Depression Treatment Breakthroughs
With the introduction of a new generation depression treatment breakthroughs, researchers are tackling this issue with greater precision than ever before. These methods will help you locate the right medications and prevent repeat relapses.
If your depression isn't responding to antidepressants then psychotherapy could be effective. These include cognitive behavior therapy as well as psychotherapy with others.
Deep Brain Stimulation
Deep brain stimulation is a surgical method where electrodes inside the brain are placed to target specific regions of the brain that cause disorders and conditions such as depression. The electrodes are connected to the device that emits electrical pulses to treat the disease. The DBS device is known as neurostimulator. It is also used to treat other neurological disorders like Parkinson's disease, essential tremor and epilepsy. The pulsing of the DBS device could "jam" circuits that cause abnormal brain activity in depression, while remaining in place other circuits.
Clinical trials of DBS for depression have revealed significant improvement in patients suffering from treatment-resistant depression (TRD). Despite the positive results however, the path to steady recovery from TRD differs for each patient. Clinicians must rely on subjective self-reports from patient interviews as well as psychiatric rating scales, which can be difficult to interpret.
Researchers from the Georgia Institute of Technology, Emory University School of Medicine, and the Icahn School of Medicine at Mount Sinai, have developed an algorithm that detects subtle changes in brain activity patterns and can differentiate the depressive from stable recovery states. The study, published in Nature Human Behaviour, exemplifies the importance of combining medical, neuroscience, and computer engineering disciplines to develop potentially life-changing therapies.
During the DBS procedure, doctors place a small wire-like lead into the brain through a hole within the skull. The lead is outfitted with electrodes that send electrical signals to the brain. It is then connected to an extension wire that runs from the brain, across the neck, behind the ear, down to the chest. The lead and extension are connected to an implanted battery-powered stimulator that is placed under the skin of your chest.
The programmable Neurostimulator generates electrical current pulses to regulate brain activity within the areas that are targeted by DBS devices. In the study, researchers employed DBS to target a region of the brain known as the subcallosal cingulate cortex (SCC). Researchers found that stimulating the SCC resulted in an increase in dopamine, which could aid in the treatment of depression.
Brain Scanners
A doctor may employ different tools and techniques to identify the depression, but the brain scan is the most effective one. This method employs imaging to observe changes at functional and structural levels of brain activity. It can be utilized by a patient to identify the affected areas of their brain and to determine what's happening in these regions in real-time.
Brain mapping can also help to determine which treatment is most effective for an individual. Some people respond better antidepressant medication than others. However, this isn't always the case. Psychologists and physicians can prescribe medications more precisely by using MRI to assess the effectiveness. It also helps increase compliance by allowing patients to see how their treatment is progressing.
Despite its widespread prevalence the research on mental health has been hampered by the difficulty of assessing it. There is plenty of information available on depression, anxiety, and other disorders. However it's been a challenge to pinpoint the causes. However, advances in technology are beginning to reveal the mechanisms that cause these disorders.
For example, a recent study published in Nature Medicine sorts depression into six distinct biological subtypes. This opens the door to personalized treatment.
Researchers employed fMRI technology in order to examine the brain activity of 801 individuals with depression, and 137 others who were not depressed. They studied the activation and connectivity of brain circuits affected by depression, such as those that control cognition and emotions. They examined a participant's brain scan during relaxation and when they completed specific tasks.
A combination of resting-state measures and task-based ones was able to predict if people would respond or not to SSRIs. This is the very first time that a predictive test in the field of psychiatry has been created. The team is currently working on the development of an automated tool that will provide these predictive results.
This is especially useful for those who don't respond to conventional therapies like therapy or medication. In fact, up to 60 percent of people with depression do not respond to the first treatment they receive. Some of these patients can be difficult to manage using an established treatment plan.
Brain Implants
Sarah had lived with a debilitating depression that she described as a black hole that dragged her down to a gravity force that was so strong that she was unable to move. She had tried all sorts of medications, but none had provided an enduring lift. She had also undergone other treatments such as electroconvulsive therapy and ketamine infusions, but they too failed to work. Then, she decided to undergo a procedure that would allow researchers to implant electrodes into her brain, and then give her a targeted jolt every time she was about to suffer from a depressive attack.
The process, also known as deep brain stimulation is widely used to treat Parkinson's disease. It has been proven to help those suffering from depression that is resistant to treatment. But it isn't a cure; it simply aids the brain in dealing with the condition. It makes use of a device to implant small electrodes in specific parts of the mind like a pacemaker.
In a study published in Nature Medicine on Monday, two researchers from the University of California at San Francisco explain how they utilized the DBS to customize the treatment for depression for a specific patient. They described it as a "revolutionary" approach that could pave the way for the development of customizable DBS treatments for other patients.
The team studied Sarah's brain's neuronal circuits and found that her amygdala was the main cause of her depression episodes. They found that the ventral region, a deep part of her brain, was responsible for calming her amygdala overreaction. Then, they inserted an implant the size of a matchbox inside Sarah's skull, and then strung its electrode legs, shaped like spaghetti, down to the two brain regions.
Now, when cognitive behavioral therapy for depression of depression develops, the device signals Sarah's brain to send a tiny electrical charge to the amygdala and to the ventral striatum. The intention is to prevent depression and encourage her to be more positive. It's not a cure however it can make a significant difference for those who need it the most. In the future it may be used to determine an indicator of a biological sign that indicates a depression is on the way, allowing doctors to prepare by increasing the stimulation.
Personalized Medicine
Personalized medicine is a way to customize diagnosis, prevention, and treatment strategies for specific patients, based on the data gathered from molecular profiling. medical imaging, lifestyle information, etc. This differs from traditional treatments, which are designed to meet the needs of an average patient.
Recent research has revealed a variety of factors which contribute to depression in different patients. These include genetic variations, neural circuitry dysfunctions biomarkers, psychosocial markers and biomarkers among others. The goal of individualized psychiatry is to incorporate these findings into clinical decision-making process to ensure the best treatment. It also aims to facilitate the development and implementation of specific treatment plans for psychiatric issues such as depression.
Personalized psychiatry continues to progress, but several obstacles are still hindering its use in clinical settings. For instance many psychiatrists aren't familiar with the different antidepressants and their chemical profiles, which could result in a suboptimal prescription. Additionally the cost and complexity of integrating multiomics data into healthcare systems as well as ethical considerations must be taken into account.
Pharmacogenetics is a promising method to improve the effectiveness of personalized psychiatry. It uses the patient's genetic makeup in order to determine the correct dosage of medication. This can help reduce the side effects of drugs and increase the effectiveness of treatment, especially with SSRIs.
However, it is important to emphasize that this is only an option and requires further research before being widely adopted. Other factors, including lifestyle choices and environmental influences are also important to take into consideration. Therefore the integration of pharmacogenetics into depression treatment must be carefully to be balanced.
Functional neuroimaging may also be used to aid in the choice of antidepressants or psychotherapy. Studies have proven that pretreatment levels of certain neural circuits (e.g. The response to pharmacological or psychotherapeutic treatment is determined by the ventral and pregenual anterior cortex. Furthermore, some clinical trials have already used these findings to help select participants, targeting those with higher activation levels and therefore having more favorable responses to therapy.