Advanced Depression Treatment

If your depression doesn't respond to a first-line antidepressant, your doctor might suggest increasing the dosage or adding another type of medication. They may also recommend psychotherapy.

Modern psychotherapy techniques like augmented depression therapy have scientific support and can help improve depression symptoms. These treatments aim at the identification and resolution of specific ways that depression interferes with daily life.

Transcranial Magnetic Stimulation (TMS)

A type of noninvasive brain stimulation, TMS employs magnetic impulses to alter the neurons responsible for mood. It is usually suggested to treat depression when medications fail or are not suitable for the individual. It is used to treat PTSD, and is sometimes combined psychotherapy. TMS is an effective and safe treatment with no serious negative side negative effects.

During the session, a healthcare 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 called the dorsolateral frontal cortex (dLPFC). This is a small area situated in front of your brain. You will hear a clicking sound and feel a tapping sensation as the device sends the brain with electrical impulses. The healthcare professional will alter the settings to stimulate the desired areas of your brain.

The healthcare professional will determine the strength of the pulses using how much energy is required to induce an itch in the thumb. This is important because it allows them to determine the amount of power they are using and to ensure the safety of the patient. In the past, the pulses were delivered at 120 percent of the threshold of motor. Current research focuses on accelerating TMS treatment to decrease 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 revealed that patients who were treated with rTMS showed significant improvement in symptoms like low mood, sadness, changes in appetite, and loss of enjoyment or interest in certain activities. The study also found that the improvements were long-lasting.

TMS is different from other forms of brain stimulation like electroconvulsive treatment and vagus nerve stimulator. It does not interfere in psychotherapy. It is safe for women who are pregnant and has a low chance of seizures. Some people may feel pain or discomfort on their scalps under the magnet during treatment.

The majority of TMS treatments last for about half an hour. Your doctor will let you know how long the treatment is and may stop the treatment to allow the magnet to cool.

Vagus nerve stimulation (VNS)

VNS (also known as Vagus Neuro Stimulation Therapy) is a treatment resistant anxiety and depression option that sends timed electrical signals to change brain wave patterns and lessen depression treatment without medication symptoms. This is an implanted surgical device that employs a tiny pulse generator that is connected to a wire that's threaded under the skin and wrapped around the left vagus nerve in the neck. FDA approved the procedure for those suffering from treatment-resistant depression who have not had relief from other treatments like psychotherapy and medications. It's also approved to control seizures in certain epileptic patients.

In the largest clinical study of VNS researchers compared its effectiveness against a sham device in people who had treatment-resistant unipolar or depressed-phase bipolar disorder. Patients in the VNS group received a low, medium or high dose of electrical stimulation during an 22-week "acute phase." The primary end point was a change in Inventory of Depressive Symptomatology Self-Report (IDS-SR30) score throughout the study. Patients in the VNS group improved significantly more than those in the group with a sham. At the 12-month check-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 common side effects were voice alteration hoarseness, a feeling of numbness, and a sensation in the chest. Other reported side effects included headaches, tingling fatigue, fatigue, and changes to swallowing or speech. Some of these happened more often in the higher dose groups, while others were seen at all doses. The frequency of AEs was comparable to those observed in other studies, and they generally eliminated by the end of the acute study period.

The psychiatrists at Ohio State Wexner Medical Center regularly participate in national discussions about the best ways to treat depression and other mood disorders. Our experts help shape the standards of care for all Americans and are currently a participant for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial to further investigate VNS as a treatment option for treatment-resistant depression. This is an important research effort, as the evidence available suggests that VNS may provide improved benefits and hope for this difficult-to-treat chronic population.

Electroconvulsive Therapy (ECT)

ECT is an effective treatment depression (you can try sciencewiki.science) for advanced depression for those who can't get better with medication. It's especially useful for those who are suicidal or cannot wait for their medication to kick in.

During the ECT procedure, doctors send small electric currents through the brain to trigger a brief seizure. This seems to change brain chemical structure and speedily improve symptoms of mental health issues. ECT has been used since the 1930s, and despite the stigma that is associated with the treatment, a lot of people have successfully benefited from it.

Your psychiatrist will first need to conduct a thorough psychiatric evaluation before recommending ECT. Then they will examine your medical history and perform a series of tests which include an electrocardiogram (EKG) as well as blood tests, and perhaps an X-ray of your chest. They will also inquire what you think about the possibility of having ECT and consider any views from family members, friends, or advocates who are supporting or speaking for you.

The ECT procedure is done under general anesthesia so you won't feel any sensation. A mouth guard protects your teeth, while masks protect your face to provide oxygen. An anesthesiologist injects an the anesthetic via a needle into your vein. When you are asleep, electrodes are placed on either one or both of your head based on whether you are receiving unilateral or bilateral ECT. These electrical pulses send small impulses to the brain, which triggers brief seizures. It only lasts 20 to 60 seconds and you awaken within a few minutes after it's finished.

You can withdraw your consent to ECT at any time, even before the first treatment. You have the right to revoke your consent under the Care Quality Commission (CQC) and your doctor must always take your preferences into consideration when deciding whether or not to use ECT.

Some people find ECT is a good option for them after they've tried other therapies but did not see any improvement, but it can also be used for mild depression or severe psychosis, or when you pose at risk to yourself or others and you are unable to wait for medication to begin working. In most instances, you'll need undergo several ECT sessions over three to six weeks.

Light therapy

Light therapy compensates for lack of sunlight, which could contribute to major depressive disorder with seasonal patterns (formerly called seasonal depression treatment affective disorder). It can be used as a standalone treatment or in conjunction with other treatments such as psychotherapy and medications. During the treatment, you sit in front of a light box or lamp that emits bright light, typically between 2,500 and 10,000 light lux. Each time you undergo a treatment you are seated for approximately 30 minutes at the light source. The light can help improve your mood and ease symptoms of SAD such as being tired all the time and sleeping excessively.

Researchers aren't aware of what the effects of light therapy on SAD. However, they know that it can have an impact on the circadian rhythms. Circadian rhythms influence 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 also impacts neurotransmitter function through affecting the production of serotonin, a chemical that lifts your mood.

Numerous studies have demonstrated how light therapy can reduce depression symptoms and enhance the effectiveness of antidepressant medications. Several studies have also shown that light therapy can be used to treat bipolar disorder. These findings are encouraging and suggest light therapy could be a viable option for those who suffer from bipolar and depression disorder.

Talk to your doctor or mental health professional prior to you start using light therapy. They can assist you in selecting the appropriate device and provide you with guidelines on how to use it. They can also tell if it is incompatible with other medications that you take.

Light therapy is a safe treatment that is not likely to cause serious adverse side effects. It is best to only take it if your doctor prescribes. It is crucial to seek treatment as quickly as you can if you're suffering from severe depression. Depression is a serious illness and it can result in grave consequences for your physical and mental well-being. In extreme instances, it may lead to thoughts of suicide. If you are having suicidal thoughts, seek help immediately from a mental health professional.