Depression Treatment Advancements

While effective treatments for depression are available, researchers are working on new and more effective ways to treat the disorder. This special Research in Context feature will look at some of these depression treatment advancements.

Psychotherapy helps alleviate depression symptoms by teaching people the skills to handle negative thoughts and feelings. Talk therapy can be performed one-on-one with a mental health professional or in a group setting.

Precision mental healthcare

Precision is the ability to be more precise or accurate in diagnosis, prevention, and treatment methods. In the context of mental health, it may comprise a variety of methods including psychotherapy, medication and. However most of these strategies tend to focus on the repercussions of the disorder instead of its roots. This can result in treatments which only reduce symptoms, but not address the underlying causes of mental illness.

Precision mental healthcare is rapidly improving. It's akin to the methods that is used in other areas that include continuous monitoring of vital indicators (e.g. fever or blood pressure) into clinical practice. It also involves combining multiple data sets and applying machine-learning to help physicians better recognize the unique requirements of each patient and devise more effective treatments.

Precision psychiatry uses EEG to measure brain function and determine a patient's ability to engage cognitive behavioral therapy. Another example is a brand new class of drugs known as NMDA receptor antagonists, which can block the neurotransmitter glutamate from reaching certain brain cells and reduce symptoms associated with depression. Another possible breakthrough is the use of pharmacogenetic testing to determine interactions between genes and drugs and prevent undesirable side effects.

In addition, a lot of companies are exploring the concept of digital precision psychiatry. This is a method that uses objective digital technologies to monitor patients remotely and gather real-time data that aids in guiding the treatment they receive. One company, for example, uses artificial intelligence to track medication adherence and optimize dosages for depression patients. These technologies have the potential of improving accessibility and effectiveness in mental health as well as enhancing the patient's adherence to treatment.

Digital precision psychiatry, specifically, can help people with mental illness overcome the barriers to treatment, especially those who are working. For instance, a Johnson & Johnson initiative in Singapore is working with other organizations to help facilitate the reintegration of workers in recovery from depression back into their work and communities. This will help them keep their jobs, which is crucial for the recovery of mental health.

Medication

Many people suffering from depression discover that medication helps ease their symptoms. This is particularly relevant if the symptoms are acute or incapacitating. Antidepressants work to restore the balance of neurotransmitters which are chemical messengers in the brain that regulate mood and emotions. Most antidepressants target one of these neurotransmitters through increasing the levels of serotonin. Selective serotonin reuptake inhibits (SSRIs) such as Prozac and Zoloft boost the level serotonin chemical within the brain. The SNRIs like Cymbalta, Effexor and Cymbalta focus on both norepinephrine as well as dopamine. Monoamine oxidase inhibitions such as Wellbutrin focus on only dopamine and norepinephrine.

Most doctors prescribe antidepressants to treat depression as a first treatment, as well as talk therapy treatment for depression. Some of these therapies are cognitive behavioral therapy (CBT) which helps improve feelings and thoughts by teaching specific techniques or interpersonal psychotherapy (which focuses on improving relationships). Other therapies such as electroconvulsive (ECT) therapy and transcranial magnet stimulation (TMS) have also proven to be effective in treating depression.

Unfortunately, some people do not respond to the first line treatment for depression and anxiety medication prescribed by their doctors. A third of people suffering from depression do not feel relief from the initial medication they take and 40 percent of people who start taking antidepressants discontinue them within three months. Recent research has enabled doctors to determine which medication is the most effective for a particular person through blood or MRI testing to identify which receptors are most affected by depression treatment plan.

In recent years, the treatment has improved with better options and doses to minimize adverse effects. For instance, newer antidepressants such as esketamine (Spravato) and Brexanolone (Auvelity) and nefazodone (Sertraline) work to rapidly reduce depression symptoms by targeting glutamate activity in the brain.

Clinical trials are currently being conducted on other drugs which could alter the method of their use. A drug called vorapaxar which is currently being studied in humans, targets a specific part of the brain associated with depression, by blocking NMDA receptors. It is expected to be available by 2024. Another drug that has shown promise is a combination of ketamine and bupropion, which could be more effective in treating depression resistant to treatment.

Psychotherapy

Psychiatric researchers have been able to identify certain elements that contribute to depression, including deficiency in the neurotransmitters serotonin as well as norepinephrine. These chemicals are essential in managing mood and emotions as well as 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 of depression-related symptoms that include depressed moods and fatigue, and increase appetite, sleep, and energy. They can also cause adverse effects, which could make them unsuitable for certain people.

Psychotherapy can be used to address the primary causes of depression and help people manage their depression better. Several types of therapy have been shown to reduce symptoms, including cognitive behavior therapy and ketamine infusion therapy. In addition, psychotherapy can help people develop a more healthy way of coping and to manage stressors. Cost, scheduling limitations and a lack of mental health professionals can restrict access to psychotherapy. Telehealth services have made it easier for many people.

Finding the right treatment mix is essential to overcome depression. Medication alone may not be enough to alleviate all your symptoms, and it could take anywhere from 6 to 12 weeks before you are able to tell if a drug is working. There are a variety of nonpharmacologic treatments options, including transcranial magnetic stimulation that is repeated and vagus nerve stimulation. These treatments employ electromagnetic fields to stimulate the brain's natural chemistry and enhance mood.

If you're considering psychotherapy or medication it's crucial to collaborate with your therapist. Be honest about your thoughts and feelings and discuss the benefits as well as the risks and effects of each method. If you're having a difficult getting a good rapport with your therapist or doctor, try to find an individual who can meet your requirements. A clinic that offers a free trial period can also be a good option, as it offers you the opportunity to try different options before committing. You'll find a solution that works for you and helps you feel better.

Brain stimulation

In just a few years, scientists have discovered new methods to target specific brain regions and alter their function quickly. These techniques can be utilized to treat physical ailments as well as certain mental disorders.

One approach is called rTMS, which utilizes electromagnetic pulses to stimulate the brain. It's similar to magnetic pulses in MRIs, but is not powerful enough to cause a seizures. The technique is based on stimulating a specific brain region with a painless magnet. The pulsations alter the way that brain signals are processed, making it easier for you to feel better. The treatment can last just 3.5 minutes and doesn't interfere with your normal activities. You might experience a mild headache afterwards.

Another option is to implant electrodes in the brain to send painful electric zaps. This treatment is also known as deep transcranial magnetic stimulation (deep TMS), and it's been used for OCD and to quit smoking. It's still being studied to help treat depression, but preliminary studies suggest that it could reduce depressive symptoms in certain people. The mechanism of this treatment isn't fully understood, but it seems to be able to alter the balance of certain neurotransmitters.

Other techniques for brain stimulation that are noninvasive are also improving. In a recent study, patients suffering from severe depression and intolerance to antidepressants responded well to a treatment using magnetics called SAINT. It is personalized for each patient's brain anatomy and utilizes high-dose magnetic pulse patterns. The treatment can be delivered in just a few hours, prior treatments required regular sessions for months or weeks.

Researchers used FMRI to identify the precise region of the brain being stimulated in every patient. They also studied minute variations in the activation of different brain regions, which allowed them to determine the direction of signals. They found that the anterior cingulate brain sent signals to the subgenual cortex in depression sufferers. These messages were frequently misdirected. The more severe depression, the more signals were directed in the wrong direction.