The 3 Most Significant Disasters In Advanced Depression Treatment History
Advanced Depression Treatment
If your depression doesn't respond to a first-line antidepressant your doctor may try increasing the dosage or adding a different type of medication. They may also suggest psychotherapy.
Modern psychotherapy techniques like augmented depression therapy have scientific support and can help improve depression symptoms. These treatments are aimed at identifying and resolving specific ways depression affects your daily life.
Transcranial magnetic stimulation (TMS)
TMS is a noninvasive brain stimulation technique that utilizes magnetic pulses to influence neurons that are responsible for mood. It is usually suggested to treat depression when medications fail or are not appropriate for a particular person. It is also used to treat PTSD and is often combined with psychotherapy. TMS is a safe and effective treatment that doesn't trigger serious side effects.
During the session, a medical professional will place an electromagnetic coil on your scalp over the region of the brain that controls mood. In the case of rTMS, it is the dorsolateral frontal cortex (dLPFC). It is a small region that is located in front of your head. You will hear a clicking sound and feel a tapping sensation as the device delivers the brain with electrical impulses. The healthcare expert will alter the settings to stimulate the specific areas of your brain.
The healthcare professional will assess the amount of energy required to trigger the thumb to flick. This is important, as it allows them to determine the amount of energy they are employing to ensure the safety of patients. In the past, pulses were delivered at 120 percent of the motor threshold. However, current research is focused on accelerating TMS therapy to reduce the treatment length and improve the rate of response.
Researchers have demonstrated in a randomized controlled study that TMS can be used to assist people suffering from MDD who are not responding well to antidepressants. The study revealed that patients treated with rTMS saw significant improvements in symptoms like depression and sadness, as well as changes in appetite, and a loss of enjoyment or enthusiasm for activities. The study also found that the improvement was long-lasting.
In contrast to other forms of brain stimulation, such as vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy. It is safe for pregnant women and has a low chance of seizure. However, some people can experience pain or discomfort on the scalp underneath the magnet while they are receiving treatment.
Typical TMS treatments last for about half an hour. Your provider will tell the length of the treatment and may pause pulses to allow the magnet to cool.
Vagus nerve stimulation (VNS)
VNS (also known as Vagus Neuro Stimulation Therapy) is a treatment option that transmits precise electrical signals to alter brain wave patterns and decrease depression symptoms. The device is surgically implanted and uses an insignificant generator that is connected to a wire wound around the left Vagus nerve at the neck. FDA approved the procedure for patients suffering from treatment-resistant depression who haven't been able to get relief from other treatments like therapy and medications. It's also approved for seizure control in certain epileptic patients.
In the most comprehensive clinical study of VNS researchers compared its effectiveness against a sham device in people who had treatment-resistant monopolar or depressed-phase bipolar disorder. Patients in the VNS group received a moderate, low or high dose of electrical stimulation over an 22-week "acute phase." The primary goal was a change in Inventory of Depressive Symptomatology Self-Report (IDS-SR30) score during the course of the study. Patients in the VNS groups showed improvement significantly more than those in the sham groups. After a 12-month follow-up the VNS group scored a mean IDSSR30 of 9.3 while the sham group scored 4.2.
The VNS treatment was well tolerated. The most frequent side effects were voice distortion, hoarseness, and a sensation on the chest. Other reported side effects were tingling, headaches, fatigue, and changes in speech or swallowing. Certain of these were more often in the higher dose groups, whereas others happened at all doses. The rate of AEs in this study was similar to other studies, and they generally resolved 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 participant for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial that will further study VNS as a treatment option for treatment-resistant depression. This is a very important research project, as the evidence available suggests that VNS could be a more effective treatment for patients suffering from chronic illness.
Electroconvulsive Therapy (ECT)
ECT is a powerful treatment for depression that isn't improving by taking medication. It is especially helpful for those who are suicidal or who are unable to wait for their medication to take effect.
During ECT doctors transmit small electrical currents to the head to deliberately trigger a short seizure. The result is that the brain changes chemical structure and improve symptoms of some mental health conditions. ECT has been around since the 1930s. Despite depression treatment advancements attached to the treatment it has helped many people.
Your doctor will first have to perform a thorough psychiatric evaluation before making a recommendation for ECT. They will then go through your medical records and conduct several tests, such as an electrocardiogram, blood tests, and perhaps a chest X ray. They will ask you to describe how you are feeling about ECT, and consider any opinions of family members or friends who are speaking on your behalf.
The ECT procedure is done under general anesthesia so you won't feel any sensation. A mouthguard protects your teeth, and masks protect your face to provide oxygen. An anesthesiologist injects an anesthetic through a needle in your vein. Once you've fallen asleep, electrodes will be placed on either or both sides of your head (depending on whether you have unilateral or bilateral ECT). These send tiny electrical impulses to the brain, which trigger an instant seizure. It lasts for 20 to 60 seconds and you'll wake up soon after it's over.
It's important to remember that you can revoke your consent for ECT at any time, even just before 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 use ECT.
Some people find ECT is a great alternative after having tried other therapies but did not see any improvement, but it can also be used to treat mild depression or severe psychosis, or when you pose risky to others or yourself and you are unable to wait for medication to begin working. In most instances, you'll need undergo several ECT sessions over the course of three to six weeks.
Light therapy
Light therapy compensates for lack of sunlight, which could contribute to major depressive disorder that has seasonal patterns (formerly called seasonal affective disorder). It can be used as a separate treatment or to complement other treatments, such as psychotherapy and medications. During light therapy, you are seated near a light box or lamp which emits bright light usually in the range of 2,500 to 10,000 lux. During each treatment session, you sit for about 30 minutes near the light. The light can boost your mood and alleviate symptoms of SAD like feeling constantly tired and a sleepy night.
Researchers aren't aware of what the effects of light therapy on SAD. However they do know that it has an effect on the circadian rhythms. Circadian rhythms are biological cycles that affect the pattern of sleep, hormone levels, and other important functions. Light therapy can reset the internal clock of your body by influencing the release of melatonin, 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 improve depression symptoms and increases the effectiveness of antidepressant medications. Numerous studies have also demonstrated that light therapy can be used to treat bipolar disorder. These results are encouraging, and suggest that light therapy could be a viable option for people suffering from bipolar disorder and depression.
Before you begin using light therapy, consult your doctor or mental health professional about it. They can assist you in selecting the appropriate device and give you instructions on how to use. They can also inform you if it interferes with other medications you take.
Light therapy is a secure treatment that does not cause serious adverse side effects. However, it is important to use it as prescribed by your physician. If you're suffering from severe depression, it's essential to seek treatment right away. Depression is a serious disease, and it can have severe consequences for your emotional and physical well-being. In extreme cases, depression can cause suicidal thoughts. If you're having suicidal thoughts, seek help immediately from an expert in mental health.