Depression Treatment Advancements
Researchers are constantly working to improve the treatment for depression. This special Research in Context feature will examine some of these advancements in depression treatment.
Psychotherapy helps ease depression symptoms by teaching people the skills to deal with negative thoughts and feelings. Talk therapy can be conducted in a group setting or one-on-one with a mental health professional.
Precision mental healthcare
The term “precision” means bringing greater precision or accuracy to diagnosis, prevention and treatment methods. In the context of mental health, this includes various approaches ranging from psychotherapy to medications. However, many of these strategies tend to focus on the effects of the disorder, rather than the root causes. This can lead to treatments that only alleviate symptoms, without addressing the root causes behind mental illness.
Fortunately, the field of precision mental health is rapidly evolving. It's akin to the methods taken in other areas which includes continuous monitoring of important indicators (e.g. fever or blood pressure) into clinical practice. It also involves combining multiple data sets and utilizing machine learning to help doctors comprehend the specific requirements of a patient and to develop more effective treatments.
Precision psychiatry uses EEG to evaluate brain function and evaluate the ability of a patient to engage in cognitive therapy for behavioral problems. A new class of medications known as NMDA receptor inhibitors may alleviate depression symptoms by blocking the neurotransmitter glutamate from reaching certain brain cells. Another possible breakthrough is the use of pharmacogenetic testing to identify drug-gene interactions and avoid unfavorable side effects.
In addition, a lot of companies are looking into digital precision psychiatry, which uses objective digital technologies to monitor patients remotely and gather real-time information that can guide the care they receive. For instance, one company is using artificial intelligence to track adherence and optimize dosages of medication for their patients suffering from depression. These types of solutions have the potential to dramatically improve accessibility and effectiveness of mental healthcare and also increase the adherence to treatment.
Furthermore, digital precision psychiatry can assist in overcoming the obstacles to treatment for those living with mental illness, especially those who are employed. Johnson & Johnson, for example, is partnering with organizations in Singapore to support the reintegration of people recovering from depression back into their work. This can help them maintain their jobs, which is crucial for mental health recovery.
Medication
(Image: https://www.iampsychiatry.uk/wp-content/uploads/2023/09/iampsychiatry-logo-wide.png)Many people who suffer from depression find that medication can help relieve their symptoms, especially when they're suffering from severe or disabling symptoms. Antidepressants restore the balance of neurotransmitters in the brain which are chemical messengers that regulate mood and emotions. The majority of antidepressants today are aimed at one of these neurotransmitters by increasing the levels of serotonin. Selective serotonin Reuptake inhibitors (SSRIs) like Prozac and Zoloft, boost the level of the chemical serotonin in the brain. SNRIs, like Cymbalta and Effexor, focus on both dopamine and norepinephrine and monoamine oxidase inhibitors like Wellbutrin which targets only dopamine and norepinephrine.
Most doctors recommend antidepressants as an initial treatment for depression, in conjunction with some form of talk therapy. Some of these therapies include cognitive behavioral therapy (CBT) which can help improve the quality of your thoughts and feelings by teaching specific skills or psychotherapy for interpersonal relationships (which concentrates 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 initial medication prescribed by doctors. About one-third of people suffering from depression do not receive relief from the first medication they take, and 40 percent of those who begin using antidepressants quit within three months. The good news is that research has helped doctors predict which kind of medication is most effective for each individual, utilizing blood or MRI tests to determine which receptors are most affected by the depression.
(Image: https://www.iampsychiatry.uk/wp-content/uploads/2023/09/Royal_College_of_Psychiatrists_logo.png)The quality of medication has improved in recent years with a wider range of options and higher doses to help minimize side effects. For instance, newer antidepressants like esketamine (Spravato) and Brexanolone (Auvelity) and Nefazodone (Sertraline) work to rapidly reduce depression symptoms by stimulating glutamate activity in the brain.
Other medications are in clinical trials that could change the ways they're used. A drug known as Vorapaxar is being studied on humans. It targets a distinct part of the brain that is that is associated with depression by blocking NMDA receptors. It is expected to be available in 2024. Another medication that has shown potential is a combination bupropion and ketamine. This could be more effective at treating depression resistant to treatment.
Psychotherapy
Researchers in psychiatry have identified certain factors that can contribute to depression. These include imbalances of the neurotransmitters serotonin as well as norepinephrine. These chemicals play an essential function in regulating mood emotions, mood, and overall brain function. 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, including depressed feelings and fatigue, and improve appetite, sleep deprivation treatment for depression, and energy. They are not without negative side effects, and could make them unsuitable for certain people.
Psychotherapy can address root causes and assist people to manage depression. Several types of therapy have been shown to reduce symptoms, such as cognitive behavioral therapy and the ketamine infusion therapy. Psychotherapy can also help people develop a more effective coping strategy and better manage stressors. However, access to psychotherapy can be limited due to cost, scheduling limitations, and a shortage of mental health professionals. Telehealth services have increased accessibility for many people.
The biggest challenge in overcoming depression is finding the best treatment for anxiety and depression combination of treatment. It may take up to 12 weeks to determine whether your medication is effective. Medication alone might not be enough to alleviate the symptoms. There are several nonpharmacologic treatments options, including transcranial magnet stimulation, which is a repetitive process, and vagus nervous stimulation. These therapies employ electromagnetic fields in order to boost mood and stimulate the brain's chemical.
It's important to work closely together with your healthcare provider, whether you're considering taking medication or therapy. Talk openly about your feelings and thoughts, and discuss the advantages of, risks, and effects of each option. Find a practitioner who can meet your needs in case you're having difficulty establishing trust with your therapist or doctor. A service that provides a trial period free of charge is also a good option, as it offers you the opportunity to try out different approaches before making a commitment. You'll eventually discover a method that works for you and will make you feel better.
Brain stimulation
In just a few short years, scientists have discovered new ways to target specific brain regions and alter their functions quickly. These techniques can also be used to treat physical ailments as well as certain mental disorders.
rTMS is a technique which uses electromagnetic pulses to stimulate brain activity. It's similar in concept to the magnetic impulses that are used in an MRI however it's not powerful enough to trigger seizures. The technique is based on stimulating a specific area of the brain with a painless magnet. The pulses affect the way that brain signals are processed which allows you to feel better. The therapy takes only 3.5 minutes, and does not interfere with your normal routine. There may be a slight headache afterward.
Another Electric Shock Treatment For Depression involves putting electrodes in the brain to send painless zaps of electricity. Deep transcranial stimulation (deep-TMS) is an option that has been used to treat OCD and stop smoking. Early studies suggest that it could reduce depression symptoms in some people. 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 as well. In a recent study, patients suffering from severe depression and intolerance to antidepressants reacted well to a treatment using magnetics called SAINT. It is individualized to each patient's specific brain anatomy, and uses high-dose magnetic pulse patterns. The electric treatment for depression can be administered within a few hours whereas previous treatments needed regular sessions for weeks or months.
Researchers employed fMRI technology to pinpoint the exact brain region that was being stimulated by every patient. They also studied minute variations in the stimulation of the various brain regions, which helped determine the direction of signals. They found that the anterior cingulate cortical sent signals to the subgenual cortex in depression sufferers. These messages were frequently incorrectly directed. The more severe the depression, the more signals were directed in the wrong direction.