Innovative Depression Treatments
Many people with depression struggle to find an effective treatment for them. Some suffer from no response to medication or experience uncontrollable adverse side effects.
Table 2 shows that intrinsic health benefits of scaling up effective coverage are huge. The discounted value for depression is $399 billion and for anxiety disorders, $169 billion.
Transcranial Magnetic Stimulation (TMS)
TMS utilizes a magnet field to deliver brief pulses of electricity to specific brain regions that are believed to be overactive in depressed patients. The therapy is noninvasive, and does not require anesthesia. It's also highly efficient and well-tolerated when as compared to antidepressant drugs.
A person is able to receive TMS by sitting in a chair similar to the chair used by dentists. A trained technician puts an instrument that has a magnetic coil to the forehead. The coil is able to pulse quickly and one may hear a sound of clicking or feel a tingling sensation on the scalp. Each magnetic pulse (measured in hertz or Hz) is known as a "pulse”. The frequency of the pulses can vary from low (1 pulse every second) to high (10 per second).
The treatment isn't painful but the magnetic field affects the cells in the outer layer. It depolarizes cortical neurons, and the subsequent transynaptic effects can influence deeper brain regions that are involved in mood. For instance, a higher-frequency TMS over the left dorsolateral pf cortex (DLPFC) can boost mesolimbic neural circuits that regulate emotional responses.
TMS can be used as an adjunct to psychiatric drugs and certain insurance plans will cover the treatment. It is important to inquire with your insurance provider to determine what your specific plan covers.
In clinical trials, TMS showed significant and long-lasting improvements in depression symptoms when compared to a placebo. In the TMS treatment program, a patient may undergo up to 30 sessions over a few weeks. Patients with severe depression may require a longer duration of treatment.
Some newer treatments of TMS utilize a lower frequency pulse that is less likely to cause side effects, such as seizure. While the procedure is still being considered a research project, it's a promising treatment for people who don't respond to psychotherapy and antidepressants.
Electroconvulsive therapy (ECT)
ECT helps to rebalance the brain's natural chemical balance. It is among the most efficient and safe treatments for depression. It can also be used in other mental health conditions such as schizophrenia.
The ECT procedure is carried out by medical professionals and occurs in a separate room at the hospital, or in an outpatient treatment center. A general anaesthetic is administered prior to the procedure, which means there is no pain. The ECT team will use monitoring equipment to measure your heart rate, blood pressure and oxygen levels, as well as brain waves. You will be given a muscle relaxant to keep you calm and a mouth guard to guard your teeth. depression therapy are placed on the head, one on each side or inside your forehead. The anaesthetist then injects you with a drug to induce sleep.
You will be awakened in the ECT room. A member of the ECT staff will be available to answer any questions you might have. Before you receive the treatment you will be required to fill out a consent form. It may be difficult to take in all the information you are given information about ECT. It is recommended to have a relative or friend accompany you. You should have at least 24 hours before you are forced to make a choice regarding the treatment.
During the procedure, you'll have brief fits or seizures, which last just 40 seconds to 2 minutes. The ECT doctor will adjust the amount of electric pulses you get depending on the response you show. You will likely have short courses of ECT. In general, 6-12 sessions are scheduled twice a week.
It isn't clear what exactly ECT functions. However, it is believed to trigger the release of certain chemicals that help brain cells communicate. It also appears to change how brain cells grow.
ECT is effective in treating severe depressions, suicidal feelings and catatonia secondary depression as well as other psychiatric conditions. Studies show that half of patients who undergo ECT recover and stay healthy for at least a year. It is especially helpful for those who have not had a positive response to medication or other psychosocial treatment.
Deep brain stimulation (DBS).
Deep brain stimulation is a surgical technique that involves implanting electrodes into the brain. The electrodes are attached to tiny devices that send electrical impulses to the region of your brain that controls symptoms. The pulses can help relieve your symptoms and improve your quality of living. DBS can treat a variety of conditions which include movement disorders, such as essential tremor and Parkinson's disease and psychiatric conditions, such as obsessive compulsive disorder and depression. It also helps reduce seizures in epilepsy sufferers. It is also employed to treat severe pain caused by nerve and brain conditions.
DBS is an option that can be combined with ECT or other treatments for TRD. However, it is important to note that not all patients benefit from DBS. Some patients don't experience any symptom improvement, and others may even have worsening symptoms of depression. This non-response is likely due to a mix of factors, including patient-related factors such as personality characteristics or psychiatric comorbidity and clinical factors, such as an inaccurate diagnosis or poor DBS targeting.
The researchers employed a machine learning algorithm to identify changes in LFPs which were measured during intraoperative DBS exposure. The results indicated that a decrease in depression symptoms was correlated with changes in beta power. These findings suggest that DBS can be used to predict the effects of antidepressants. However more research is needed to verify this theory.
Although DBS is an established treatment for movement disorders and a growing number of psychiatric disorders but it is not widely recognized as a reliable treatment for depression. The FDA has approved DBS to help reduce seizures in people with difficult-to-treat epilepsy. Research is currently being conducted to determine if DBS is effective in treating depression.
Before undergoing DBS, you should discuss your options with a neurologist or psychiatrist. Your neurologist will examine you and suggest the best treatment option for you. He or she will inform you of the advantages and disadvantages of DBS. In addition, you should ask about any tests or preparations that you might require prior to the procedure. You may require a blood-test, imaging and other tests prior to the procedure.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy has been shown to be effective in numerous outcome studies. It is most often employed as a stand-alone treatment but it may be used in conjunction with medication in certain instances. CBT is a type of psychotherapy that helps you learn to change the negative attitudes and thoughts that are contributing to your depression. It is based on the theory that how you see and react to situations is more significant than the issue itself. It is a highly active type of psychotherapy and emphasizes problem-solving and finding and changing the maladaptive thinking patterns.
CBT's goal is to help you become your own therapy by helping you understand and alter the way you think and behave. It uses exercises and homework during and outside of the session to teach you new skills. CBT focuses on current issues and problems and not past experiences or root causes. However, it requires some information about your personal history to be able to recognize and address problems in the present.
CBT is a relatively short-term therapy, usually lasting 6-20 sessions. It is an empirically grounded therapy and its duration is guided by the extent to which you are reaching the goals you established at the start of therapy. It is an active and demanding therapy that requires a high level of commitment and dedication from you.
There are many other types of cognitive behavioral therapies that may be useful for you, such as acceptance and commitment therapy, which teaches you to take positive actions even when you experience negative emotions or thoughts and dialectical behavior therapy which is designed to address self-injury and suicidal thinking as well as interpersonal psychotherapy which aims to resolve issues with relationships that contribute to your depression.
There are many exciting new treatments that could bring revolutionary results for people suffering from depression. Some treatments are already available. For example, deep brain stimulation. A surgeon implants electrodes in your brain to send impulses that alter the electric activity that triggers your symptoms. However, many other advancements are still in the research stage, such as personalized medicine for depression that could eventually end the trial-and-error method of finding what works best for you.