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Innovative Depression Treatments Many sufferers of depression are unable to find a treatment they can accept. Some suffer from no response to medications or suffer from uncontrollable adverse effects. The health benefits that come from scaled-up effective treatment coverage are believed to be substantial (table 2). The discounted value for depression is $399 billion and for anxiety disorders, $169 billion. Transcranial magnetic stimulation (TMS) TMS utilizes a magnetic field to deliver brief pulses of current to certain brain regions that appear to be overactive in depression patients. The treatment is non-invasive and does not require anesthesia. It's also extremely effective and well tolerated as compared to antidepressant drugs. A person is able to receive TMS by sitting in a chair that resembles dental chairs. A trained technician puts an instrument with a coil of magnetic material against the frontal area of the head. The coil pulses rapidly, and the person may hear or feel a clicking noise on their scalp. Each magnetic pulse is called”a “pulse” and the frequency of the pulses (measured in hertz or Hz) can range from low (1 pulse per second) to high (10 pulses per second). The treatment isn't painful however the magnetic field can affect cells in the cortex's outer layer. It depolarizes cortical neurons and the transynaptic effects can affect the brain's deeper regions that are involved in mood. For instance, a higher-frequency TMS over the left dorsolateral prefrontal cortex (DLPFC) can increase mesolimbic neurocircuits that modulate emotional responses. Certain insurance plans provide TMS as an alternative to psychiatric medication. It's important to check with your insurance provider to find out what your specific plan covers. In clinical trials, TMS produced significant and long-lasting improvements in depression symptoms versus a placebo. During a TMS treatment program patients can go through up to 30 sessions over a couple of weeks. Patients who suffer from more severe depression might require more time to complete their treatment. Certain of the latest TMS treatments employ low-frequency pulses, which is less likely to trigger side effects such as seizures. Although the procedure is being considered a research project however, it's a promising option for people who don't respond to antidepressants and psychotherapy. Electroconvulsive Therapy (ECT) ECT aids in restoring the brain's natural chemical balance. It is among the most efficient and safest treatments for depression. It can also be used in other mental health conditions such as schizophrenia. The ECT procedure is performed in a hospital or an outpatient treatment center. It is carried out by medical professionals. Prior to the procedure is completed, a general anaesthetic should be administered to ensure that you don't feel any discomfort. The ECT team will connect monitoring equipment to keep track of your heart rate oxygen levels, blood pressure and brain waves. You will be given a muscle relaxant and a mouthguard to protect your teeth. Two metal discs are positioned on the head, one each side or on your forehead. The anaesthetist will then inject you with a medication to help you sleep. You will be awakened in the ECT room. A member of the ECT staff will be available to answer any questions that you may have. Before you are treated you will be required to sign an authorization form. It may be difficult to absorb all the information when you're given information about ECT. It is recommended to have a family member or friend with you. You must be given at least 24 hours to think about the treatment prior to having to make a decision. During the procedure you will experience brief fits or seizures that last between 40 seconds and 2 minutes. The ECT doctor will adjust the intensity of your electric pulses based on how you respond. You will probably have short courses of ECT typically 6-12 sessions, twice a week. There isn't a single theory on how ECT works however, it does cause the release of certain chemicals that help your brain cells communicate with each other. It also appears to alter how parts of your brain expand. ECT is effective in treating severe depressions, suicidal feelings as well as catatonia secondary depression and other psychiatric disorders. Research shows that half of people who have ECT improve and remain healthy for one year or more. It's particularly beneficial for those who haven't been treated with medications or other psychosocial treatments. Deep brain stimulation (DBS). Deep brain stimulation (DBS) is a surgical procedure that involves the placement of electrodes into the brain. The electrodes are connected to a small neurostimulator that delivers electric pulses to the region of the brain that regulates your symptoms. The pulses could help alleviate your symptoms and enhance the quality of your life. DBS can treat a range of conditions which include movement disorders like essential tremor, Parkinson's disease, and psychiatric disorders like depression and obsessive-compulsive disorder. It also helps reduce seizures for people with epilepsy. It is also employed to treat severe pain caused by brain and nerve conditions. www.iampsychiatry.com is a successful treatment for many patients suffering from TRD, and it can be combined with other treatments, such as ECT. However, it is important to understand that not all patients benefit from DBS. Certain patients don't see any improvement in their symptoms, and some may even experience a worsening symptoms of depression. This non-response is likely due to a combination of factors, such as factors that are related to patients like personality traits or psychiatric comorbidity, and factors that affect the clinical, such as incorrect diagnosis or inadequate DBS treatment. Researchers used a machine learning algorithm to classify changes in LFPs that were observed during intraoperative DBS exposure. The results showed that changes in beta power were related to a decrease in depressive symptoms. These findings suggest that DBS can be used to predict antidepressant effects. However, more research is needed to test this hypothesis. Although DBS is a proven treatment for movement disorders and a growing array of psychiatric disorders but it is not widely known as an effective treatment for depression. The FDA has approved DBS to decrease seizures in people with difficult-to-treat Epilepsy. Research is currently being conducted to determine if DBS is effective in treating depression. Before undergoing DBS, you should discuss your options with a psychiatrist or neurologist. Your neurologist will evaluate you and recommend the best treatment option for you. They will explain the advantages and disadvantages of DBS. Additionally you should inquire about any tests or preparations you may need before the procedure. You may require a blood test, imaging and other tests prior to the procedure. Cognitive behavioral therapy (CBT) Cognitive behavioral therapy has been proven to be effective by a number different outcomes studies. It is typically employed as a stand-alone treatment however it can be combined with medication in some instances. CBT is a type of psychotherapy that helps you overcome negative beliefs and behaviors that are contributing to depression. It is based on the notion that how you perceive and react to situations is more significant than the actual situation. It is a very active type of psychotherapy and emphasizes solving problems and identifying and changing maladaptive thinking patterns. The purpose of CBT therapy is to help you become your own therapy. It accomplishes this by assisting you to change the way you think and act. It incorporates exercises and homework in sessions and outside of the session to help you learn new techniques. CBT focuses on current issues and problems and not past experiences or root causes. It requires some knowledge about your life experience to be able to deal with and address issues in the present. CBT is a relatively short-term therapy, typically lasting 6 to 20 sessions. It is an empirically-based therapy and its duration is determined by whether or not you are reaching the goals you established at the start of therapy. It is an active therapy that requires a high level of commitment and dedication on your part. There are many different types of cognitive behavior therapies that could be beneficial for you, including acceptance and commitment therapy, which trains you to take positive actions even when you are experiencing negative thoughts or emotions as well as dialectical behavior therapy, that is designed to deal with self-injury and suicidal thoughts that are persistent and interpersonal psychotherapy, which is aimed at resolving relationships that contribute to depression. There are a variety of exciting new treatments that could bring revolutionary results for people suffering from depression. There are some that are already in use for treatment, like deep brain stimulation, which involves a surgeon implants electrodes in your brain, which send out harmless zaps to alter the electrical activity contributing to your symptoms. Many other breakthroughs are still in the research phase like personalized medication for depression that could eventually eliminate the trial-and-error process of determining what's most effective for you.