Depression Treatment Advancements
While effective treatments for depression are available Researchers are developing innovative and more effective methods to treat depression. This special Research in Context feature will explore some of these breakthroughs in treatment for depression.
Psychotherapy can ease depression symptoms by educating the person how to deal with negative feelings and thoughts. Talk therapy can be conducted in groups or one-on-1, with a mental healthcare professional.
Precision mental healthcare
The term "precision" means bringing greater precision or accuracy to prevention, diagnosis and treatment methods. In the case of mental health, this means a variety of approaches including psychotherapy and medications. However, many of these strategies tend to focus on the repercussions of the disorder rather than its root causes. This can lead to treatments which only reduce symptoms, but not address the underlying causes of mental illness.
Fortunately, the field of precision mental health is rapidly evolving. It's comparable to the approach used in other areas of healthcare, such as incorporating continuous monitoring of key indicators into clinical practice (e.g., fever or blood pressure). It also involves combining multiple data sets and using machine learning to help doctors comprehend the specific requirements of each patient and develop more efficient treatments.
Precision psychiatry uses EEG to evaluate brain function and determine the ability of a patient to engage in cognitive behavioral therapy. Another example is a novel class of drugs known as NMDA receptor antagonists, which can block the neurotransmitter glutamate from entering certain brain cells, and thus reduce symptoms associated with depression. Pharmacogenetic testing can also be used to determine drug-gene interaction and prevent unfavorable 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. For instance, one company is leveraging artificial intelligence to track adherence and optimize dosages of medication for their depression patients. These types of solutions are likely to dramatically increase accessibility and effectiveness of mental healthcare and also increase compliance to treatment.
Digital precision psychiatry in particular it can help those suffering from mental illness overcome barriers to treatment, particularly those who work. Johnson & Johnson, for example, has partnered with organizations in Singapore to aid in the reintegration of people recovering from depression back into their work. This will allow them to keep their job, which is vital for the recovery of mental health.
Medication
Many people with depression find that medication helps alleviate their symptoms, particularly those who are suffering from severe or disabling symptoms. Antidepressants restore the balance of neurotransmitters within the brain that are chemical messengers that regulate mood and emotion. Most antidepressants focus on one of these neurotransmitters, increasing levels of serotonin, norepinephrine, and dopamine. Selective serotonin reuptake inhibitors (SSRIs), such as Prozac and Zoloft increase the amount of the serotonin chemical in the brain; SNRIs, like Cymbalta and Effexor which target both norepinephrine and dopamine and monoamine oxidase inhibiters like Wellbutrin and Effexor, focus on only norepinephrine and dopamine.
The majority of doctors recommend antidepressants as the first option of treatment for depression, as well as some form of talk therapy. Some of these treatments include cognitive therapy that helps improve the quality of your thoughts and feelings by teaching specific skills, or psychotherapy for interpersonal relationships which focuses on improving relationships. Other therapies, such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) have also been proved to be effective in treating depression.
However, some people do not respond to the first medications prescribed by doctors. A third of patients suffering from depression don't receive any relief from their initial medication and about 40 percent who begin taking antidepressants cease them within three months. The good news is that research has helped doctors determine which type of medication will be most effective for each individual, utilizing blood or MRI tests to determine which receptors are the most affected by depression.
In recent times, medication has improved with better options and dosages that minimize side effects. For instance, antidepressants that are more recent such as esketamine (Spravato) and brexanolone (Auvelity) and nefazodone (Sertraline) help to quickly alleviate depression symptoms by stimulating glutamate activity in the brain.
Other medications are undergoing clinical trials that could alter the method of their use. Vorapaxar, a drug which is currently being studied in humans, targets a distinct 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 shown potential is a combination ketamine and bupropion, which could be more effective at treating treatment-resistant depression.
Psychotherapy
Psychiatric researchers have been able to pinpoint certain factors that contribute to depression, including problems with the neurotransmitters serotonin as well as norepinephrine. These chemicals are vital in controlling mood and emotions as well as the general function of the brain. Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors are the main treatment options. They can help alleviate many of the symptoms of depression that include depressed moods and fatigue, and increase appetite, sleep, and energy. However, they aren't without adverse effects that can make them unsuitable for some people.
Psychotherapy can address the root causes and help individuals manage depression. Cognitive behavioral therapy and ketamine therapy are two kinds of therapy that have been shown to reduce depression symptoms. Psychotherapy can also help people learn a healthier coping style and manage stressors better. Cost, scheduling restrictions and a lack of mental health providers can limit access to psychotherapy. Telehealth services have improved access for many people.
Finding the best treatment combination is essential to overcome depression. The use of medication alone isn't enough to relieve all of your symptoms, and it could take anywhere from 6 to 12 weeks before you are able to tell whether a medication is effective. There are several alternatives to nonpharmacologic treatment, such as repetitive transcranial magnet stimulation and vagus nerve stimulation. types of therapy for depression employ electromagnetic fields to stimulate the brain's natural chemical and enhance mood.
If you're thinking of trying medication or psychotherapy, it's essential to be in close contact with your provider. Discuss your thoughts and feelings and discuss the benefits as well as the risks and effects of each method. If you have a hard time establishing a trusting relationship with your doctor or therapist Try to find the right person to meet your requirements. A service that provides a trial period free of charge could be a great option, since it gives you the chance to try different methods before making a commitment. You'll find a solution that is effective for you and helps you feel better.
Brain stimulation
In just a few short years scientists have discovered new ways to target specific brain areas and change their function quickly. These techniques can be utilized to treat physical ailments and some mental disorders.
One approach is called rTMS, which employs electromagnetic pulses to stimulate the brain. It's similar to the magnetic impulses that are used in an MRI however, it's not strong enough to cause a seizure. The method works by stimulating an exact part of the head using the use of a non-painful magnetic. The pulses alter the way your brain communicates and allow you to feel better. The treatment could take just 3.5 minutes and doesn't interfere with your daily activities. You may experience a slight headache afterward.
Another treatment involves putting electrodes in the brain to send painless electrical impulses. This treatment is also known as deep transcranial magnetic stimulation (deep TMS) and has been used for OCD and to stop smoking. Initial studies suggest that it may reduce depression symptoms in some individuals. It's not known how this treatment works but it does appear to alter the balance of certain Neurotransmitters.
Other forms of noninvasive brain stimulation are advancing also. In a recent study, patients with severe depression and intolerance to antidepressants reacted well to a treatment using magnetics known as SAINT. It is individualized to the specific anatomy of each patient's brain and employs high-dose magnetic pulse patterns. The treatment can be administered in just a few hours unlike previous treatments that required daily sessions for weeks or months.
Researchers used fMRI technology to pinpoint the exact brain region that was being stimulated by each patient. They also examined the tiny variations in the activation of different brain regions, which allowed them to determine the direction of the signals. They found that the anterior cingulate cortex sent signals to the subgenual cortex of depression sufferers. However, these signals were often misdirected and the more severe depression, the greater number of these incorrect signals were.