Depression Treatment Advancements Researchers are constantly striving to improve the treatment of depression. This special Research in Context will explore some of the advancements in depression treatment. Psychotherapy helps alleviate depression symptoms by teaching people skills to handle negative thoughts and feelings. Talk therapy can be conducted one-on-one with a mental health professional or in a group. Precision mental healthcare The term "precision" means bringing more precision or precision to the prevention, diagnosis and treatment methods. For mental health, this means various approaches ranging from medications to psychotherapy. Many of these strategies focus on the symptoms of the disorder, rather than its root causes. This can lead to treatments which only alleviate symptoms, without addressing the underlying causes of mental illness. Fortunately, the field of precision mental health is rapidly evolving. It's similar to the method used in other areas of healthcare that include continuous monitoring of important indicators into the clinical setting (e.g., fever or blood pressure). It also includes combining multiple data sources and utilizing machine learning to aid doctors understand the patient's individual needs and formulate more efficient treatment plans. Precision psychiatry uses EEG to evaluate brain function and assess the patient's capacity to engage in cognitive behavioral therapy. A new class of medications known as NMDA receptor inhibitors may reduce symptoms of depression by preventing the neurotransmitter glutamate from reaching specific brain cells. Pharmacogenetic testing can be used to detect interactions between genes and drugs, and to prevent undesirable effects. A number of companies are also experimenting with digital precision medicine, which utilizes objective digital technology to monitor patients remotely and gather real-time data that can help guide their treatment. One example is that a company is using artificial intelligence to monitor adherence and optimize medication dosages for their patients suffering from depression. These solutions have the possibility of increasing accessibility and effectiveness in mental health as well as enhancing adherence to treatment. Digital precision psychiatry, in particular, can help people with mental illness overcome the barriers to treatment, particularly those who work. For example one Johnson & Johnson initiative in Singapore is partnering with organizations to aid in the reintegration of workers in recovery from depression back into their work and communities. This will help them keep their jobs, which is essential to recovery from mental illness. Medication Many people suffering from depression find that medication can help relieve their symptoms, especially when they're suffering from severe or disabling symptoms. Antidepressants aid in restoring the balance of neurotransmitters, which are chemical messengers within the brain that regulate mood and emotions. The majority of antidepressants today are aimed at one of these neurotransmitters through increasing the levels of serotonin. https://www.iampsychiatry.com/depression-treatment (SSRIs) such as Prozac and Zoloft increase the amount of serotonin in the brain. SNRIs such as Cymbalta, Effexor and Cymbalta are able to target both norepinephrine and dopamine. Monoamine oxidase inhibitors such as Wellbutrin focus on only dopamine and norepinephrine. Most doctors recommend antidepressants for the first option of treatment for depression, as well as some kind of talk therapy. Some of these therapies include cognitive behavioral therapy, which can help improve your mood and thoughts by educating specific skills or psychotherapy for interpersonal relations which is focused on improving relationships. Other therapies, like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) have also been proven to be effective in treating depression. Some people, however, don't respond to the first medications prescribed by doctors. A third of people suffering from depression do not receive any relief from their initial medication and a majority of people who begin taking antidepressants stop them within three months. The good news is that research has allowed doctors to predict which type of medication will work best for each person, using blood or MRI tests to identify which receptors are most affected by depression. In recent years, the treatment has gotten better with improved options and dosages to reduce adverse effects. For instance, the newest antidepressants like esketamine (Spravato), the brexanolone (Auvelity) and nefazodone (Sertraline) are designed to rapidly alleviate depression symptoms through affecting glutamate production in the brain. Other medications are undergoing clinical trials that could alter the way they're used. A drug known as Vorapaxar is being tested on humans. It targets a different part of the brain that is associated with depression, by blocking NMDA receptors. It's expected to be available in 2024. Another medication that has demonstrated promise is a combination of bupropion and ketamine. This could be more effective in treating depression that is resistant to treatment. Psychotherapy Researchers in psychiatry have identified certain factors that cause depression. These include imbalances in the neurotransmitters serotonin as well as norepinephrine. These chemicals are essential 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 help alleviate a variety of symptoms of depression, including fatigue, depressed feelings, and sleep problems. They can also cause adverse effects, which could make them unsuitable for certain people. Psychotherapy can be used to address the primary causes of depression and help people manage their depression better. Cognitive therapy for behavioral disorders and ketamine therapy are two types of therapy that have been proven to reduce depression symptoms. Additionally, psychotherapy can help people develop a more healthy way of coping and to manage stressors. Cost, scheduling limitations and a shortage of mental health professionals can hinder access to psychotherapy. The recent growth of the telehealth industry has increased access for some people. Finding the right treatment mix is the key to beating depression. It could take up to 12 weeks to know if your medication is working. Medication alone might not be enough to alleviate all your symptoms. There are many nonpharmacologic treatments options, including transcranial magnet stimulation, which is a repetitive process, and vagus nerve stimulation. These treatments employ electromagnetic fields in order to improve mood and increase the brain's chemical. Whether you're interested in trying psychotherapy or medication, it's essential to work closely with your therapist. Discuss your thoughts and feelings and discuss the advantages, risks, and side effects of each method. Find a provider that can meet your requirements in case you're having difficulty getting trust from your therapist or doctor. You can also select one that offers the opportunity to test their services for free. This allows you to experiment with different strategies before you commit. You'll eventually find a treatment that works for you and will make you feel better. Brain stimulation In just a few years, scientists have come up with new ways to target specific areas of the brain and quickly change how they function. These techniques can be used to treat depression and other mental disorders as well as a variety of physical ailments. One approach is called rTMS, which employs electromagnetic pulses to stimulate the brain. It's similar to magnetic impulses used in an MRI however, it's not strong enough to trigger a seizure. The technique is achieved by stimulating a specific area of the head with a non-painful magnet. The pulses alter the way the brain signals and allows you to feel better. The treatment only takes 3.5 minutes and does not interfere with your normal routine. You might experience a mild headache afterwards. Another option is to implant electrodes into the brain to send painless electrical sparks. This treatment is also known as deep transcranial magnetic stimulation (deep TMS) and has been utilized to treat OCD and to quit smoking cigarettes. Recent studies suggest that it may alleviate depression symptoms in certain individuals. It's not known what the effect of this treatment is, however, it seems to alter the balance of certain Neurotransmitters. Other noninvasive brain stimulation techniques are also advancing. For example, a recent study found that people suffering from severe depression who were not tolerant to antidepressants, responded to a magnetic treatment called SAINT. It is customized to each patient's specific brain anatomy, and uses high-dose magnetic pulse patterns. The treatment can be administered in just a few hours while previous treatments required daily sessions for months or weeks. Researchers utilized fMRI technology to pinpoint the exact brain area that was being stimulated by every patient. They also examined the tiny differences in the activation of the different brain regions, which allowed them to determine the direction of the signals. They discovered that the anterior cingulate cortex sent signals to the subgenual cortex in depressed individuals. However, these signals were frequently misdirected, and the more severe depression, the more of these wrong-way signals there were.