Advanced Depression Treatment
If your depression doesn't respond to a first-line antidepressant your doctor might suggest increasing the dosage or adding a different medication. They might also suggest psychotherapy.
The newer psychotherapy techniques like enhanced depression treatment have scientific evidence-based support and could help alleviate depression symptoms. These therapies are focused on the identification and resolution of specific ways in which depression affects your daily life.
Transcranial magnetic stimulation (TMS)
A type of noninvasive brain stimulation, TMS utilizes magnetic impulses to alter the neurons that are responsible for mood. It is usually suggested to treat depression when medications have failed or are not appropriate for a particular person. It is also used to treat PTSD and is often combined with psychotherapy. TMS is an effective and safe treatment that doesn't trigger serious side effects.
During the session, the medical professional will place an electromagnetic coil on your scalp over the region of the brain that controls mood. In the case rTMS this is called the dorsolateral frontal cortex (dLPFC). This is a small region situated in front of your brain. The device sends pulses to the brain. You will hear clicking sounds and feel a tingling sensation. The healthcare professional will alter the settings to stimulate the desired areas of your brain.
The healthcare professional will determine the intensity of the pulses by determining how much energy is required to induce a thumb twitch. This is crucial, since it allows them to know the amount of power they're employing to ensure the safety of patients. In the past, pulses were delivered 120% of the motor threshold. But, current research is focusing on speeding up TMS treatment to decrease the treatment length and improve response rates.
In a controlled trial that was randomized researchers have proven that TMS can help people with major depressive disorder (MDD) who do not respond to antidepressants. The study revealed that patients treated with rTMS experienced significant improvement in symptoms like depression sadness, depression, changes in appetite, and loss of enjoyment or enthusiasm for activities. The study also revealed that the improvements were long-lasting.
TMS is not like other types of brain stimulation, such as electroconvulsive treatment and vagus nerve stimulator. It is not a factor in psychotherapy. It is safe for pregnant women and has a low risk of seizures. However, some patients may suffer from discomfort or pain on their scalp under the magnet during treatment.
The majority of TMS treatments last around half an hour. Your doctor will inform you what the duration of the treatment will take and may even stop the pulses during this time to allow the magnet to cool down.
Vagus Nerve Stimulation (VNS)
VNS (also called Vagus Neuro Stimulation) is a treatment that uses timing of electrical signals to alter brainwave patterns and decrease depression symptoms. It's an implanted surgical device that uses a small pulse generator that is connected to a wire that's wrapped beneath the skin and wound around the left vagus nerve of the neck. The procedure is FDA-approved for people suffering from depression that is treatment-resistant who have not received relief from other treatments, such as psychotherapy or medication. It's also approved as a seizure treatment option for those suffering from epilepsy.
Researchers compared the efficacy of VNS with a sham-device in patients with bipolar disorder or unipolar disorder that is resistant treatment. depression. Patients in the VNS group received a low, medium or high dose of electrical stimulation during a 22-week "acute phase." The primary goal was change in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS groups had significantly better results than patients in the sham groups. After a 12-month follow-up the VNS group had an average IDSSR30 of 9.3 while the sham group scored 4.2.
The VNS treatment was well-tolerated. The most frequently reported adverse effects were voice changes, hoarseness, and a feeling on the chest. Other reported side effects were the feeling of tingling, headache fatigue, fatigue and changes in swallowing or speech. Certain of these were more frequently in higher dose groups, whereas others happened at all doses. The rate of AEs was similar to that in other studies, and were typically cleared by the end the acute study period.
Psychiatrists from Ohio State Wexner Medical Center are regularly invited to take part in national discussions about the best approach to treat depression and other mood disorders. Our experts are helping to define national standards for health care. We are also a site for a multicenter clinical study 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 evidence available suggests that VNS may provide improved benefits and hope for this difficult-to-treat chronic patient.
Electroconvulsive therapy (ECT)
ECT is a potent treatment for depression that isn't improving by taking medication. It's especially useful for those who are suicidal or cannot wait for their medication to take effect.
During ECT, doctors send small electrical impulses through the head to cause a brief seizure. This is believed to alter brain chemical processes, and may help alleviate symptoms of some mental health problems. ECT has been in use since the 1930s and despite the stigma that is associated with the treatment, numerous people have seen positive results from it.
If personalized depression treatment are to receive ECT the doctor will have to conduct a thorough psychiatric assessment. Then they will review your medical history and do various tests, including an electrocardiogram (EKG), blood tests, and perhaps a chest X-ray. They will also inquire about your feelings about having ECT and will consider any opinions from family members, friends, or advocates who are supporting or advocating for you.
The ECT procedure is carried out when you're asleep under general anesthesia, so you won't feel any pain during the procedure. A mouth guard is used to protect your teeth, while masks protect your face to allow oxygen. An anesthesiologist injects an esthetic into your vein using a needle. When you are asleep, electrodes are placed on either one side or both of your heads depending on whether you're receiving bilateral or unilateral ECT. These send tiny electrical impulses to the brain which cause an instant seizure. It lasts for 20 to 60 seconds, and you are awake shortly after it's over.
You can revoke your consent to ECT at any point before the initial treatment. You have the right to revoke your consent under the Care Quality Commission (CQC), and your doctor must always take your wishes into consideration when deciding whether or not to make use of ECT.
ECT can be a beneficial treatment option for those who have tried other treatments but have failed to see any improvement. It can also help with mild depression, severe psychosis or when you're a risk to yourself or others and can't wait for medication effects to kick in. Most people will require several ECT sessions over a period of three to six weeks.
Light therapy
Light therapy can compensate for the lack of sunlight. This is a reason that can contribute to the development of seasonal affective disorder (formerly known as major depressive disorder). It is utilized as a stand-alone treatment or as an add-on to other treatments, such as psychotherapy or medication. In light therapy you sit in front of an illuminated box that emits white light with bright colors. The light is usually between 10,000 and 2,500 lux. In each session you are seated for approximately 30 minutes at the light source. The light could aid in improving your mood as well as ease other symptoms of SAD, such as feeling tired all the time and sleeping too much.
Although researchers aren't sure how light therapy works to treat SAD but they do know that it has a direct effect on circadian rhythms. Circadian rhythms affect sleep patterns, hormones, and other functions. Light therapy can alter the internal clock of your body by altering the release of melatonin. It is a chemical which regulates sleep-wake cycles. It also impacts neurotransmitter function through affecting the production of serotonin which is a chemical that improves your mood.
A number of studies have proven that light therapy can help improve depression symptoms and enhance the effectiveness of antidepressant medications. In addition, a few studies have found that light therapy is effective in treating bipolar disorder. These findings are encouraging and suggest light therapy may be a viable option for those who suffer from bipolar and depression disorder.
Talk to your doctor or a mental health professional before you start using light therapy. They can help you choose the best device for your needs and offer guidance on how to use it. They can also tell you whether it interacts with any other medications that you are taking.
Light therapy is a safe treatment that is safe and does not cause negative side negative effects. It is best to only use it if your doctor prescribes. It is essential to seek treatment as quickly as possible if you are suffering from severe depression. Depression is a serious condition that can cause serious consequences on your mental and physical well-being. In severe instances, depression can result in suicidal ideas. Get immediate help from a professional in mental health in the event that you feel suicidal.