Advanced Depression Treatment
If you don't see any improvement from an antidepressant that you first try, your doctor could increase the dosage or suggest another kind of medication. They may also suggest psychotherapy.
depression treatment resources I Am Psychiatry , such as enhanced depression treatment have scientific evidence-based support and could help alleviate depression symptoms. These treatments concentrate on identifying and solving the specific ways depression affects your daily routine.
Transcranial magnetic stimulation (TMS)
TMS is a noninvasive brain stimulation technique that utilizes magnetic pulses to stimulate the brain's neurons that control mood. It is typically used to treat depression when medication fails or isn't suitable for the person. It is also used to treat PTSD and is sometimes paired with psychotherapy. TMS is an effective and safe treatment that doesn't cause serious side effects.
During the session, a health professional will install an electromagnetic coil over the area of your brain that controls mood. In the case of rTMS, this is the dorsolateral frontal cortex (dLPFC). This is a small area that is located in front of your head. You will hear a click sound and feel a tapping sensation as the device delivers pulses to your brain. The healthcare professional will adjust the settings to stimulate the specific areas of your brain.
The healthcare professional will determine the strength of the pulses by determining the amount of energy required to elicit an itch in the thumb. This is crucial because it lets them know the power they are employing to ensure the safety of patients. In the past, pulses were delivered at 120 percent of the motor threshold. The current research focuses on speeding up TMS treatment to reduce the duration of treatment and increase the rate of response.
In a randomized control trial researchers have proven that TMS can aid people suffering from major depressive disorder (MDD) who do not respond to antidepressants. The study showed that patients who were treated with rTMS saw significant improvements in symptoms such as sadness and low mood as well as changes in appetite and loss of enthusiasm or enjoyment in activities. The study also showed that the improvement was long-lasting.
In contrast to other forms of brain stimulation like vagus nerve stimulation or electroconvulsive therapy, TMS does not interfere with psychotherapy. It is also safe for women who are pregnant, and it has a very low risk of having seizures. Some people might experience pain or discomfort on their scalp beneath the magnet while they are receiving treatment.
The majority of TMS treatments last around 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 called Vagus Nerve Stimulation Therapy) is an option for treatment that sends timed electrical signals to change brain wave patterns and lessen depression symptoms. This device is surgically implanted and consists of an insignificant generator that is connected to a wire 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 such as psychotherapy or medications. It is also approved for seizure control in a few epileptic patients.
Researchers compared the efficacy of VNS with a sham device in people with bipolar disorder that is resistant to treatment or depression. The VNS group was given an extremely low, medium dose, or high dose of electrical stimulation for 22 weeks. The primary goal was improvement in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS group had significantly better results than those in the group of sham. At the 12-month check-up the VNS group had an average IDSSR30 score of 9.3 while the group of sham scored 4.2.
The VNS treatment was well-tolerated. The most frequent adverse effects were voice changes hoarseness and a feeling on the chest. Other reported side effects included the feeling of tingling, headache fatigue, fatigue and changes in speech or swallowing. Certain of these were more frequently in higher dose groups, whereas others happened at all doses. The rate of AEs was comparable to those observed in other studies, and generally resolved by the end of the acute study period.
Psychiatrists from Ohio State Wexner Medical Center are regularly invited to take part in national discussions on the best method to treat depression and mood disorders. Our experts are involved in shaping the national standards of care and are currently a site for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial that will further evaluate VNS as a treatment option for treatment-resistant depression. This is a crucial research endeavor, since the evidence suggests that VNS could be a more effective treatment for this chronically ill population.
Electroconvulsive therapy (ECT)
ECT is an effective advanced depression treatment for those who aren't getting better with medication. It is particularly helpful for people who are suicidal or are unable to wait until their medication to start working.
During ECT, doctors send small electrical impulses through the head to deliberately trigger a short seizure. This is believed to alter brain chemical structure and improve the symptoms of mental health issues. ECT has been in use since the 1930s, and despite the stigma that is associated with the treatment, a lot of people have successfully benefited from it.
If you are to receive ECT the doctor will need to do an exhaustive psychiatric assessment. They will review your medical records and perform various tests, such as an electrocardiogram, blood tests and perhaps a chest X ray. They will ask you to describe how you think about ECT and take into account any opinions from family members, friends, or advocates speaking on your behalf.
The ECT procedure is carried out when you're asleep under general anesthesia, so you won't feel any pain during the procedure. A mouthguard protects your teeth, and masks cover your face to allow oxygen. The anesthesiologist injects Anesthetic using a needle in your vein. When you are asleep, electrodes will be placed on one side or both of your heads based on whether you are receiving unilateral or bilateral ECT. These deliver small electrical pulses to the brain, which trigger brief seizures. It only lasts 20 to 60 seconds and you'll awaken soon after it's over.
It is important to remember that you can withdraw your consent for ECT at any time, even just before the first treatment. This is your right under the Care Quality Commission (CQC) regulations, and your doctor should always consider your wishes when deciding whether to use ECT for you.
ECT is a great treatment option for people who tried other treatments but have failed to notice any improvement. It can also be helpful those suffering from mild depression, severe psychosis, or when you're a risk to yourself or others and can't wait for medication effects to take effect. Most people will require several ECT sessions spread out over three to six weeks.
Light therapy
Light therapy can compensate for the lack of sunlight. This is a factor which may contribute to the development of seasonal affective disorder (formerly known as major depressive disorder). It can be used as a stand-alone treatment or to complement other treatments such as psychotherapy and medications. When you undergo light therapy you are seated next to a light box that emits white light with bright colors. The light intensity is typically between 2,500 and 10,000 in lux. Each session, you'll be sitting for 30 minutes in front of the lamp. The light can boost your mood as well as ease other symptoms of SAD that can be a problem, like being tired all the time and sleeping too much.
Although researchers don't know exactly how light therapy works to treat SAD however, they do know that it has a direct effect on circadian rhythms. Circadian rhythms are biological cycles that influence sleep patterns, hormone levels, and other vital functions. Light therapy can reset your internal clock by altering the release of melatonin, which is a chemical that regulates your sleep-wake cycle. It can also impact neurotransmitter function by affecting the production of serotonin, a chemical that lifts your mood.
Several studies have shown that light therapy can improve 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 light therapy might be a viable option for those with both depression and bipolar disorder.
Consult your physician or a mental health professional prior to you start using light therapy. They can help you choose the appropriate device for your needs and provide instructions on how to use it. They can also inform you whether it interacts with other medications you are taking.
Light therapy is a secure treatment that does not cause any serious side effects. It is best to only take it if your doctor prescribes. It is essential to seek treatment as quickly as you can if you're suffering from depression that is severe. Depression is a serious illness and it can result in grave consequences for your physical and emotional well-being. In severe instances, depression can result in suicidal ideas. If you are having suicidal thoughts or feelings, seek help immediately from a mental health professional.