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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 might also suggest psychotherapy.

The latest psychotherapy techniques, such as augmented depression therapy offer empirical evidence-based support and can help reduce depression symptoms. These treatments are aimed at identifying 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 alter the brain cells responsible for mood. It is usually prescribed to treat depression when medications fail or are not suitable for the person. It is used to treat PTSD, and is sometimes combined with psychotherapy. TMS is an effective and safe treatment, with no significant negative side effects.

During the session, the healthcare professional will position an electromagnetic coil on your scalp to the brain region that controls mood. In the case of rTMS, this is known as the dorsolateral forefrontal cortex (dLPFC). It is a small region situated on the front of your head. You will hear a click sound and feel a thumping sensation as the device delivers signals medicines to treat depression your brain. The healthcare expert will adjust the settings to stimulate the desired areas of your brain.

The healthcare professional will determine the amount of energy required to trigger a thumb flick. This is important as it helps them know how much power they're using and ensures the safety of the patient. In the past, pulses were administered at 120% of the motor threshold. However, current research is focused on accelerating TMS therapy to reduce the duration of treatment and increase response rates.

Researchers have demonstrated in a controlled, randomized study that TMS can help people with MDD who do not respond well 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 enthusiasm for activities. The study also revealed that the effects lasted for a long time.

In contrast to other types of brain stimulation such as vagus nerve stimulation or electroconvulsive therapy, TMS does not interfere with psychotherapy. It is safe for pregnant women and has a low risk of seizures. Some people might experience pain or discomfort on their scalps under the magnet during treatment.

The typical TMS treatments last around half an hour. Your provider will tell you what treatment for depression the duration of the treatment will last and may pause the pulses during this time to allow the magnet to cool down.

Vagus Nerve Stimulation (VNS)

VNS (also called Vagus Nerve Stimulation Therapy) is a treatment option that transmits precise electrical signals to alter brain wave patterns and reduce herbal depression treatments symptoms. It's an implanted surgical device that uses a small pulse generator that is connected to a wire which is threaded beneath the skin and wound around the left vagus nerve inside the neck. The procedure is FDA-approved for treating depression that is resistant to treatment in patients who have not received relief from other treatments such as psychotherapy or medication. It is also approved for seizure control in a few epileptic patients.

In the largest clinical study of VNS, researchers compared its effectiveness with an sham device for patients 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 over a 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 groups improved significantly more than those in the sham group. At the end of a 12-month period patients in the VNS group had a mean IDS-SR30 score of 9.3 points, while those in the sham group scored 4.2 points.

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

Psychiatrists at Ohio State Wexner Medical Center regularly participate in national conversations on the best treatment for depression ways to treat depression and other mood disorders. Our experts are helping to shape national standards of health treatment. We are also a site for a multicenter clinical study called RECOVER which is being conducted by the Centers for Medicare & Medicaid Services. The goal of this study is to examine VNS for treating resistant depression. This is an important research project, as the available evidence suggests that VNS could provide a better shock treatment For depression for patients suffering from chronic illness.

Electroconvulsive Therapy (ECT)

ECT is a highly effective treatment for depression that doesn't improve by taking medication. It is especially helpful for those who are suicidal or are unable to wait until their medication to take effect.

During the ECT procedure doctors send tiny electric currents to the brain to trigger a brief seizure. The brain is reportedly altered by this chemical structure and improve the symptoms of mental health issues. ECT has been around since the 1930s. Despite the stigma attached to the treatment, it has helped many people.

Your doctor will first have to perform a thorough psychiatric examination before suggesting ECT. They will then go through your medical records and run various tests, such as an electrocardiogram, blood tests and maybe the chest X-ray. They will ask you about how you feel about ECT and will take into account any opinions of family members or friends representing you.

The ECT procedure is carried out under general anesthesia so you will not feel anything. A mouth guard is put in place to protect your teeth and an air mask is placed over your face to allow oxygen. An anesthesiologist injects an esthetic into your vein using a needle. When you're asleep, electrodes are placed on both sides of your head (depending on whether you have bilateral or unilateral ECT). These send tiny electrical impulses to the brain that cause an instant seizure. It lasts between 20 and 60 seconds, and you'll be able to get up shortly after.

You are able to revoke your consent to ECT at any point prior to the first treatment. This is your right under the Care Quality Commission (CQC) regulations and your doctor must always take into account your wishes when deciding on ECT for you.

Certain people find ECT is a good option after having tried other treatments and did not see any improvement, but it is also a viable option to treat mild depression or severe psychosis or when you are risky to others or yourself and can't wait for medication to start working. The majority of patients will require several ECT sessions spread over three to six weeks.

Light therapy

Light therapy compensates the lack of sunlight. This is a reason that can contribute to seasonal affective disorder (formerly known as major depression). It is used as a stand-alone therapy or as an adjunct to other treatments, such as psychotherapy or medication. During the treatment, you sit near a light box or lamp that emits bright light usually between 2,500 and 10,000 lux. During each session, you'll sit for 30 minutes at the lamp. The light may help improve your mood and alleviate other symptoms of SAD, such as being tired most of the time and sleeping too much.

Although researchers aren't sure how light therapy can help treat SAD, they do know that it has an immediate impact on circadian rhythms. Circadian rhythms impact sleep patterns, hormones, and other functions. Light therapy can reset the internal clock of your body by influencing the release of melatonin, an ingredient that regulates sleep-wake cycles. It also affects neurotransmitter functions by altering the production of serotonin.

A number of studies have proven that light therapy can improve depression symptoms and increase the effectiveness of antidepressant medications. Several studies have also shown that light therapy can be used to treat bipolar disorder. These results are encouraging and suggest that light therapy could be a viable option for people with depression and bipolar disorder.

Before you start using light therapy, talk to your physician or a mental health professional about it. They can assist you in choosing the right device and provide you with instructions on how to use. They can also inform you if it interferes with other medications you're taking.

Light therapy is a safe treatment that does not cause serious adverse side negative effects. You should only use it when your doctor prescribes. It is essential to seek treatment as soon as you can if suffering from severe depression. Depression is a serious disease that can have a significant impact on your physical and mental well-being. In extreme cases, depression can result in suicidal ideas. Get immediate help from a mental health professional If you are experiencing suicidal thoughts.