Depression Treatment Breakthroughs
Scientists are attacking depression from more angles than before. These treatments are designed to aid in avoiding relapses and find the right drug.
If your depression doesn't respond to antidepressants then psychotherapy could be beneficial. This includes cognitive behavior therapy and interpersonal psychotherapy.
Deep Brain Stimulation
Deep brain stimulation is a surgical technique where electrodes inside the brain are used to target specific areas of the brain that are responsible for disorders and conditions such as depression. The electrodes are connected to the device that emits electric pulses to help treat the condition. The DBS device is known as a neurostimulator and is also used to treat other neurological disorders such as Parkinson's disease, essential tremor, and epilepsy. The pulses of the DBS device could "jam" circuits that are causing abnormal brain activity in depressed patients while keeping other circuits in place.
Clinical trials of DBS for depression have demonstrated 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 interviews with patients and the psychiatric rating scales that 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 can detect subtle changes in brain activity patterns that can distinguish between stable and depressive recovery states. The study was published in Nature Human Behaviour, exemplifies the importance of combining medical, neuroscience and computer engineering disciplines to develop potentially life-changing treatments.
During the DBS procedure, doctors place a thin wire-like lead in the brain through a hole in the skull. The lead is outfitted with electrodes that transmit electrical signals to the brain. It is then connected to an extension wire that runs from the brain, across the neck and behind the ear down to the chest. The extension and lead are connected to an implanted battery-powered stimulator that is placed under the skin of your chest.
The programmable Neurostimulator generates pulses of electrical current to control abnormal brain activity in the areas that are targeted by DBS devices. In the study, researchers used DBS to target a particular region of the brain referred to as the subcallosal cingulate cortex (SCC). The researchers found that when SCC was stimulated, it caused an increase in dopamine levels, which may improve symptoms of depression.
Brain Scanners
A doctor may employ different methods and tools to diagnose the depression, but brain scans are the most effective one. This technology makes use of imaging to track changes in brain activity at the structural and functional levels. It can be used by a patient to pinpoint the affected areas of their brain and to determine what's happening in these regions in real-time.
Brain mapping can also help to predict which type of treatment will be the most efficient for a particular person. For instance, certain people are more responsive to antidepressant medication than others, however this isn't always case. Utilizing MRI to evaluate the effectiveness of a medication, psychologists and physicians are more precise when prescribing it to their clients. Monitoring how their treatment going can help increase compliance.
The difficulty of measuring mental health has hindered research despite its wide-spread prevalence. While there is an abundance of information about depression anxiety, depression and other disorders, a clear understanding of what causes these disorders has been difficult. However, the latest technology is beginning to reveal the mechanisms behind these conditions.
A recent study published in Nature Medicine, for example, classified depression into six distinct subtypes. This opens the way to a personalized treatment.
Researchers used fMRI to analyze the brain activity of 801 individuals with depression and 137 people who were not. Researchers studied the activity of brain circuits affected by depression, such as those that control cognition or emotions. They examined a participant's brain scans during rest and while completing specific tasks.
A combination of resting-state measures and task-based ones was able to predict whether an individual would respond to SSRIs. This is the first time a predictive test for the field of psychiatry has been created. The team is now working on a computerized tool that will provide these predictions.
This is particularly beneficial for those who do not respond to conventional therapies like therapy or medication. About 60% of people with depression don't respond to the first treatment they receive. Some of these patients could be difficult to manage using the standard treatment regimen.
Brain Implants
Sarah suffered from a severe form of depression that was debilitating. She described it as a black hole that pulled her down. It was a force so strong that she was unable to move. She had tried all sorts of medications however none of them had given an indefinite lift. She also tried other treatments such as ketamine injections and electroconvulsive treatments, but they did not work either. Finally, she was able to undergo a surgery that would allow researchers to implant electrodes in her brain and give her a targeted shock whenever she was likely to have a depressive episode.
The method, also called deep brain stimulation is used extensively to treat Parkinson's disease and has been proven to aid those suffering from depression that is resistant to treatment. But it isn't a cure, but rather helps the brain cope with the disease. It's based on a device that places tiny electrodes in certain areas of the brain, such as a brain pacemaker.
In an article published in Nature Medicine on Monday, two researchers from the University of California at San Francisco explain how they utilized a DBS to customize the treatment for depression for a specific patient. They called it an "revolutionary" new method that could open the way for the development of customizable DBS therapies for other patients.
For Sarah the team traced the circuits in her brain and discovered that her amygdala was a source of depression episodes. They found that the ventral striatum, a deep part of her brain is responsible for calming her amygdala's overreaction. They then placed the matchbox-sized device in Sarah's head, and then strung its electrode legs that resembled spaghetti to the two brain regions.
If a sign of depression occurs, the device signals Sarah's brain to send a small electrical charge to the amygdala, and to the ventral striatum. This jolt is intended to stop the development of depression and help her into a more positive mindset. It's not a cure, however it can make a huge impact for those who require it the most. In the future, this will be used to determine the biological indicators that indicate depression is on the horizon and give doctors the chance to prepare by increasing stimulation.
Personalized Medicine
The concept of personalized medicine allows doctors to customize diagnosis, prevention and treatment strategies for individual patients, based on the information gathered from molecular profiling. medical imaging, lifestyle data, etc. This differs from traditional treatments that are geared towards the average patient. It is a one-size-fits-all approach which may not be effective or efficient.
Recent studies have revealed a variety factors that cause depression in a variety of patients. These include genetic variations and neural circuitry malfunctions biomarkers and psychosocial markers as well as other factors. The goal of psychiatry that is personalized is to integrate these findings into the clinical decision-making process to ensure optimal care. It also aims to assist in the creation and implementation of individualized treatment for psychiatric disorders such as depression.
While the field of personalized psychotherapy is growing, several obstacles still hinder its clinical application. Many psychiatrists are not familiar with the pharmacological profile of antidepressants. This can result in a suboptimal prescription. It is also important to consider the cost and the complexity of integrating multiomics into healthcare systems, and ethical issues.
Pharmacogenetics is a promising method to advance the field of personalized psychotherapy. It utilizes the patient's genetic makeup in order to determine the appropriate dose of medication. depression counseling has been suggested that this can help to reduce the adverse effects associated with drugs and improve the effectiveness of treatment, particularly in the case of SSRIs.
However, it is crucial to emphasize that this is just an idea and will require further research before being widely adopted. Other factors, like lifestyle choices and environmental influences are also important to take into consideration. Therefore, the integration of pharmacogenetics in depression treatment should be carefully balanced.
Functional neuroimaging may also be used to aid in the choice of antidepressants or psychotherapy. Studies have demonstrated that the levels of pretreatment activation in specific neural circuitries (e.g. ventral and pregenual anterior cingulate cortex) determine the response to both pharmacological and psychotherapeutic treatments. Certain clinical trials have utilized these findings as a guide to select participants. They target those who have higher activation and, consequently, more favorable responses to treatment.