Advanced Depression Treatment

If your depression doesn't respond to a first-line antidepressant your doctor might suggest increasing the dose or adding a different medication. They may also recommend psychotherapy.

Modern psychotherapy techniques like augmented depression therapy have empirical support and can help improve depression symptoms. These treatments aim at finding and resolving specific ways depression affects your daily life.

Transcranial magnetic stimulation (TMS)

A form of non-invasive brain stimulation, TMS utilizes magnetic impulses to influence the brain's neurons that are responsible for mood. It is usually prescribed to treat depression when medication fails or is not suitable for the person. It is also used to treat PTSD and is sometimes paired with psychotherapy. TMS is a safe and effective treatment that doesn't cause serious side effects.

During the session, a medical professional will place an electromagnetic coil on your scalp that is over the brain region that controls mood. In the case of rTMS this is the dorsolateral frontal cortex (dLPFC). It is a tiny area located on the front of your head. The device will send electrical impulses to your brain. You will hear clicking sounds and feel tapping sensations. The healthcare professional will adjust settings to stimulate desired areas of the brain.

The healthcare professional will assess the strength of the pulses using the amount of energy required to induce the thumb to twitch. This is crucial, since it allows them to know the amount of energy they are employing to ensure the safety of patients. In the past, pulses were administered at 120% of motor threshold. But, current research is focused on accelerating TMS therapy to reduce duration of treatment and increase response rates.

Researchers have demonstrated in a randomized controlled study that TMS can help people with MDD who do not respond well to antidepressants. The study showed that patients treated with rTMS experienced significant improvement in symptoms, such as sadness and low mood as well as changes in appetite and decreased enthusiasm or enjoyment for activities. The study also showed improvements that lasted a long duration.

Unlike other types of brain stimulation such as vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy. It is also safe for women who are pregnant and has a very low risk of seizures. Some people may feel pain or discomfort on their scalps beneath the magnet during treatment.

TMS treatments usually last for around 30 minutes. The doctor will inform you of the length of the treatment and may also pause the pulses to allow the magnet to cool.

Vagus nerve stimulation (VNS)

VNS (also known as Vagus Nerve Stimulation) is a treatment that makes use of timed electrical signals in order to change brainwave patterns and reduce depression symptoms. The device is surgically implanted, and it uses an insignificant generator that is connected to a wire wrapped around the left Vagus nerve of the neck. The procedure has been approved by the FDA for treating depression that is resistant to treatment in patients who have not received relief from other treatments like psychotherapy or medications. It's also approved as a seizure treatment to those suffering from epilepsy.

In the largest study of VNS researchers compared its effectiveness with a sham device in people 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 the 22-week "acute phase." The primary end point was a change in the Inventory of Depressive Symptomatology Self Report (IDS-SR30) score over the course of the study. Patients in the VNS groups had significantly better results than those in the sham groups. At a 12-month check-up the VNS group scored an average IDSSR30 of 9.3 while the group of sham scored 4.2.

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

Psychiatrists from Ohio State Wexner Medical Center are frequently invited to participate in national discussions about the best way to treat depression and mood disorders. Our experts are involved in shaping 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 for treatment-resistant depression. This is an important research project, as the evidence suggests that VNS could provide a better treatment for patients who are chronically ill.

Electroconvulsive Therapy (ECT)

ECT is a potent treatment for depression that doesn't improve through medication. It's especially useful for those who are suicidal or unable to wait for their medication to take effect.

During ECT, doctors send small electrical impulses through the head to intentionally cause a brief seizure. This appears to alter brain chemical processes, and may help alleviate symptoms of some mental health conditions. ECT has been used since the 1930s. Despite the stigma associated with the treatment, it has helped many people.

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

The ECT procedure is done under general anesthesia so you won't feel anything. A mouth guard is used to protect your teeth, and masks cover your face to allow oxygen. An anesthesiologist injects an esthetic into your vein by using needle. After you are asleep, electrodes are placed on either or both sides of your head (depending on whether you suffer from bilateral or unilateral ECT). These send tiny electrical impulses to the brain, which trigger a short seizure. It lasts for 20 to 60 seconds, and you'll be awake within a few minutes after.

It's important to remember that you can revoke your consent for ECT at any time, even just 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 wishes into consideration when deciding whether or not to use ECT.

ECT is a great treatment option for people who tried other treatments but have failed to notice any improvement. It can also help those suffering from mild depression treatment psychology, severe psychosis, or when you're a risk to yourself or others and cannot wait for medication effects to begin. In the majority of instances, you'll need take several ECT sessions over three to six weeks.

Light therapy

Light therapy compensates the lack of sunlight. This is a reason that can contribute to the development of seasonal affective disorder (formerly known as major depression). It can be used as a standalone treatment or in conjunction with other treatments such as psychotherapy and medications. In light therapy you sit in front of a light box that emits white light with bright colors. The light intensity is typically between 2,500 and 10,000 light lux. During each session, you will sit for 30 minutes near the lamp. The light can improve your mood and alleviate symptoms of SAD such as being exhausted all the time and sleeping excessively.

Although scientists don't know for certain how light therapy works to treat SAD but they do know Meds that treat depression and anxiety it has an immediate influence on the circadian rhythms. Circadian rhythms are biological cycles that impact sleep patterns, hormone levels, and other vital functions. Light therapy can alter 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 production of serotonin.

A number of studies have proven that light therapy improves depression symptoms and boosts the effectiveness of antidepressant medication. A number of studies have also proven that light therapy can be used to treat bipolar disorder. These results are encouraging, and suggest that light therapy could be an option for those with inpatient depression treatment centers and bipolar disorder.

Consult your doctor or a mental health professional before you start using light therapy. They can help you find the right device for your needs, and provide guidance on how to use it. They can also tell whether it is incompatible with other medications that you take.

Light therapy is a successful treatment that is safe and does not cause negative side adverse effects. However, you should use it in accordance with the prescriptions of your doctor. If you're experiencing severe depression, it is essential to seek treatment right away. Depression is a serious illness that can have a significant impact on your physical and mental well-being. In severe cases, depression may lead to suicidal thoughts. If you are having suicidal thoughts or feelings, seek help immediately from a mental health professional.