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Depression Treatment Advancements

Researchers are constantly striving to improve treatment for depression. This special Research in Context feature will look at some of these breakthroughs in treatment for depression.

Psychotherapy can help alleviate depression symptoms by educating the person how to manage negative thoughts and feelings. Talk therapy can be conducted one-on-one with a mental health professional or in group settings.

Precision mental healthcare

The term "precision" means bringing more exactness or accuracy to the prevention, diagnosis and treatment methods. In the context of mental health, it could include a range of approaches that range from psychotherapy to medication. A lot of these strategies focus on the symptoms of the disorder rather than its root causes. This can result in what treatments are available for depression that do nothing more than alleviate symptoms, without addressing the root causes behind mental illness.

The precision of mental health is rapidly advancing. It's comparable to the approach that's been taken in other areas of healthcare by incorporating continuous monitoring of important indicators into the clinical setting (e.g. fever, temperature or blood pressure). It also involves combining several data sets and utilizing machine-learning to assist physicians comprehend the specific needs of a patient and devise more efficient treatments.

Precision psychiatry employs EEG to measure brain function and assess a patient's ability to engage cognitive therapy for behavioral problems. A new class of drugs known as NMDA receptor inhibitors can reduce depression symptoms by preventing the neurotransmitter glutamate from reaching certain brain cell. Another potential advance is the use of pharmacogenetic testing to identify drug-gene interactions and prevent undesirable side effects.

Many companies are also experimenting with digital precision medicine, which uses objective digital technology to monitor patients remotely, and collect real-time information that can help guide their treatment. One company, for instance employs artificial intelligence to track medication adherence and improve dosages for people suffering from depression. These kinds of solutions are likely to significantly improve accessibility and efficiency of mental health care and increase adherence to treatment resistant bipolar depression.

Furthermore Digital precision psychiatry could help overcome barriers to treatment for people who suffer from mental illness, especially those who are employed. For example an Johnson & Johnson initiative in Singapore is working with other organizations to help facilitate the reintegration of people recovering from depression back into their work and communities. This can help them keep their jobs, which are essential to a successful recovery.

Medication

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

Most doctors recommend antidepressants as an initial treatment for depression, along with some form of therapy for talk. Some of these therapies include cognitive therapy that helps improve the quality of your thoughts and feelings by teaching specific skills or psychotherapy for interpersonal relations which concentrates on improving relationships. Other treatments, such as electroconvulsive (ect treatment for depression and anxiety) therapy and transcranial magnet stimulation (TMS) have also been proven to be effective in treating depression.

However, some people do not respond to the initial medication prescribed by doctors. About one-third of patients suffering from depression don't get relief from the first medication they take and 40% of those who begin taking antidepressants stop them after three months. The good news is that recent research has helped doctors determine which type of medication is most effective for each patient, using blood or MRI tests to determine which receptors are most affected by the depression.

In recent times, medication has improved with better options and dosages to reduce side effects. Newer antidepressants such as esketamine and brexanolone as well as nefazodone work to quickly alleviate depression symptoms.

Other medications are undergoing clinical trials that could change the method of their use. A drug called vorapaxar, which is currently being studied in humans, targets a different brain region that's associated with depression by blocking NMDA receptors. It is expected to be available by 2024. A combination of ketamine and bupropion has also shown promise. It could be more effective at treating depression that is resistant to treatment.

Psychotherapy

Researchers in psychiatry have been able to pinpoint certain factors that contribute to depression, such as problems with the neurotransmitters serotonin and norepinephrine. These chemicals are crucial in regulating mood and emotions as in 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 relieve many symptoms of depression, including depressed mood, fatigue and sleep issues. However, they can have negative side effects that could cause them to be unsuitable for certain people.

Psychotherapy can be used to address the primary causes of depression and help people cope better. Cognitive therapy for behavior and ketonamine therapy are two forms of therapy that have been found to decrease depression symptoms. Psychotherapy can help people to develop a healthier way of coping and help them manage stressors. Cost, scheduling limitations and a shortage of mental health professionals can restrict access to psychotherapy. The recent rise of telehealth services has improved access for some people.

Finding the right treatment combination is key to overcoming depression. Medication alone may not be enough to alleviate all your symptoms. It may take between 6 and 12 weeks before you can tell whether a medication is effective. There are a variety of nonpharmacologic therapies available like transcranial magnetic stimulation and vagus nerve stimulation. These treatments employ electromagnetic fields to stimulate the brain's natural chemistry and improve mood.

It's important to be in close contact with your healthcare provider, whether you're considering taking medication or therapy. Be honest about your feelings and thoughts, and discuss the advantages of, risks, and effects of each option. If you're having a difficult to establish a trusting relationship with your therapist or doctor Find a provider who can meet your needs. You can also choose one that offers an opportunity to try a trial for no cost. This allows you to experiment with different methods before committing. You'll eventually find a treatment that works for you and will make you feel better.

Brain stimulation

In a few short years, scientists have developed new ways to target specific regions of the brain, and rapidly alter their functioning. These methods can be used to treat depression and other mental disorders, and also for some physical illnesses.

rTMS is a method that employs electromagnetic pulses to stimulate brain activity. It is similar to magnetic pulses used in MRIs but not powerful enough to cause seizures. The method works by stimulating a precise part of the brain using a painless magnet. The pulsations alter the way that the brain communicates, making it easier for you to feel better. The treatment could take just 3.5 minutes and doesn't interfere with your normal activities. There may be a slight headache afterward.

Another treatment involves putting electrodes in the brain to send painful electric zaps. This procedure is also referred to as deep transcranial magnetic stimulation (deep TMS) and is employed to treat OCD and to quit smoking. Recent research suggests that it can alleviate depression symptoms in certain individuals. The mechanism behind this treatment isn't completely clear, but it seems to work by altering the balance of certain neurotransmitters.

Other forms of noninvasive brain stimulation are also advancing as well. For example an upcoming study has found that patients with severe depression who were resistant to antidepressants responded to an electromagnet treatment known as SAINT. It is individualized to each patient's specific brain anatomy, and uses high-dose magnetic pulse patterns. The treatment can be administered within a few hours whereas previous treatments needed regular sessions spread over weeks or months.

Researchers used fMRI to pinpoint the precise region of the brain being stimulated in each patient. They also looked at the small variations in the activation of different brain regions, which helped them determine the direction of the signals. They found that in patients suffering from depression the brain's anterior cortex cortex was sending signals to an area known as the subgenual cingulate cortex. These messages were frequently incorrectly directed. The more severe depression the more signals were directed in the wrong direction.