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Advanced Depression Treatment

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

Modern psychotherapy techniques like augmented depression therapy have scientific support and can help improve depression symptoms. These therapies are focused on identifying and resolving specific ways that depression affects your daily life.

Transcranial magnetic stimulation (TMS)

TMS is a non medical treatment for Depression-invasive brain stimulation that uses magnetic pulses to stimulate the brain's neurons that control mood. It is frequently advised to treat depression if medications fail or are not suitable for a person. It is also used to treat PTSD and is sometimes combined with psychotherapy. TMS is an effective and safe treatment with no serious side adverse effects.

During the session, the medical professional will place an electromagnetic coil on your scalp that is over the region of the brain that controls your mood. In the case of rTMS, it is known as the dorsolateral forefrontal cortex (dLPFC). This is a small area 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 areas you want of your brain.

The healthcare professional will determine the amount of energy needed to cause a thumb twitch. This is important because it helps them know how much power they're using and to ensure the safety of the patient. In the past, pulses were administered at 120% of the motor threshold. Current research focuses on accelerating TMS treatment to decrease time to biological treatment for depression and increase the rate of response.

Researchers have shown in a randomized controlled trial that TMS can aid people suffering from MDD who are not responding well to antidepressants. The study showed that patients treated with rTMS saw significant improvement in symptoms like depression, sadness, changes in appetite, and decreased enjoyment or interest in activities. The study also showed that the improvements were 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 women who are pregnant and has a low chance of seizures. Some people might experience pain or discomfort on their scalp beneath the magnet while they are receiving treatment.

TMS treatments usually last for around 30 minutes. Your doctor will let you know how long the treatment is and may stop the treatment to allow the magnet to cool down.

Vagus nerve stimulation (VNS)

VNS (also called Vagus Nerve Stimulation Therapy) is a treatment option that sends precise electrical signals to alter brain wave patterns and lessen 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 at the neck. The procedure is FDA-approved for treating depression that is resistant to treatment in patients who have not found relief from other treatments like psychotherapy or medications. It is also approved for seizure control in a few epileptic patients.

In the most comprehensive clinical study of VNS researchers compared the effectiveness against the use of a sham device among patients who had treatment-resistant monopolar or depressed-phase bipolar disorder. Patients in the VNS group received a moderate depression treatment, low or high dose of electrical stimulation throughout the 22-week "acute phase." The primary goal was changes in the Inventory of Depressive Symptomatology (IDS-SR30). Patients in the VNS groups had significantly better results than patients in the sham group. After a 12-month follow-up, the VNS group had a mean IDSSR30 of 9.3 while the group of sham scored 4.2.

The VNS treatment was well tolerated. The most frequently reported side effects were voice distortion hoarseness and a feeling on the chest. Other reported side effects included headache, tingling, fatigue and changes in swallowing or speech. Some of these occurred more often in the higher dose groups, while others happened at all doses. The frequency of AEs in this study was comparable to other studies, and they usually resolved by the end the acute study time.

The psychiatrists at Ohio State Wexner Medical Center regularly take part in national discussions about the best ways to treat depression and other mood disorders. Our experts are helping drugs to treat depression and anxiety establish national standards for health treatment. We are also a part of a multicenter clinical trial called RECOVER, which is being conducted by the Centers for Medicare & Medicaid Services. The goal of this study is to assess VNS for treating resistant depression. This is a crucial research effort, as the evidence available suggests that VNS could provide better benefits and hope to this difficult-to-treat chronic population.

Electroconvulsive therapy (ECT)

ECT is an effective advanced depression treatment for those who can't get better on their medications. It is particularly beneficial for those who are depressed or can't wait for their medication to kick in.

During the ECT procedure doctors transmit tiny electric currents through the brain to intentionally trigger an instant seizure. This is believed to alter brain chemistry and rapidly improve symptoms of certain mental health conditions. ECT has been used since the 1930s and despite the stigma associated with the treatment, many people have seen positive results from it.

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

The ECT procedure is performed under general anesthesia, so you will not feel any sensation. A mouth guard is put on to protect your teeth. an air mask is placed over your face to provide oxygen. An anesthesiologist injects a local anesthetic into your vein using a needle. After you have fallen asleep, electrodes will be placed on one side or both of your head based on whether you are receiving bilateral or unilateral ECT. These pulses deliver small electrical impulses to the brain, which triggers an instant seizure. It only lasts 20 to 60 seconds, and you wake up within a few minutes after it's finished.

You are able to revoke your consent to ECT at any point before the initial treatment. This is your right under Care Quality Commission (CQC) regulations, and your doctor should always consider your wishes when deciding on ECT for you.

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

Light therapy

Light therapy compensates the lack of sunlight. This is a reason that can cause seasonal affective disorder (formerly known as major depression). It can be used as a stand-alone therapy or as an addition to other treatments like psychotherapy or medication. During the treatment, you sit close to a light box lamp that emits bright light typically in the range of 2,500 to 10,000 lux. In each session you will sit for around 30 minutes near the light source. The light can boost your mood as well as ease other symptoms of SAD like being tired all the time and having trouble sleeping.

Researchers aren't aware of how light therapy can treat SAD. However they do are aware that it has an effect on the circadian rhythms. Circadian rhythms influence the patterns of sleep, hormones, and other functions. Light therapy can alter the internal clock of your body by altering the release of melatonin. It is a chemical which regulates sleep-wake cycles. It can also affect neurotransmitter functions by affecting serotonin production.

Numerous studies have demonstrated that light therapy improves depression symptoms and increases the effectiveness of antidepressant medications. In addition, a few studies have shown that light therapy is effective in treating bipolar disorder. These results are encouraging and suggest that light therapy might be an option for people who suffer from bipolar and depression disorder.

Before you start using light therapy, consult your physician or mental health professional about it. They can help you find the appropriate device for your needs and offer guidance on how to utilize it. They can also tell you whether it interacts with other medications you are taking.

Light therapy is a safe treatment that does not cause any adverse side negative effects. However, you should only use it as prescribed by your physician. If you're experiencing severe depression, it's important to get treatment immediately. Depression is a serious condition, and it can have severe consequences for your physical and mental well-being. In extreme instances, depression can result in suicidal ideas. If you are experiencing suicidal thoughts, seek help immediately from a mental health professional.