Depression Treatment Advancements
Researchers are constantly striving to improve treatment for depression. This special Research in Context will explore some of the advancements in depression treatment.
Psychotherapy can help alleviate depression symptoms by educating the person how to manage negative feelings and thoughts. Talk therapy can take place 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, it could encompass a variety of strategies including psychotherapy, medication and. However, many of these strategies tend to focus on the repercussions of the disorder, rather than its root causes. This can lead to treatments that do little more than ease symptoms but don't address the root causes that cause mental illness in the beginning.
The precision of mental health is rapidly advancing. It's comparable to the approach which has been used in other healthcare areas that include continuous monitoring of key indicators into the clinical setting (e.g., fever or blood pressure). It also involves combining a variety of data sources and utilizing machine learning to help physicians better understand a patient's individual needs and formulate more effective treatment strategies.
One example of precision psychiatry is using EEG to monitor brain activity and assist doctors assess the ability of a person to participate in cognitive behavioral therapy. stay with me is a novel class of drugs called NMDA receptor antagonists. These can block the neurotransmitter glutamate from reaching certain brain cells, and thus reduce symptoms associated with depression. Another possible breakthrough is the use of pharmacogenetic tests to detect drug-gene interactions and prevent undesirable side effects.
Many companies are also looking into digital precision medicine, which uses objective digital technology to monitor patients remotely, and collect real-time data that aids in their treatment. For example, one company is leveraging artificial intelligence to track adherence and optimize dosages of medication for patients suffering from depression. These kinds of solutions could be used to dramatically improve the accessibility and effectiveness of mental health services, as well as increase the patients' adherence to treatment.
Digital precision psychiatry, specifically it can help those suffering from mental illness overcome obstacles to treatment, especially those who are employed. For example 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 maintain their jobs, which is essential for the recovery of mental health.
Medication
Many people with depression find that medication can help relieve their symptoms, especially those who are suffering from severe or disabling symptoms. Antidepressants restore the balance of neurotransmitters in the brain, which are chemical messengers that regulate mood and emotions. Most current antidepressants target one of these neurotransmitters, increasing levels of serotonin, norepinephrine, and dopamine. Selective serotonin Reuptake inhibitors (SSRIs), such as Prozac and Zoloft, boost the level of serotonin's chemical in the brain. the SNRIs, such as Cymbalta and Effexor are able to target both norepinephrine and dopamine; and monoamine oxidase inhibitors like Wellbutrin and Effexor, focus on only dopamine and norepinephrine.
The majority of doctors prescribe antidepressants to treat depression as a first treatment, in addition to talk therapy. Some of these therapies are cognitive behavioral therapy (CBT) which can help improve feelings and thoughts by teaching specific skills, or psychotherapy for interpersonal relations (which focuses 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 certain people don't respond to the first medication prescribed by their doctors. A third of people suffering from depression do not get relief from the first medication they take and 40% of people who start taking antidepressants discontinue them within three months. The good news is that recent research has helped doctors determine which type of medication will work best for each person, using blood or MRI tests to determine which receptors are the most affected by the depression.
The quality of medication has improved in recent years, with more options and better doses to help minimize adverse effects. Newer antidepressants such as esketamine, brexanolone, and Nefazodone are effective in reducing depression symptoms.
Clinical trials are underway on other medications which could alter the method of their use. A drug called Vorapaxar is currently being tested on humans. It targets a distinct area of the brain associated with depression, by blocking NMDA-receptors. It's expected to be available by 2024. Another medication that has demonstrated potential is a combination of bupropion and ketamine. This may be more effective in treating depression resistant to treatment.
Psychotherapy
Psychologists have identified certain factors that cause depression. These include imbalances of the neurotransmitters norepinephrine and serotonin. These chemicals are vital 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 ease many of depression-related symptoms such as depressed feelings and fatigue, and improve appetite, sleep, and energy. They are not without negative side effects, and could make them unsuitable to some people.
Psychotherapy can be used to tackle the primary causes of depression and assist people manage their depression better. Cognitive therapy for behavior and ketamine therapy are two types of therapy that have been proven to decrease depression symptoms. Psychotherapy can also assist people in developing a healthy coping style and reduce stressors. Cost, scheduling restrictions and a lack of mental health professionals can restrict access to psychotherapy. Telehealth services have improved access for many people.
The difficulty in beating depression is figuring out the best combination of treatment. The use of medication alone isn't enough to alleviate all your symptoms, and it can take 6 to 12 weeks before you are able to tell whether a medication is effective. 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 chemistry.
It's important to collaborate closely with your provider, whether you're interested trying medication or therapy. Discuss your feelings and thoughts, and discuss the advantages, risks, and side effects of each method. If you're having a hard to establish a trusting relationship with your therapist or doctor Find the right person to meet your requirements. You can also select a clinic that provides an opportunity to try a trial at no cost. This will allow you to try different approaches before committing. You'll find a solution that is effective for you and will make you feel better.
Brain stimulation
In just a few years, scientists have developed new ways to target specific areas of the brain, and rapidly change how they function. These techniques can be utilized to treat depression and other mental disorders and also for some physical illnesses.
rTMS is a method that utilizes electromagnetic pulses to stimulate brain activity. It's similar to magnetic pulses that are used in MRIs, but is not powerful enough to cause seizures. The method works by stimulating a precise area of the brain with an innocuous magnet. The pulses change the way that your brain processes and help you feel better. The therapy can take just 3.5 minutes and doesn't interfere with your everyday activities. There may be a slight headache afterward.
Another treatment involves implanting electrodes in the brain to send painless electrical sparks. Deep transcranial stimulation (deep-TMS) is a treatment that has been used to treat OCD and to quit smoking. It's still being researched for depression, but early research suggest that it could reduce depressive 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 growing also. For example, a recent study found that people suffering from severe depression who were resistant to antidepressants benefited from an electromagnet treatment known as SAINT. It is customized for each patient's brain anatomy and employs high-dose magnetic pulse patterns. The treatment can be completed within a couple of hours, whereas previous treatments required daily sessions for months or weeks.
The researchers used FMRI to identify the precise region of the brain that was being stimulated in every patient. They also studied the tiny differences in the way that the brain's different regions were activated which allowed them to determine the direction of signals. They found that the anterior cingulate cortex sent signals to the subgenual cortex in depressed people. But these messages were often misdirected and the more severe depression, the greater number of these wrong-way signals there were.