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Innovative Depression Treatments Many sufferers of depression have a difficult time finding a treatment that works for them. Some experience a lack of response to medications or suffer from uncontrollable adverse side effects. The health benefits inherent to 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 an electric field to deliver short pulses of electric current to specific brain areas that are to be overactive in those suffering from depression. The treatment is non-invasive, and doesn't require anesthesia. It is also extremely effective and well-tolerated compared to antidepressant medication. A person receives TMS by sitting in a chair similar to the chair used by dentists. A trained technician places the device that has an electromagnetic coil against the frontal part of the head. The coil's pulses are rapid and the person could feel or hear a clicking sound on their scalp. Each magnetic pulse (measured in hertz or Hz) is referred to as a “pulse”. The frequency of the pulses can vary from low (1 pulse every second) to high (10 per second). The treatment is not painful however the magnetic field does affect the cells in the outer layer. It depolarizes cortical neurons and the resulting transynaptic changes can affect deeper brain regions that are involved in mood. For instance, higher frequency TMS over the left DLPFC can boost mesolimbic neuron activity that regulate emotional responses. TMS can be utilized as an adjunct to psychiatric medications and certain insurance plans cover the treatment. It's important to check with your insurance provider to find out what benefits your specific plan covers. In clinical studies, TMS showed significant and long-lasting improvements in depression symptoms when compared with placebo. During a TMS treatment course, a patient may undergo up to 30 sessions over a few weeks. Patients who suffer from more severe depression may need a longer treatment course. Certain modern treatments of TMS use a lower-frequency pulse that's less likely to cause adverse reactions, such as seizure. While the procedure is still in its early stages, it is an effective treatment alternative for patients who don't respond to psychotherapy or antidepressants. Electroconvulsive therapy (ECT) ECT aids in restoring the brain's natural chemical balance. It is among the most safe and effective treatments for depression that can be used to treat other mental health conditions like schizophrenia. The ECT procedure is performed in a hospital or an outpatient treatment center. It is performed by medical professionals. An anaesthetic general is administered prior to the procedure, which means there is no pain. 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 safeguard your teeth. Two discs made of metal (bilateral ECT) or one disc (unilateral ECT) is placed on your head one on each side or in the middle of your forehead. The anaesthetist will then inject you with a medication to induce sleep. You will be awakened in the ECT room. A member of the ECT staff will answer any questions that you may have. You will be asked to sign a consent form prior to when you receive the treatment. It can be difficult to take in all the information you are informed about ECT. It is best to bring a relative or friend accompany you. You must be given at least 24 hours to consider the treatment before having to make a decision. During the procedure, you will have brief fits or seizures, which last just 40 seconds to 2 minutes. The ECT doctor will alter the amount of electric pulses you get depending on the response you show. It is likely that you will receive short courses of ECT. Usually 6-12 sessions are scheduled twice a week. It isn't clear how ECT functions. However, it is believed to trigger the release certain chemicals that allow brain cells to communicate. It also seems to alter the way parts of your brain develop. ECT is extremely effective in treating severe depression, suicidal ideas and catatonia that is secondary to depression, and other psychiatric disorders. Studies show that half of those who undergo ECT recover and stay healthy for at least a year. It is particularly beneficial for those who haven't had a positive response to medication or other psychosocial treatment. Deep brain stimulation (DBS) Deep brain stimulation is a surgical procedure that involves implanting electrodes into the brain. The electrodes are connected to a small neurostimulator which delivers electric impulses to the part of the brain that controls your symptoms. The electrical pulses can help alleviate your symptoms and enhance the quality of your life. DBS can treat a variety of conditions, including movement disorders like Parkinson's or essential tremors and psychiatric conditions such as obsessive-compulsive disorder and depression. It can also help reduce seizures in epilepsy sufferers. It can also treat the severe pain that comes from brain and nerve disorders. DBS is a successful treatment for many patients with TRD, and it can be used in conjunction with other treatments, such as ECT. However, it is important to remember that not all patients benefit from DBS. Certain patients may not see any improvement in their symptoms, while others may be experiencing worsening depression. This non-response may be due to a mix of factors, including those that are related to the patient like personality traits, or psychiatric co-morbidity as well as clinical factors like an incorrect diagnosis or a poor DBS targets. Researchers utilized a machine learning algorithm to classify changes in LFPs that were recorded during intraoperative DBS. The results revealed that the reduction in depression symptoms was correlated with changes in beta power. These findings suggest that DBS can be used to predict the effects of antidepressants. This theory needs to be tested by more research. DBS is a well-known treatment for movement disorders, and it is also being used to treat an increasing number of mental health issues. However, it's not widely used as an option for treating depression. The FDA has approved DBS to decrease seizures in some people with epilepsy that is difficult to treat. Moreover, studies are underway to determine whether DBS can be used to treat depression. Before you undergo DBS, you should discuss your options with a neurologist or psychiatrist. The neurologist will examine you and recommends the best treatment for you. The doctor will also inform you about the risks and benefits of DBS. You should also inquire about any tests or preparations you may need to do before the procedure. You may require a blood test, imaging and other tests before the procedure. Cognitive behavioral therapy (CBT) Cognitive behavioral therapy is one of the most common types of psychotherapy and has been proven to be efficient in a variety of different outcome studies. It is typically employed as a stand-alone treatment, but it can be combined with medications in certain instances. CBT is a kind of psychotherapy that helps you learn to change the negative attitudes and thoughts that contribute to depression. It is based on the notion that how you think about and respond to situations is more important than the situation itself. It is an extremely active form of psychotherapy that places an emphasis on solving problems, and discovering and changing dysfunctional thinking patterns. CBT's goal is to help you become your own therapist by helping you understand and change the ways you think and behave. It utilizes exercises and at-home sessions as well as outside of sessions to teach new skills. CBT is focused on current issues and problems and not past experiences or the root causes. It requires some knowledge about your past to be able to deal with and address issues in the present. CBT is a fairly short-term therapy, usually lasting 6 to 20 sessions. It is an empirically-based therapy and its duration is determined by whether or not you reach the goals set at the start of the therapy. It is an active therapy that requires a high level of commitment and dedication on your part. Other cognitive behavioral therapies could be beneficial for you. These include acceptance and commitment therapy, which helps you be positive even when you are experiencing negative thoughts or emotions; dialectical behaviour therapy which deals with suicidal thoughts and self-injury, and psychotherapy for interpersonal relationships that aims to fix relationship issues that can be a contributing factor to depression. There are many exciting new treatments that could be game-changing for those suffering from depression. Certain treatments are available. For example deep brain stimulation. comprehensive depression treatment in your brain to send pulses that alter the electrical activity that causes your symptoms. Other advancements are being studied, including personalized treatment for depression. This could reduce the need for trial and error to discover what works for you.