Innovative Depression Treatments
Many sufferers of depression have a difficult time finding a treatment that works for them. Some suffer from a lack of response to medication or experience uncontrollable adverse side effects.
Table 2 shows that intrinsic health benefits of scaling up effective coverage are significant. The discounted value of these benefits is $399 billion for depression and $169 billion for anxiety disorders.
Transcranial magnetic stimulation (TMS)
TMS utilizes a magnet field to deliver brief pulses of current to specific brain regions that appear to be overactive in depressed patients. The therapy is noninvasive and does not require anesthesia. It is also highly effective and well-tolerated compared to antidepressant medication.
For depression treatment plans , a person is seated in a chair reminiscent of a dentist and remains awake. A trained technician puts the device, which is small, with a magnetic coil on the head's front. The coil is able to pulse rapidly and the user may be able to feel or hear a click noise on their scalp. Each magnetic pulse (measured in hertz or Hz) is known as a "pulseor pulse. The frequency of pulses can range from low (1 pulse every second) to high (10 per second).
The treatment is not painful The magnetic field is affecting cells in the outer layer of the brain. It depolarizes cortical cells and the transynaptic effect can affect the brain's deeper regions that are involved in mood. For instance, TMS with higher frequencies over the left dorsolateral prefrontal cortex (DLPFC) can increase mesolimbic neural circuits that regulate emotional responses.
Some insurance plans cover TMS as an adjunct to psychiatric medications. It is recommended to check with your insurance provider to determine what coverage your plan provides.
In clinical trials, TMS produced significant and sustained improvements in depression symptoms over the placebo. A patient could receive up to 30 TMS sessions over the period of a few weeks. Patients suffering from more severe depression may need more time to complete their treatment.
Certain modern treatments of TMS employ a lower-frequency pulse that 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 or antidepressants.
Electroconvulsive therapy (ECT)
ECT helps to restore the brain's natural chemical balance. It is one of most efficient and safe treatments for depression. It is also used in other mental health disorders such as schizophrenia.
The ECT procedure is performed in a hospital or an outpatient treatment center. It is carried out by medical professionals. Prior to the procedure the general anaesthetic will be administered to ensure that there is no discomfort. The ECT team will connect monitoring equipment to monitor your heart rate, oxygen levels, blood pressure and brain waves. You will receive an anti-muscle relaxant to keep you calm, as well as a mouthguard to safeguard your teeth. Two metal discs (bilateral ECT) or one disc (unilateral ECT) is positioned on your head, one on each side or in the middle of your forehead. The anaesthetist injects you with a medication to help you sleep.
You will be awakened in the ECT room. A member of the ECT staff will answer any questions that you may have. Before you receive the treatment you will be required to fill out a consent form. You may find it difficult to comprehend all the information when you're told about ECT. It is recommended to have a relative or a friend with you. You should be given at minimum 24 hours to think about the treatment prior to having to make a decision.
During the procedure, you may suffer brief seizures or fits lasting between 40 seconds to 2 minutes. The ECT doctor will alter the amount of electrical pulses you receive depending on the response you show. You will probably have short courses of ECT generally 6-12 sessions, twice a week.
There isn't a single theory on how ECT is performed however, it does trigger the release of certain chemicals that aid your brain cells communicate with each with each other. It also appears to change the way that brain cells develop.
ECT is extremely effective in treating suicidal thoughts, severe depression and catatonia that is secondary to depression, and other psychiatric disorders. Studies show that around half of patients who receive ECT improve and remain healthy for an entire year or longer. It's particularly beneficial for those whose symptoms aren't responding to medication or other psychosocial treatments.
Deep brain stimulation (DBS).
Deep brain stimulation is a surgical procedure that involves implanting electrodes into the brain. The electrodes are connected to small devices that transmit electric impulses into the region of your brain which controls symptoms. The electrical pulses can help ease your symptoms and enhance your quality of living. DBS can treat a variety of conditions including movement disorders such as Parkinson's or essential tremors, as well as psychiatric conditions such as depression and obsessional-compulsive condition. It can also reduce seizures in people suffering from epilepsy. It can also treat the severe pain that comes from brain and nerve conditions.
DBS is an effective treatment for many patients with TRD and can be used in conjunction with other treatments like ECT. However, it is important to understand that not all patients can benefit from DBS. Some patients may not see any improvement in their symptoms, while others may experience a worsening of depression. This inability to respond could be caused by a combination factors that include patient-related factors, like personality traits or psychiatric co-morbidity, and also clinical factors like a misdiagnose or a poor DBS goal.
Researchers employed a machine-learning algorithm to classify the changes in LFPs that were recorded during intraoperative DBS. The results indicated that changes in beta power were related to a decrease in depressive symptoms. These findings suggest that DBS can be used to predict the effects of antidepressants. However more research is needed to verify this theory.
While DBS is a well-established treatment for movement disorders and a growing array of psychiatric illnesses, it is not well recognized as a reliable treatment for depression. The FDA has approved DBS to decrease seizures in some people with hard-to-treat epilepsy, and studies are underway to determine whether DBS can be used to treat depression.
Before undergoing DBS it is recommended that you discuss your options with a neurologist or psychiatrist. The neurologist will examine you and recommends the appropriate treatment for you. He or she will also inform you about the risks and benefits of DBS. It is also important to inquire about any preparations or tests you might need to take prior to the procedure. You may require an imaging test, blood test and other tests before the procedure.
Cognitive behavioral therapy (CBT).
Cognitive behavioral therapy has been proven to be effective by various outcomes studies. It is often used as an independent treatment, however it can be combined with medications in some instances. CBT is a type of psychotherapy that helps you learn to change the negative thoughts and behaviors that are contributing to depression. It is based on the idea that how you perceive and react to situations is more important than the situation itself. It is an active form of psychotherapy that is focused on problem-solving by identifying and modifying unhelpful thinking patterns, and identifying the thoughts that are not adapted to your needs.
The aim of CBT is to assist you in becoming your own therapy by helping you understand and alter the way you think and behave. It uses exercises and homework during sessions and outside of the session to help you develop 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 to be able to tackle and comprehend issues that you face in the present.
CBT is a relatively short-term therapy, typically lasting 6-20 sessions. It is an empirically grounded therapy and its duration is determined by whether or not you are meeting the goals established at the start of therapy. It is an active therapy that requires a strong level of commitment and effort on your part.
There are a myriad of different types of cognitive behavior therapies that may be useful for you, such as acceptance and commitment therapy, which teaches you to be positive and engaging in positive behavior even when you have negative emotions or thoughts as well as dialectical behavior therapy, that is designed to deal with chronic suicidal thoughts and self-injury; and interpersonal psychotherapy, that focuses on resolving relationships that contribute to depression.
There are numerous exciting new treatments that could offer a game-changing solution for those suffering from depression. There are some that are already in use for treatment, like deep brain stimulation, in which surgeons implant electrodes into your brain that send painful zaps that alter the electrical activity causing your symptoms. Other advancements are in the research phase, like the development of a personalized treatment for depression. This could reduce the need for trial and error to determine the best treatment for you.