Advanced Depression Treatment

If your depression isn't responding to a first-line antidepressant your doctor might suggest increasing the dosage or adding a different medication. They might also suggest psychotherapy.

The latest psychotherapy techniques, such as augmented depression treatment offer empirical evidence-based support and could help alleviate depression symptoms. These treatments concentrate on identifying and solving the ways in which depression interferes with your daily routine.

Transcranial magnetic stimulation (TMS)

TMS is a noninvasive brain stimulation technique that utilizes magnetic pulses to stimulate the brain's neurons that control mood. It is typically prescribed to treat depression when medication fails or isn't suitable for the person. It is used to treat PTSD, and is sometimes used in conjunction with psychotherapy. TMS is an effective and safe treatment with no serious side adverse effects.

During the session, a health professional will place an electric coil over the area of your brain which controls mood. In the case of rTMS this is the dorsolateral frontal cortex (dLPFC). This is a small area that is located in front of your head. The device will send pulses to the brain. You will hear sounds of clicking and feel tapping sensations. The healthcare professional will adjust settings to stimulate the desired areas of the brain.

The healthcare professional will assess the strength of the pulses using the amount of energy required to elicit the thumb to twitch. This is crucial, since it lets them know the amount of power they're using to ensure patient safety. In the past, the pulses were delivered at 120 percent of the threshold for motor. The current research focuses on speeding up TMS treatment to reduce time to treatment and increase response rates.

In a randomized control trial, researchers have shown that TMS can benefit people suffering from major depressive disorder (MDD) who are unable to respond to antidepressants. The study found that those treated with rTMS experienced significant improvements in symptoms like low mood and sadness as well as changes in appetite and decreased enthusiasm or enjoyment in activities. The study also revealed improvements that lasted for a long duration.

Unlike other types of brain stimulation like vagus nerve stimulation or electroconvulsive therapy, TMS does not interfere with psychotherapy. It is also safe for women who are pregnant, and it has a low chance of seizures. Some patients may experience discomfort or pain on their scalp beneath the magnet during treatment.

The typical TMS treatments last for about half an hour. Your doctor will let you know the length of the treatment and may stop the treatment to allow the magnet to cool down.

Vagus Nerve Stimulation (VNS)

VNS (also known as Vagus Neuro Stimulation Therapy) is a holistic treatment for anxiety and depression option that transmits timed electrical signals to change brain wave patterns and decrease depression symptoms. The device is surgically implanted and consists of a small generator that's connected to a wire wound around the left Vagus nerve at the neck. FDA approved the procedure for people with treatment-resistant depression who have not been able to get relief from other treatments like therapy and medication. It's also approved for seizure control in certain epileptic patients.

In the largest clinical study of VNS researchers compared the effectiveness against the use of a sham device among patients who suffered from treatment-resistant unipolar or depressed-phase bipolar disorder. Patients in the VNS group received a moderate, low or high dose of electrical stimulation throughout the 22-week "acute phase." The primary endpoint was changes in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS group improved significantly more than those in the sham group. At a 12-month follow-up, those in the VNS group had a mean IDS-SR30 score of 9.3 points, while those in the sham group had a score of 4.2 points.

The VNS treatment was well-tolerated. The most common side effects were voice distortion hoarseness, a feeling of numbness, and a sensation on the chest. Other reported side effects were the feeling of tingling, headache fatigue, fatigue and changes in swallowing or speech. Certain of these side effects were observed more frequently in the higher dose groups, while others occurred at all doses. The frequency of AEs was comparable to those observed in other studies, and were usually eliminated by the end of the acute study period.

Psychiatrists from Ohio State Wexner Medical Center are regularly invited to participate in national discussions about the best approach to treat depression and other mood disorders. Our experts contribute to shaping national standards of care and are currently a site for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial that will further evaluate VNS as a treatment option for treatment-resistant depression. This is an important research project, as the evidence available today suggests that VNS may provide improved benefits and hope for this difficult-to-treat chronic patient.

Electroconvulsive therapy (ECT)

ECT is a highly effective treatment for depression that doesn't improve by taking medication. It is especially helpful for those who are suicidal or are unable to wait until their medication to start working.

During the ECT procedure doctors transmit tiny electric currents through the brain to deliberately trigger an instant seizure. The result is that the brain changes chemical structure and improve symptoms of certain mental health conditions. ECT has been used since the 1930s. Despite the stigma attached to the treatment it has helped many people.

Your doctor will first have to perform a thorough psychiatric assessment before suggesting ECT. They will then review your medical records and perform various tests, including an electrocardiogram, blood tests, and possibly an X-ray of your chest. They will also inquire about your thoughts about having ECT and will consider any opinions from family members, friends, or others who are supportive or advocating for you.

The ECT treatment is given when you're asleep under general anesthesia. This means that you will not feel anything during the procedure. A mouth guard is put on to protect your teeth, and a mask is put over your face to provide oxygen. An anesthesiologist injects a local anesthetic into your vein by using needle. After you are asleep, electrodes are placed on either or both sides of your head (depending on whether you have bilateral or unilateral ECT). These pulses deliver small electrical impulses to the brain, causing a short seizure. It lasts for 20 to 60 seconds and you wake up soon after it's over.

You can revoke your consent to ECT at any point prior to the first treatment. You are entitled to withdraw your consent under Care Quality Commission (CQC) and your doctor must always consider your wishes when deciding whether or not to utilize ECT.

ECT can be a beneficial treatment option for those who tried other treatments but failed to see any improvement. It can also be helpful with mild depression, severe psychosis or when you're a danger to yourself or others and you are unable to wait for medication effects to kick in. The majority of patients will require several ECT sessions spread out over three to six weeks.

Light therapy

Light therapy helps to compensate for the absence of sunlight, which can contribute to major situational depression treatment (click through the next article) disorder that has seasonal patterns (formerly called seasonal affective disorder). It is used as a stand-alone therapy or as an addition to other treatments, like psychotherapy or medication. In light therapy you are seated next to the light box, which emits bright, white light. The light is usually between 10,000 and 2,500 light lux. Each session, you'll be sitting for 30 minutes near the lamp. The light could aid in improving your mood as well as ease other symptoms of SAD like feeling tired all the time and having trouble sleeping.

Although scientists don't know for certain how light therapy can help treat SAD but they do know that it has an immediate impact on circadian rhythms. Circadian rhythms affect sleep patterns, hormones, and other functions. Light therapy can alter your internal clock by altering the release of melatonin an ingredient that regulates the sleep-wake cycle. It can also impact neurotransmitter function through affecting the production of serotonin which is a chemical that improves your mood.

Several studies have shown that light therapy improves depression symptoms and boosts the effectiveness of antidepressant drugs. Several studies have also shown that light therapy can be used to treat bipolar disorder. These results are encouraging and suggest that light therapy might be a viable option for those with bipolar and depression disorder.

Before you start using light therapy, talk to your doctor or mental health professional about it. They can guide you in selecting the best drug to treat anxiety and depression device and provide you with instructions on how to use it. They can also inform you whether it interacts with other medications you're taking.

Light therapy is a successful treatment that has no serious side effects. You should only use it if your doctor prescribes. If you are experiencing severe depression, it's crucial to seek treatment as soon as you notice it. Depression is a serious illness and can have grave consequences for your emotional and physical well-being. In extreme cases, depression may cause suicidal thoughts. Seek immediate assistance from a mental healthcare professional in the event that you feel suicidal.