Innovative Depression Treatments
Many people suffering from depression struggle to find the right treatment for them. Some sufferers have a low response to medications or experience uncontrollable adverse reactions.
The intrinsic health benefits of expanded treatment coverage are believed to be substantial (table 2). 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 current to specific brain regions that appear to be overactive in depressed patients. The treatment is non-invasive, and doesn't require anesthesia. It's also highly efficient and well-tolerated as compared to antidepressant drugs.
To treat TMS the patient sits in a dental chair and remains awake. A trained technician places an instrument with a coil of magnetic material against the frontal area of the head. The coil's pulses are quick and the person could hear a clicking sound or feel tapping sensations on the scalp. Each magnetic pulse is known as"a "pulse" and the frequency of the pulses (measured in hertz, or Hz) can range from low (1 pulse per second) to high (10 pulses per second).
The treatment is not painful however the magnetic field can affect cells located in the brain's outer layer. It depolarizes cortical neurons and the transynaptic effect can affect brain regions deeper that are involved in mood. For instance, higher-frequency TMS in the left DLPFC can boost mesolimbic neuron activity that regulate emotional responses.
TMS can be used as an adjunct to psychiatric drugs and certain insurance plans provide coverage for the treatment. It is recommended to check with your insurance company to find out what you're covered under your plan.
In clinical studies, TMS produced significant and long-lasting improvements in depression symptoms versus the placebo. A patient could receive up to 30 TMS sessions over the period of just a few weeks. Patients suffering from more severe depression may need more time to complete their treatment.
Certain modern treatments of TMS use a lower-frequency pulse that's less likely to cause side effects such as seizures. Although the procedure is being considered a research project, it's a promising treatment for people who don't respond to antidepressants and psychotherapy.
Electroconvulsive Therapy (ECT)
ECT aids in restoring the brain's natural chemical balance. It is among the most efficient and safe treatments for depression. It can also be used to treat other mental health issues like schizophrenia.
The ECT procedure is carried out by medical professionals and is performed in a separate room at the hospital or an outpatient treatment center. Prior to the procedure, a general anaesthetic will be administered to ensure that there is no discomfort. The ECT team will connect monitoring equipment to monitor your heart rate, blood pressure, oxygen levels and brain waves. You will be provided with a muscle relaxant that will keep you relaxed and a mouthguard to guard your teeth. Two discs of metal (bilateral ECT) or a single disc (unilateral ECT) is positioned on your head one on each side or in the middle of your forehead. The anaesthetist injects you with a medication to help you sleep.
You will be awakened in the ECT room. A member of the ECT staff will be available to answer any questions you have. Before you are treated you will be required to sign the consent form. It can be difficult to absorb all the information you are given information about ECT. It is recommended to have a family member or a friend with you. You should be given at minimum 24 hours to consider the treatment before you have to decide.
During the procedure, you will have brief fits or seizures that last between 40 seconds to 2 minutes. The ECT doctor will adjust the intensity of your electric pulses depending on the way you react. You may experience short courses of ECT generally 6-12 sessions, two times a week.
It isn't clear how ECT functions. However, it appears to trigger the release of certain chemicals that aid brain cells to communicate. It also appears to change how parts of your brain expand.
ECT is very effective in treating severe depression, suicidal ideas and catatonia that is secondary to depression, and other psychiatric disorders. Studies show that around half of patients who receive ECT improve and stay well for an entire year or more. It is particularly helpful for those whose symptoms haven't been treated with medications or other psychosocial treatments.
Deep brain stimulation (DBS)
Deep brain stimulation is a surgical technique which involves the placement of electrodes in the brain. The electrodes are attached to a small device that sends electric impulses into the region of your brain that controls symptoms. The pulses can ease the symptoms and improve your quality of living. DBS can treat many conditions such as movement disorders like Parkinson's disease or essential tremor and mental health conditions like depression and obsessional-compulsive condition. It can also help reduce seizures in people suffering from epilepsy. It can also be used to treat severe pain caused by nerve and brain conditions.
DBS is a treatment that can be used in conjunction with ECT or other treatments for TRD. However, it is important to remember that not all patients benefit from DBS. Certain patients don't see any improvement in their symptoms, while others may even have worsening of their depression. This lack of response could be due to a variety of factors, including those that are related to the patient like personality traits, or psychiatric co-morbidity and also clinical factors like a misdiagnose or suboptimal DBS goal.
Researchers utilized a machine learning algorithm to classify the changes in LFPs observed during intraoperative DBS. The results revealed that changes in beta power were related to a decrease in depressive symptoms. These findings suggest that DBS can be used to predict the effects of antidepressants. This theory needs to be further tested through research.
DBS is a well-established treatment for movement disorders, and it is also used to treat a growing number mental health issues. However, it's not widely used as a treatment for depression. The FDA has approved DBS to decrease seizures in some patients suffering from epilepsy that is difficult to treat. Moreover, depression treatment recommendations are ongoing to determine whether DBS can be used to treat depression.
It is recommended to discuss the DBS procedure with a neurologist before undergoing it. The neurologist will examine you and recommends the best treatment for you. They will also advise you of the potential risks and benefits associated with 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 is one of the most popular kinds of psychotherapy and has been proven efficient in a variety of different outcome studies. It is most often used as a standalone treatment however it can be used in conjunction with medication in some instances. CBT is a kind of psychotherapy that helps you develop a positive attitude towards the negative thoughts and behaviors that are contributing to your depression. It is based on the notion that the way you think about and respond to situations is more significant than the actual situation. It is an active type of psychotherapy that is focused on problem-solving as well as identifying and changing harmful thinking patterns and identifying thoughts that are not adapted to your needs.
The purpose of CBT therapy is to assist you to become your own therapist. It accomplishes this by assisting you to change the way you think and behave. It utilizes exercises and at-home sessions as well as outside of sessions to teach new skills. CBT is focused on current issues and problems and not on past experiences or root causes. However, it requires some information about your history to understand and tackle issues in the present and future.
CBT is typically a short-term treatment, lasting between 6-20 sessions. It is an empirically-based therapy, and its duration is determined by whether or not you achieve the goals that were set at the start of the therapy. It is an active therapy and requires a lot of commitment and work on your part.
Other cognitive behavioral therapies could be helpful for you. These include acceptance and commitment therapy that helps you engage in positive behavior even when you are experiencing negative thoughts or emotions; dialectical behaviour therapy which treats suicidal thoughts that are persistent and self-injury, and psychotherapy for relationships, which aims to fix relationship issues that are contributing to your depression.
There are a variety of exciting new treatments in the pipeline that promise to be game-changing for people with depression. Some treatments are already available. For instance, deep brain stimulation. A surgeon places electrodes in your brain to send zaps that alter the electrical activity contributing to your symptoms. There are many other advances in the research phase, like the development of a personalized medication for depression. This could eliminate the need to trial and error to find what works best for you.