Innovative Depression Treatments
Many people suffering from depression struggle to find the right treatment for them. Some people experience a lack response to medications or experience intolerable adverse effects.
The health benefits inherent to expanded treatment coverage are believed to be significant (table 2). The discounted value for depression is $399 billion, and for anxiety disorders $169 billion.
Transcranial Magnetic Stimulation (TMS)
TMS uses an electric field to deliver short pulses of electric current to specific brain regions that are overactive in people with depression. The treatment is non-invasive and does not require anesthesia. It's also extremely efficient and well-tolerated as compared to antidepressant drugs.
A person is able to receive TMS by sitting in a chair that resembles dental chairs. A trained technician will place an instrument with a coil of magnetic material against the frontal portion of the head. The coil is able to pulse rapidly, and the person may feel or hear a clicking noise on their scalp. Each magnetic pulse (measured in hertz or Hz) is known as a "pulse”. The frequency of the pulses can range from low (1 pulse every second) to high (10 per second).
The treatment isn't painful, but the magnetic field can affect cells in the cortex's outer layer. It depolarizes cortical neurons, and the resulting transynaptic changes can influence deeper regions of the brain involved in mood. For instance, TMS with higher frequencies over the left dorsolateral prefrontal cortex (DLPFC) can boost mesolimbic neurocircuits that modulate emotional responses.
Certain insurance plans cover TMS as an adjunct to psychiatric medications. It's important to check with your insurance provider to find out what benefits your specific plan covers.
In clinical studies, TMS produced significant and sustained improvements in depression symptoms over an placebo. During the TMS treatment course, a patient may undergo up to 30 sessions over a couple of weeks. Patients with severe depression might require a more prolonged course of treatment.
Certain of the latest TMS treatments use a lower frequency pulse, which is less likely to cause side-effects such as seizures. While the procedure is still considered experimental however, it's a promising option for people who don't respond to psychotherapy and antidepressants.
Electroconvulsive Therapy (ECT)
The brain's natural chemicals are balanced with ECT. It is among the most efficient and safest treatments for depression. It is also used in other mental health issues like schizophrenia.
The ECT procedure takes place in a hospital or outpatient treatment center. It is carried out by medical professionals. A general anaesthetic is given prior to the procedure, meaning you will not feel any 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 provided with a muscle relaxant that will keep you calm and a mouth guard to safeguard your teeth. Two metal discs are positioned on your head, one each side or in your forehead. The anaesthetist then injects you with a medicine to put you to sleep.
You will be awakened in the ECT room. A member of the ECT staff will be available to answer any questions that you may have. You will be asked to complete a consent form prior to you undergo the treatment. You may find it difficult to absorb all the information that you are told about ECT. It is best to bring a relative or friend accompany you. You should be given at least 24 hours to think about the treatment prior to having to make a decision.
During the procedure, you'll have brief fits or seizures lasting between 40 seconds to two minutes. The ECT doctor will alter the frequency of your electrical pulses according to the way you react. You will probably have short courses of ECT typically 6-12 sessions, two times a week.
There is no one theory about how ECT is performed, but it seems to cause the release of certain chemicals that aid your brain cells communicate with one other. It also appears to change how parts of your brain expand.
ECT is effective in treating severe depressions, suicidal feeling as well as catatonia secondary depression and other psychiatric issues. Research shows that about half of those who receive ECT improve and stay well for an entire year or more. It is especially beneficial for those whose symptoms haven't been treated with medications or other psychosocial treatments.
Deep brain stimulation (DBS)
Deep brain stimulation is a surgical method that involves implantation of electrodes into the brain. The electrodes are connected to a tiny neurostimulator that sends electric pulses to the area of the brain responsible for your symptoms. The pulses can help relieve your symptoms and improve your quality of life. DBS can treat a variety of conditions that include movement disorders, such as essential tremor, Parkinson's disease, and psychiatric disorders such as depression and obsessive-compulsive disorder. It can also reduce seizures in epilepsy sufferers. It can also treat the severe pain that comes from brain and nerve conditions.
DBS is an option that can be used in conjunction with ECT or other treatments for TRD. However, latest depression treatments is important to remember that not all patients benefit from DBS. Some patients may not experience any improvement in their symptoms, while others may experience a worsening of depression. This is likely caused by a combination of factors, such as factors that are related to patients such as personality traits or psychiatric comorbidity, and other factors related to clinical issues, like an inaccurate diagnosis or poor DBS treatment.
Researchers employed a machine-learning algorithm to classify the changes in LFPs that were recorded during intraoperative DBS. The results indicated that the reduction in depression symptoms was correlated with changes in beta power. These findings suggest DBS can be used to predict the severity of antidepressant effects. However further research is required to verify this theory.
Although DBS is an established treatment for movement disorders and a growing array of psychiatric illnesses however, it isn't widely recognized as a reliable treatment for depression. The FDA has approved DBS to decrease seizures in people with difficult-to-treat Epilepsy. Studies are currently being conducted to determine whether DBS can be used for treating depression.
Before you undergo DBS, you should discuss your options with a neurologist or psychiatrist. Your neurologist will evaluate you and recommend the best treatment option for you. The doctor will inform you about the benefits and risks of DBS. You should also inquire about any tests or preparations you might require prior to the procedure. You may require a blood test, imaging and other tests before the procedure.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy has been proven to be effective through numerous outcomes studies. It is often utilized as an alternative treatment, but it can be combined with medication in some instances. CBT is a kind of psychotherapy which helps you change negative thoughts and behavior that can cause 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 a very active type of psychotherapy and emphasizes problem-solving and identifying and changing maladaptive thinking patterns.
The goal of CBT therapy is to assist you to become your own therapy. It accomplishes this by assisting you to change your thinking and behave. It employs exercises and home work in sessions and out of session to teach new techniques. CBT focuses on present-day issues and problems, not previous experiences and their root causes. It does require some information about your past in order to be able to deal with and understand problems in the present.
CBT is a short-term therapy, usually lasting 6 to 20 sessions. It is an empirically based therapy and its duration is determined by whether or not you meet the goals you set at the beginning of the therapy. It is an active therapy and requires a lot of commitment and effort on your part.
Other cognitive behavioral therapies could be helpful for you. They include acceptance and commitment therapy that helps you engage in positive behavior even when you are struggling with negative thoughts or emotions. dialectical behavior therapy that treats suicidal thoughts that are persistent and self-injury, and psychotherapy for interpersonal relationships that aims to resolve relationship problems which can be a contributing factor to depression.
There are a variety of exciting new treatments on the horizon that promise to be game-changing for people with depression. Some treatments are already available. For example, deep brain stimulation. A surgeon places electrodes in your brain to send zaps that alter the electrical activity that causes your symptoms. There are many other advances in the research phase, like personalized medication for depression. This could reduce the need for trial and error to find the best treatment for you.