Advanced Depression Treatment

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

Newer psychotherapy methods like augmented depression therapy offer empirical support and can aid in reducing depression symptoms. These treatments are aimed at identifying and resolving specific ways in which depression treatment without meds interferes with 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 typically prescribed to treat depression when medications fail or are not suitable for the person. It can also be used to treat PTSD and is sometimes combined with psychotherapy. TMS is a safe and effective treatment that doesn't cause severe side effects.

During the session, the healthcare professional will position an electromagnetic coil on your scalp to the brain region that regulates mood. In the case of rTMS, it is the dorsolateral prefrontal cortex (dLPFC). It is a small region situated on the front of your head. The device will deliver signals to the brain. You will hear sounds of clicking and feel tapping sensations. The healthcare professional will alter the settings to stimulate the desired areas of your brain.

The healthcare professional will assess the strength of the pulses by determining the amount of energy required to elicit an itch in the thumb. This is important as it helps them to know how much power they're using and to ensure the safety of the patient. In the past, pulses were delivered at 120% of the threshold for motor. Current research is focused on speeding up TMS treatment to reduce time to treatment and increase response rates.

In a controlled trial that was randomized researchers have proven that TMS can aid people suffering from major depressive disorder (MDD) who are unable to respond to antidepressants. The study found that those treated with rTMS experienced significant improvements in symptoms such as depression sadness, depression, changes in appetite, and decreased enjoyment or interest in certain activities. The study also revealed that the improvement was long-lasting.

TMS is different from other forms of brain stimulation such as electroconvulsive treatment and vagus nerve stimulator. It does not interfere with psychotherapy. It is safe for pregnant women and has a low chance of seizures. However, some individuals may feel pain or discomfort on the scalp underneath the magnet while they are receiving treatment.

Typical TMS treatments last about half an hour. Your doctor will inform you what the duration of the treatment will last and may even stop the pulses at this point to let the magnet cool down.

Vagus Nerve Stimulation (VNS)

VNS (also known as Vagus Neuro Stimulation Therapy) is a treatment option that transmits periodic electrical signals to alter brain wave patterns and decrease depression symptoms. This is a surgically implanted device that uses a small pulse generator that connects to a wire which is wrapped beneath the skin and wound around the left vagus nerve in the neck. The procedure has been approved by the FDA for treatment-resistant depression in people who have not found relief from other treatments such as psychotherapy or medication. It is also approved for seizure control in a few epileptic patients.

Researchers evaluated the effectiveness of VNS with a sham-device in patients with bipolar disorder that is resistant to treatment or depression. The VNS group received an extremely low, medium dose, or high dose of electrical stimulation over a 22-week period. The primary endpoint was the changes in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS group improved significantly more than those in the group with a sham. After a 12-month follow-up participants in the VNS group had an average IDS-SR30 score of 9.3 points, whereas those in the sham group scored 4.2 points.

The VNS therapy was well tolerated, with the most common side effects being voice alteration or hoarseness and a feeling of weight on the chest. Other reported side effects were headaches, tingling fatigue, fatigue, and changes in speech or swallowing. Some of these side effects were observed more frequently in the higher dose groups while others occurred at all doses. The frequency of AEs was similar to that in other studies, and generally eliminated by the end of the acute study period.

Psychiatrists from Ohio State Wexner Medical Center are frequently invited to participate in national discussions about the best natural treatment for anxiety and depression approach to treat depression and mood disorders. Our experts are involved in shaping the national standards of care and are currently a participant for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial to further study VNS as a treatment for treatment-resistant depression. This is a crucial research project, as the evidence available today suggests that VNS can offer improving benefit and hope for this difficult-to-treat chronic population.

Electroconvulsive Therapy (ECT)

ECT is an effective treatment for depression that is advanced and suitable for people who don't get better on their medications. It is especially helpful for people who are suicidal or are unable to wait until their medication to take effect.

During ECT doctors use small electrical currents to the head to deliberately trigger a short seizure. This seems to change brain chemical structure and improve the symptoms of certain mental health conditions. ECT has been in use since the 1930s. Despite the stigma attached to the treatment it has helped many people.

If you are to receive ECT the doctor will require an extensive psychiatric evaluation. Then, they will examine your medical history and do various tests which include an electrocardiogram (EKG) and blood tests, and possibly 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 carried out under general anesthesia so you will not feel anything. A mouth guard is put on to protect your teeth and a mask is put over your face to provide oxygen. An anesthesiologist injects an esthetic into your vein with needle. After you have fallen asleep, electrodes are placed on one side or both of your head depending on whether you are receiving unilateral or bilateral ECT. These pulses deliver small electrical impulses to the brain, which triggers brief seizures. It lasts only 20 to 60 second and you will be able to get up shortly after.

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

Some people find that ECT is a good alternative after having tried other treatments but did not see any improvement. However, it is also a viable option for mild depression or severe psychosis or if you're a danger to yourself or others and can't wait for medication to start working. In the majority of instances, you'll need take several ECT sessions over the course of three to six weeks.

Light therapy

Light therapy helps to compensate for the absence of sunlight. This is a reason that can cause seasonal affective disorder (formerly known as major depressive disorder). It can be used as a stand-alone treatment or as an addition to other treatments, like psychotherapy or medication. In light therapy, you are seated close to a light box lamp that emits bright light, typically in the range of 2,500-10,000 lux. During each session, you'll be sitting for 30 minutes at the lamp. The light can improve your mood and alleviate symptoms of SAD like being tired all the time and sleeping too much.

Researchers don't yet know 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 influence the pattern of sleep hormone levels, sleep patterns, and other vital functions. Light therapy can reset the internal clock of your body by altering the release of melatonin, the chemical that regulates sleep and wake cycles. It can also affect neurotransmitter functions by affecting serotonin production.

Several studies have shown that light therapy can improve depression symptoms and boosts the effectiveness of antidepressant drugs. Several studies have also shown that light therapy can be used to treat bipolar disorder. These findings are encouraging, and suggest that light therapy could be an option for those suffering from bipolar disorder and depression.

Before you begin using light therapy, speak to your doctor or a mental health professional about it. They can assist you in finding the right device for your needs, and provide instructions on how to use it. They can also inform you whether it interacts with other medications that you are taking.

Light therapy is a successful treatment that does not cause any adverse side negative effects. However, it is important to use it according to the instructions of your doctor. It is essential to seek treatment as quickly as you can if suffering from severe depression. Depression is a serious illness that can cause serious consequences on your mental and physical well-being. In severe cases, it could cause thoughts of suicide. Seek immediate assistance from a mental healthcare professional in the event that you feel suicidal.