Advanced Depression Treatment

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

Modern psychotherapy techniques like augmented chronic depression treatment therapy offer empirical support and can help improve depression symptoms. These treatments concentrate on identifying and solving the specific ways that depression can affect your daily routine.

Transcranial Magnetic Stimulation (TMS)

A type of noninvasive brain stimulation, TMS employs magnetic impulses to affect the neurons that are responsible for mood. It is usually advised to treat depression if medications fail or are not suitable for a person. It is used to treat PTSD, and what is the best treatment for anxiety and depression sometimes combined with psychotherapy. TMS is an effective and safe treatment that has no serious side negative effects.

During the session, a medical professional will place an electromagnetic coil on your scalp to the region of the brain that regulates mood. In the case of rTMS this is the dorsolateral frontal cortex (dLPFC). This is a small region located at the front of your brain. The device will deliver pulses to the brain. You will hear sounds of clicking and feel a tingling sensation. The healthcare professional will adjust the settings to stimulate the desired areas of the brain.

The healthcare professional will assess the intensity of the pulses by determining the amount of energy required to trigger an itch in the thumb. This is crucial, since it allows them to determine the amount of power they're using to ensure patient safety. In the past, the pulses were given at 120% of the motor threshold. Current research focuses on accelerating TMS treatment to decrease time to treatment and increase the rate of response.

Researchers have demonstrated in a controlled, randomized study that TMS can aid people suffering from MDD who are not responding well to antidepressants. The study found that patients who were treated with rTMS saw significant improvements in symptoms like sadness and low mood, changes in appetite and the loss of enthusiasm or enjoyment in activities. The study also revealed improvements that lasted for a long duration.

In contrast to other forms of brain stimulation, like vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy. It is also safe for women who are pregnant, and it has a low chance of having seizures. Some patients might experience pain or discomfort on their scalp beneath the magnet while they are receiving treatment.

The majority of TMS treatments last around half an hour. The provider will inform you how long the treatment will last and may also stop the pulses in this period to allow the magnet to cool down.

Vagus Nerve Stimulation (VNS)

VNS (also known as Vagus Neuro Stimulation Therapy) is a treatment option that sends timed electrical signals to change brain wave patterns and reduce depression symptoms. It's a surgically implanted device that utilizes a small pulse generator that is connected to a wire that's wrapped under the skin and wound around the left vagus nerve in the neck. The procedure has been approved by the FDA for treatment-resistant depression in people who have not found relief from other treatments like psychotherapy or medications. It's also approved as a seizure treatment option for those suffering from epilepsy.

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

The VNS therapy was well tolerated with the most common adverse effects being voice changes or hoarseness, as well as a feeling of weight on the chest. Other reported side effects were tingling, headaches, tiredness, and changes in speech or swallowing. Some of these happened more frequently in higher dose groups, whereas others happened at all doses. The rate of AEs in this study was similar to previous studies and usually resolved by the end the study period of acute.

Psychiatrists from Ohio State Wexner Medical Center are regularly invited to take part in national discussions on the best method to treat depression and other mood disorders. Our experts are helping establish national standards for health treatment. We are also a part of an international clinical trial, called RECOVER, which is being conducted by the Centers for Medicare & Medicaid Services. The goal of this study is to examine VNS for treating resistant depression. This is an important research project, as the available evidence suggests that VNS could provide a better treatment for this chronically ill population.

Electroconvulsive therapy (ECT)

ECT is a highly effective treatment for depression that isn't improving by taking medication. It's especially useful for those who are suicidal or unable to wait for their medication to take effect.

During the ECT procedure, doctors send small electrical currents through the brain to deliberately trigger an immediate seizure. This is believed to alter brain chemistry and rapidly improve symptoms of certain mental health disorders. ECT has been used since the 1930s, and despite the stigma associated with the treatment, a lot of patients have benefited from it.

Your psychiatrist will need to conduct a thorough mental evaluation before suggesting ECT. Then, they will examine your medical history and do various tests which include an electrocardiogram (EKG) as well as blood tests, and perhaps an X-ray of the chest. They will ask you to describe how you are feeling about ECT and will take into account any opinions from family members, friends, or advocates speaking on your behalf.

The ECT procedure is done under general anesthesia. This means that you will not feel any sensation. A mouth guard is put in place to protect your teeth. a mask is put over your face to allow oxygen. The anesthesiologist will inject an the anesthetic via a needle into your vein. Once you've fallen asleep, electrodes will be placed on one or both sides of your head (depending on whether you suffer from unilateral or bilateral ECT). These electrical pulses send small impulses to the brain, causing brief seizures. It lasts between 20 and 60 seconds, and you awaken shortly after it's over.

It is important to keep in mind that you can revoke your consent to ECT at any time, even just before the first line treatment for depression and anxiety treatment. You have the right to withdraw your consent under Care Quality Commission (CQC), and your doctor must always take your wishes into consideration when deciding whether or not to use ECT.

ECT is a great treatment option for those who tried other treatments but failed to see any improvement. It can also assist with mild depression, severe psychosis, or when you're a danger to others or yourself and cannot wait for the effects of medication to take effect. The majority of people require several ECT sessions spread over three to six weeks.

Light therapy

Light therapy compensates for lack of sunlight, which could contribute to major depressive disorder with seasonal depression treatment patterns (formerly called seasonal affective disorder). It can be used as a standalone treatment of depression or to complement other treatments, such as psychotherapy and medications. In light therapy you sit in front of the light box, which emits white light with bright colors. The light usually has between 2,500 and 10,000 in lux. In each session you are seated for approximately 30 minutes at the light. The light can boost your mood and ease other symptoms of SAD that can be a problem, like feeling tired all the time and sleeping too much.

Researchers aren't sure how light therapy can treat SAD. However, they are aware that it has an effect on the circadian rhythms. Circadian rhythms impact the patterns of sleep, hormones, and other functions. Light therapy can reset the internal clock of your body by altering the release of melatonin. It is the chemical that regulates sleep and wake cycles. It can also affect neurotransmitter functions by altering the serotonin production.

A number of studies have proven that light therapy improves depression symptoms and increases the effectiveness of antidepressant medication. In addition, some studies have demonstrated that light therapy is effective in treating bipolar disorder. These findings are encouraging and suggest light therapy could be an option for people with bipolar and depression disorder.

Talk to your doctor or a mental health professional before you begin using light therapy. They can guide you in selecting the best device and provide you with guidelines on how to use it. They can also tell you whether it interacts with any other medications that you are taking.

Light therapy is an effective treatment that has no adverse side effects. However, you should only use it in accordance with the prescriptions of your doctor. If you are experiencing severe depression, it is essential to seek treatment right away. Depression is a serious illness that can have serious effects on your physical and mental well-being. In extreme cases, it could cause thoughts of suicide. Seek immediate assistance from a mental healthcare professional If you are experiencing suicidal thoughts.