francewave83 – https://www.iampsychiatry.com/depression-treatment

Depression Treatment BreakthroughsResearchers are tackling depression from a variety of ways than they did before. These strategies are designed to help you avoid relapses and discover the right medication.Psychotherapy is a viable option if antidepressants aren’t working. This includes cognitive behavior therapy as well as psychotherapy with others.Deep Brain StimulationDeep brain stimulation (DBS) is an operation in which electrodes are implanted inside the brain to target specific areas that cause diseases and conditions such as depression. The electrodes are connected to a device that emits electric pulses to treat the disease. The DBS device is known as a neurostimulator. It can also be used to treat other neurological disorders like essential tremor, Parkinson’s disease epilepsy, and essential tremor. The pulses of the DBS device could “jam” circuits that are causing abnormal brain activity in depression while keeping other circuits in place.Clinical trials of DBS have demonstrated significant improvements in patients with treatment resistant depression (TRD). Despite the positive results, the path to stable recovery from TRD looks different for every patient. Clinicians rely on the subjective reports from interviews with patients and 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 detects subtle changes in brain activity patterns and can differentiate the depressive from stable recovery states. The study is published in Nature Human Behaviour, exemplifies the importance of combining neuroscience, medicine and computer engineering fields to create potentially life-changing treatments.In DBS the doctors insert a thin, wire-like lead into the brain through a tiny hole in the skull. The lead is outfitted with electrodes that transmit electrical signals to the brain. The lead is connected to an extension cable that runs from the head, behind the ear and down to the chest. The extension wire and the lead are connected to a battery-powered stimulator implanted under the skin of the chest.The programmable neurostimulator generates pulses of electricity to control abnormal brain activity in the regions targeted by DBS devices. In latest depression treatments , the researchers employed DBS to target a specific region of the brain known as the subcallosal cingulate cortex (SCC). Scientists discovered that stimulating the SCC caused a rise in dopamine levels, which could help alleviate depression symptoms.Brain ScannersA doctor may employ various methods and tools to diagnose depression, but a brain scan is the most effective. This technology makes use of imaging to track changes in brain activity at the functional and structural levels. It can be utilized by a patient to determine the affected regions of their brain and to determine what’s happening in these regions in real-time.Brain mapping can help determine the type of treatment will be most effective for an person. For instance, certain people are more responsive to antidepressant medication than others, however this isn’t always the situation. Utilizing MRI to determine the effectiveness of a medication psychologists and doctors can be more precise when prescribing it to their patients. Seeing how their treatment is progressing can also encourage better compliance.Despite its wide-spread prevalence, research in mental health has been hampered by the difficulty of measuring it. While there is an abundance of information on depression anxiety, depression and other issues, a comprehensive understanding of what causes these issues has been elusive. However, advances in technology are beginning to unravel the causes that cause these disorders.A recent study published in Nature Medicine, for example, classified depression into six distinct subtypes. This paves the way toward individualized treatment.Researchers employed fMRI technology in order to examine brain activity of 801 people with depression, and 137 others without. They looked at the connectivity and activation of brain circuits affected by depression, including those which regulate cognition and emotions. They looked at the brain scan of a subject in a state of rest and while completing specific tasks.A combination of resting-state measures and task-based ones could predict whether someone would respond or not to SSRIs. This is the very first time a predictive test in the field of psychiatry was developed. The team is currently working on developing an automated test that will give these predictive results.This is particularly helpful for those who do not respond to conventional treatments like therapy and medication. In fact, more than 60% of people suffering from depression do not respond to the first form of treatment they receive. Some of these patients could be difficult to manage with a standard treatment regimen.Brain ImplantsSarah suffered from a debilitating type of depression that was debilitating. She described it as a black hole that pulled her down. It was a force so powerful that she was unable to move. She tried all kinds of medications however none of them had given an enduring lift. She also tried other treatments such as ketamine injections and electroconvulsive treatment, but these failed too. Finally, she was able to undergo a procedure that would permit researchers to implant electrodes in her brain, and then send her a specific shock whenever she was likely to suffer from a depressive attack.Deep brain stimulation is a technique which is extensively used in the treatment of Parkinson’s disease. It has also been shown to be beneficial for people who are unable to respond to treatment. It is not an effective treatment, but it helps the brain cope. It utilizes a device that can implant small electrodes in specific parts of the mind such as the pacemaker.In an article published in Nature Medicine on Monday, two researchers at the University of California at San Francisco explain how they utilized a DBS to tailor depression treatment for a particular patient. They described it as an “revolutionary” approach that could open the way for a more flexible DBS treatments for other patients.The team studied Sarah’s brain circuitry, and discovered that her amygdala may be the reason for her depressive episodes. They discovered that the ventral striatum, a deep part of her brain was responsible for calming her amygdala’s overreaction. They then implanted the matchbox-sized gadget in Sarah’s head and strung its spaghetti like electrode legs to the two brain regions.If a symptom of depression occurs, the device sends an electrical signal to Sarah’s amygdala and ventral striatum. This jolt is meant to stop the development of depression and nudge her into a more positive mindset. It’s not an effective treatment for depression, however it makes a significant difference for those who require it the most. In the future, this could be used to determine biological indicators for depression giving doctors the chance to prepare by increasing the stimulation.Personalized MedicineThe concept of personalized medicine refers to customizing diagnosis, prevention and treatment strategies for individual patients based upon information obtained through molecular profiling, medical imaging, lifestyle data and so on. This differs from traditional treatments, which are developed to fit an average patient.Recent studies have revealed a myriad of factors that can cause depression among different patients. These include genetic variants, neural circuitry dysfunctions biomarkers, psychosocial markers and biomarkers as well as other factors. The goal of psychiatry that is personalized is to integrate these findings into the clinical decision-making process for optimal care. It is also intended to aid in the development of specific treatment methods for psychiatric conditions such as depression, aiming at a more efficient use of resources and improving the outcomes for patients.While the field of personalization in psychotherapy is advancing, a number of obstacles hinder its clinical implementation. For instance many psychiatrists aren’t familiar with the various antidepressants and their chemical profiles, which could cause a poor prescribing. It is also essential to take into consideration the cost and difficulty of integrating multiomics into healthcare systems and ethical issues.Pharmacogenetics is a promising way to advance the field of personalized psychiatry. It uses the genetic makeup of a patient in order to determine the correct dosage of medication. It has been suggested that this could aid in reducing the adverse effects associated with drugs and improve treatment efficacy, especially for SSRIs.It is important to note that this is a potential solution and further research is needed before it can be widely accepted. Other factors, including lifestyle choices and environmental influences, are also important to think about. Therefore, the integration of pharmacogenetics into depression treatment must be carefully and balanced.Functional neuroimaging may also be used to aid in the choice of antidepressants and psychotherapy. Studies have demonstrated that the pretreatment activation levels of specific neural circuits (e.g. The response to pharmacological or psychotherapeutic treatment is predicted by the ventral and pregenual anterior cortex. Moreover, some clinical trials have already utilized these findings to guide their selection of participants, focusing on those with more activation levels and consequently having better responses to treatment.