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Depression Treatment Advancements

While effective treatments for depression are available, researchers are working on innovative and more effective methods to treat the disorder. This special Research in Context will explore some of the latest advances in treatment for depression.

Psychotherapy can ease depression symptoms by teaching the person how to handle negative thoughts and feelings. Talk therapy can be done one-on-one with a health professional or in a group.

Precision mental healthcare

Precision is the ability to be more precise or accurate in prevention, diagnosis and treatment strategies. In the case of mental health, this means a variety of approaches from medications to psychotherapy. A lot of these strategies concentrate on the symptoms of the disorder rather than the root causes. This can lead treatments that only reduce symptoms, but not address the root causes of mental illness.

The precision of mental health is rapidly advancing. It's akin to the methods taken in other areas that include continuous monitoring of key indicators (e.g. fever or blood pressure) into clinical practice. It also involves combining a variety of sources of data and applying machine learning to aid doctors understand the patient's unique needs and develop more effective treatment plans.

One example of precision psychiatry is the use of EEG to determine brain activity and help doctors determine whether a patient is able to participate in cognitive behavioral therapy. Another example is a novel class of medications known as NMDA receptor antagonists, which can block the neurotransmitter glutamate from reaching certain brain cells and decrease symptoms of depression. Another possible breakthrough is the use of pharmacogenetic tests to determine interactions between genes and drugs and avoid unfavorable side effects.

In addition, a number of companies are exploring digital precision psychiatry, which uses objective digital technology to monitor patients remotely and gather real-time information that can guide the treatment they receive. For example, one company is leveraging artificial intelligence to monitor compliance and optimize dosages for their depression patients. These technologies have the potential of enhancing accessibility and efficiency in mental healthcare as well as improving the patient's adherence to treatment.

Additionally, digital precision psychiatry can aid in overcoming obstacles to treatment for those living with mental illness, especially those working. Johnson & Johnson, for example, has partnered with organizations in Singapore to help facilitate the reintegration process of those recovering from depression back into their work. This will allow them to keep their jobs, which is crucial for mental health recovery.

Medication

Many people suffering from depression discover that medication can relieve their symptoms, especially when they're suffering from extreme or debilitating symptoms. Antidepressants can restore the balance of neurotransmitters in the brain, which are chemical messengers that regulate mood and emotions. The majority of antidepressants today focus on one of these neurotransmitters by increasing levels of serotonin. Selective serotonin Reuptake inhibitors (SSRIs), such as Prozac and Zoloft, boost the level of the chemical serotonin in the brain; SNRIs, like Cymbalta and Effexor which target both norepinephrine and dopamine and monoamine oxidase inhibiters such as Wellbutrin and Effexor, focus on only norepinephrine and dopamine.

Most doctors recommend antidepressants as a first form of treatment for depression, in conjunction with some kind of talk therapy. Some of these treatments include cognitive therapy that helps improve thoughts and feelings by teaching specific skills or interpersonal psychotherapy, which is focused on improving relationships. Other therapies such as electroconvulsive (ECT) therapy and transcranial magnetic stimulation (TMS) have also been proven to be effective at treating depression.

However, some people do not respond to the first medications prescribed by doctors. Up to a third of people suffering from depression do not get any relief from their initial medication and around 40 percent of those who begin taking antidepressants stop within three months. The good news is that research has allowed doctors to predict which type of medication will work best for each patient, using blood or MRI tests to identify which receptors are most affected by depression.

The quality of medication has improved in recent years with a wider range of options and higher doses to help minimize side effects. Newer antidepressants such as esketamine, brexanolone, and 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 is currently being tested on humans. It targets a distinct part of the brain that is which is a source of depression, by blocking NMDA-receptors. It is expected to be available in 2024. Another drug that has shown potential is a combination of ketamine and bupropion, which may be more effective in treating treatment-resistant depression.

Psychotherapy

Psychologists have identified certain elements that can contribute to depression. These include imbalances in the neurotransmitters serotonin as well as norepinephrine. These chemicals play a crucial role 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 that include depressed moods and fatigue, and improve appetite, sleep, and energy levels. However, they do have negative side effects that could make them unsuitable for certain people.

Psychotherapy can help address the root causes and help individuals cope with depression. Different types of therapy have been proven to reduce symptoms, including cognitive behavior therapy and the ketamine infusion therapy. Psychotherapy can also aid people in developing a healthy coping style and manage stressors. Cost, scheduling restrictions and a lack of mental health professionals can hinder access to psychotherapy. The recent increase in Telehealth services has made it easier for some people.

The challenge with overcoming depression is figuring out the best combination of treatment. It may take up to 12 weeks to know whether your medication is effective. A single dose of medication may not be enough to relieve all your symptoms. There are a variety of nonpharmacologic therapies available, such as repetitive transcranial magnetic treatment for depression stimulation and vagus nerve stimulation. These therapies use electromagnetic fields to improve mood and stimulate the brain's chemistry.

It is essential to work closely together with your healthcare provider, whether you're interested trying medication or therapy. Talk openly about your feelings and thoughts, and discuss the advantages, risks, and side effects of each method. Find a service that will meet your needs when you're having trouble getting trust from your therapist or doctor. You may also consider a provider who offers a trial period at no cost. This allows you to test different strategies before you commit. Eventually, you'll find the best treatment for you and helps you feel at your best.

Brain stimulation

In the span of just a few years, scientists have discovered new ways to target certain brain areas and change their function rapidly. These techniques can be utilized to treat physical ailments as well as some mental disorders.

One approach is called rTMS, which uses electromagnetic pulses to stimulate the brain. It's similar to the magnetic impulses that are used in an MRI, but isn't powerful enough to trigger a seizure. The technique works by stimulating a specific region of the brain using an unpainful magnet. The pulses alter the way your brain communicates and make it easier to feel better. The treatment could take as little as 3.5 minutes and won't interfere with your daily activities. There may be a slight headache following the therapy.

Another option is to implant electrodes into the brain to send painless electrical zaps. Deep transcranial stimulation (deep-TMS) is a treatment that has been used to treat OCD and stop smoking cigarettes. Initial studies suggest that it could alleviate depression symptoms in certain individuals. The mechanism of this treatment isn't fully understood however it appears to work by altering the balance of certain neurotransmitters.

Other types of noninvasive brain stimulation are advancing, too. For example, a recent study found that patients suffering from severe depression who were not tolerant to antidepressants responded to an electromagnet treatment known as SAINT. It is customized for each patient's brain anatomy, and uses high-dose magnetic pulse patterns. The treatment can be delivered in just a few hours while previous treatments required daily sessions over months or weeks.

Researchers employed fMRI technology to pinpoint the exact brain area that was being stimulated by each patient. They also looked at the small differences in the activation of the different brain regions, which helped them determine the direction of the signals. They discovered that in patients suffering from depression the brain's anterior cortex cortex was sending signals to an area called the subgenual cingulate cortex. But these messages were often misdirected and the more severe the depression, the greater number of these signals that were not directed in the right direction were.