you know whether a medication is effective. There are also several nonpharmacologic treatments available like transcranial magnetic stimulation as well as 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 is essential to be in close contact with your therapist. Discuss your feelings and thoughts about the potential risks and adverse effects associated with each option. Find a practitioner who will meet your needs if you are having trouble getting trust from your doctor or therapist. A service that provides a trial period free of charge could be a great option, since it gives you the chance to try different options before committing. You'll eventually find a treatment that is effective for you and makes you feel better.
Brain stimulation
In a few short years, scientists have come up with new techniques to target specific areas of the brain and swiftly change how they function. These techniques can be utilized to treat physical ailments as well as certain mental disorders.
One method is referred to as rTMS, which utilizes electromagnetic pulses to stimulate the brain. It is similar to magnetic pulses used in MRIs but not powerful enough to cause a seizures. The method is based on stimulating a specific area of the brain with an uninvolved magnet. The pulses change the way your brain communicates and allow you to feel better. The therapy takes only 3.5 minutes, and will not interfere with your daily routine. There may be a slight headache following the therapy.
Another treatment involves implanting electrodes in the brain to send painful electric zaps. This treatment is also referred to as deep transcranial magnetic stimulation (deep TMS) and is used for OCD and to stop smoking. It's still being researched for depression, but preliminary studies suggest it may reduce depression symptoms in some individuals. The mechanism behind this treatment isn't clear however, it appears to work by altering the balance of certain neurotransmitters.
Other techniques for brain stimulation that are noninvasive are also advancing. In a recent study patients with severe depression and intolerance to antidepressants responded well to a treatment using magnetics known as SAINT. It's personalized to each patient's brain anatomy and utilizes high-dose patterns of magnetic pulses. The treatment can be delivered within a couple of hours, while previous treatments required daily sessions over several weeks or months.
The researchers used fMRI to locate exactly the region of the brain that was being stimulated in each patient. They also looked at the small variations in the activation of the various brain regions, which helped determine the direction of 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 frequently incorrectly directed. The more severe depression, the more signals were sent in the wrong direction.