Depression Treatment Advancements
Researchers are constantly working to improve treatment for depression. This special Research in Context will explore some of the depression treatment advances.
Psychotherapy helps ease depression symptoms by teaching people the skills to deal with negative thoughts and emotions. Talk therapy can be done in a group setting or one-on-one with a mental health professional.
Precision mental healthcare
The term "precision" means bringing more precision or precision to diagnosis, prevention and treatment methods. In the case of mental health, this means many different approaches, from medications to psychotherapy. Many of these strategies concentrate on the symptoms of the disorder rather than the root causes. This can result in treatments that do little more than ease symptoms but don't address the underlying factors that cause mental illness in the first place.
The precision of mental health is rapidly improving. It's a similar approach to that used in other areas of healthcare, such as incorporating continuous monitoring of important indicators into the clinical practice (e.g. fever, temperature or blood pressure). It also involves combining multiple data sources and applying machine learning to aid doctors understand the patient's unique needs and develop more efficient treatment strategies.
One example of precision psychiatry is using EEG to determine brain activity and help doctors assess the ability of a person to engage in cognitive behavior therapy. A new class of drugs referred to as NMDA receptor inhibitors could alleviate depression symptoms by blocking the neurotransmitter glutamate from reaching certain brain cells. Another possibility is the use of pharmacogenetic tests to identify drug-gene interactions and avoid unfavorable side effects.
Additionally, a variety of companies are exploring the concept of digital precision psychiatry, which makes use of objective digital technologies to monitor patients remotely and collect real-time data that aids in guiding the care they receive. One company, for instance employs artificial intelligence to monitor medication adherence and improve dosages for people suffering from depression. These solutions have the possibility of enhancing accessibility and efficiency in mental health as well as improving the adherence to treatment.
Furthermore digital precision psychiatry may assist in overcoming the obstacles to treatment for those suffering from mental illness, especially those working. For instance one Johnson & Johnson initiative in Singapore is working with other organizations to support the re-integration of people recovering from depression into their workplaces and communities. This can help them keep their jobs, which is essential for mental recovery.
Medication
Many people with depression discover that medication can relieve their symptoms, especially when they're suffering from extreme or debilitating symptoms. Antidepressants help restore the balance of neurotransmitters which are chemical messengers in the brain that regulate mood and emotions. Most current antidepressants target one of these neurotransmitters, boosting levels of serotonin and norepinephrine as well as dopamine. Selective serotonin-reuptake inhibition (SSRIs), like Prozac and Zoloft boost the level serotonin, a chemical in the brain. The SNRIs like Cymbalta, Effexor and Cymbalta focus on both norepinephrine as well as dopamine. Monoamine oxidase inhibitors like Wellbutrin target only dopamine and norepinephrine.
Most doctors recommend antidepressants as the first option of treatment for depression, along with some kind of talk therapy. Some of these therapies are cognitive behavioural therapy (CBT), which helps improve your mood and thoughts by teaching specific techniques or psychotherapy for interpersonal relationships (which is focused on improving relationships). Other therapies, like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are also known to have been proven to be effective in treating depression.
Unfortunately certain people don't respond to the first medication prescribed by their doctors. depression treatment approaches of patients suffering from depression don't get any relief from their first medication, and about 40 percent who start taking antidepressants stop them within three months. The good news is that research has helped doctors predict which kind of medication will be most effective for each individual, utilizing blood or MRI tests to determine which receptors are the most affected by the depression.
The way we treat depression has improved over the last few years, with more options and better dosages that help reduce negative 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 being conducted on different medications which could alter the ways they are used. A drug called vorapaxar, which is currently being tested in humans, targets a specific brain region that's associated with depression by blocking NMDA receptors. It is expected to be available by 2024. Another medication that has shown potential is a combination bupropion and ketamine, which may be more effective in treating depression that is resistant to treatment.
Psychotherapy
Psychologists have been able to pinpoint certain elements that contribute to depression, such as deficiency in the neurotransmitters serotonin as well as norepinephrine. These chemicals are crucial in managing 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 also improve appetite, sleep and energy levels. They do not come without negative side effects, and could make them unsuitable to some people.
Psychotherapy can be used to tackle the root causes of depression and help people manage their depression better. Cognitive therapy for behavior and ketamine therapy are two kinds of therapy that have been found to decrease depression symptoms. Additionally, psychotherapy can help people develop a more healthy way of coping and to manage stressors. However, access to psychotherapy can be limited due to cost, scheduling limitations, and a shortage of mental health providers. Telehealth services have increased accessibility for many people.
Finding the right treatment mix is key to overcoming depression. Medication alone may not be 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 working. There are many alternatives to nonpharmacologic treatment, such as repetitive transcranial magnet stimulation and vagus nervous stimulation. These therapies use electromagnetic fields in order to boost mood and stimulate the brain's chemical.
Whether you're interested in trying medication or psychotherapy it is essential to be in close contact with your provider. Discuss your thoughts and feelings as well as the risks and side effects associated with each option. Find a provider that can meet your needs when you're having trouble establishing trust with your therapist or doctor. You can also choose a provider who offers an opportunity to try a trial for no cost. This will allow you to try different strategies before you commit. Eventually, you'll find the best treatment for you and makes you feel at your best.
Brain stimulation
In just a few years, scientists have developed new ways to target specific areas of the brain and swiftly alter their functioning. These techniques can be utilized to treat physical ailments as well as some mental disorders.
rTMS is a technique which employs electromagnetic pulses to stimulate brain activity. It's similar to magnetic pulses that are used in MRIs, but not powerful enough to cause seizures. The method is achieved by stimulating a specific area of the head with a non-painful magnet. The pulsations alter the way that the brain communicates, making it easier for you to feel better. The treatment takes just 3.5 minutes, and does not interfere with your normal routine. You may experience a slight headache following the treatment.
Another treatment involves implanting electrodes in the brain to send painless electrical sparks. Deep transcranial stimulation (deep-TMS) is an option that has been used to treat OCD and to quit smoking cigarettes. Recent studies suggest that it may alleviate depression symptoms in certain individuals. It's not clear how this treatment works, but it does appear to alter the balance of certain neurotransmitters.
Other types of noninvasive brain stimulation are growing also. In a recent study patients suffering from severe depression and intolerance to antidepressants reacted well to a magnetic therapy called SAINT. It's customized to each patient's brain anatomy and uses high-dose patterns of magnetic pulses. The treatment can be delivered in a few hours, whereas previous treatments required daily sessions for weeks or months.
Researchers used fMRI to locate the exact area of the brain being stimulated in every patient. They also analyzed minute variations in the way that brain's different regions were activated which helped them discern the direction of signals. They discovered that in depressed people the brain's anterior cortex cortex was sending signals to an area called the subgenual cingulate cortex. However, these signals were frequently misdirected and the more severe the depression was, the more of these incorrect signals were.