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Depression Treatment Advancements Researchers are constantly working to improve the treatment of depression. This special Research in Context will explore some of the depression treatment advances. Psychotherapy can help ease depression symptoms by teaching people skills to handle negative thoughts and feelings. Talk therapy can be performed one-on-one with a mental health professional or in group settings. Precision mental healthcare Precision is the ability to be more precise or accurate in diagnosis, prevention and treatment strategies. In the field of mental health, it may encompass a variety of strategies that range from psychotherapy to medication. However, progressive depression treatment of these strategies tend to focus on the consequences of the disorder rather than the root causes. This can lead to treatments that do nothing more than alleviate symptoms, without addressing the root causes of mental illness. Precision mental healthcare is rapidly improving. It's comparable to the approach which has been used in other areas of healthcare by incorporating continuous monitoring of key indicators into the clinical setting (e.g. fever, temperature or blood pressure). It also involves combining different data sets and using machine-learning to help physicians better recognize the unique requirements of a patient and devise more effective treatments. Precision psychiatry employs EEG to measure brain function and evaluate the ability of a patient to engage in cognitive therapy for behavioral problems. A new class of medications known as NMDA receptor inhibitors can reduce depression symptoms by preventing the neurotransmitter, glutamate, from reaching specific brain cells. The test can also be used to determine interactions between genes and drugs, and to prevent undesirable effects. A number of companies are also exploring digital precision medicine, which utilizes objective digital technology to monitor patients remotely and collect real-time data that aids in their treatment. One company, for instance employs artificial intelligence to monitor the adherence of medication and optimize dosages for patients suffering from depression. These solutions have the possibility of enhancing accessibility and efficiency in mental healthcare and also enhancing the patient's adherence to treatment. Digital precision psychiatry, in particular it is a way to help people suffering from mental illness overcome obstacles to treatment, particularly those who are working. Johnson & Johnson, for instance, is working with organizations in Singapore to aid in the reintegration of people recovering from depression back into their work. This will allow them to keep their jobs, which are essential for the mental health recovery process. Medication Many people suffering from depression find that medication eases their symptoms. This is especially relevant if the symptoms are intense or incapacitating. Antidepressants work to restore the balance of neurotransmitters which are chemical messengers within the brain that regulate mood and emotions. Most antidepressants focus on one of these neurotransmitters and increase levels of serotonin, norepinephrine and dopamine. Selective serotonin reuptake inhibits (SSRIs) such as Prozac and Zoloft increase the levels of serotonin chemical within the brain. SNRIs such as Cymbalta, Effexor and Cymbalta focus on both norepinephrine as well as dopamine. Monoamine oxidase inhibitors such as Wellbutrin focus on only dopamine and norepinephrine. Most doctors recommend antidepressants for the first option of treatment for depression, along with some form of talk therapy. Some of these therapies include cognitive behavioural therapy (CBT) which can help improve your mood and thoughts by teaching specific skills, or psychotherapy for interpersonal relations (which focuses on improving relationships). Other treatments, such as electroconvulsive (ECT) therapy and transcranial magnet stimulation (TMS) have also been proven to be effective in treating depression. However, some people do not respond to the first medications prescribed by doctors. Up to a third of patients suffering from depression don't see any improvement from their first medication and about 40 percent who begin taking antidepressants stop them within three months. The good news is that recent research has helped doctors predict the type of medication that is most effective for each individual, utilizing blood or MRI tests to determine which receptors are most affected by the depression. The way we treat depression has improved over the last few years, with more options and better dosages that help reduce side effects. For instance, the newest antidepressants like esketamine (Spravato) and Brexanolone (Auvelity) and Nefazodone (Sertraline) are designed to rapidly alleviate depression symptoms through affecting glutamate production in the brain. Other medications are undergoing clinical trials that could change the ways they're used. Vorapaxar, a drug which is currently being tested in humans, targets a specific part of the brain associated with depression by blocking NMDA receptors. It's expected to be available by 2024. Another medication that has demonstrated potential is a combination of bupropion and ketamine. This could be more effective at treating treatment-resistant depression. Psychotherapy Psychiatric researchers have been able identify certain factors that contribute to depression, including problems with the neurotransmitters serotonin and norepinephrine. These chemicals play a crucial role in regulating mood emotions, moods and brain function in general. Medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors are the main treatment options. They can relieve many symptoms of depression including depressed mood, fatigue and sleep issues. They can also cause side effects, which can make them unsuitable for certain people. Psychotherapy can be used to address the root causes of depression and help individuals manage their depression better. Different types of therapy have been shown to reduce symptoms, such as cognitive behavioral therapy and the ketamine infusion therapy. Psychotherapy can also aid people in developing a healthy coping style and reduce stressors. Cost, scheduling limitations and a lack of mental health professionals can restrict access to psychotherapy. Telehealth services have improved access for many people. The difficulty in beating depression is figuring out the best combination of treatment. The use of medication alone isn't enough to alleviate all your symptoms. It may take between 6 and 12 weeks before you know if a drug is working. There are many nonpharmacologic treatments available including repetitive transcranial magnetic stimulation and vagus nerve stimulation. These treatments employ electromagnetic fields in order to improve mood and stimulate the brain's chemistry. If you're thinking of trying medication or psychotherapy it's crucial to collaborate with your healthcare provider. Be honest about your thoughts and feelings and discuss the benefits of, risks, and consequences of each choice. Find a service that can meet your requirements in case you're having difficulty getting trust from your therapist or doctor. You can also choose a clinic that provides the opportunity to test their services at no cost. This will allow you to try different strategies before you commit. You'll find a solution that works for you and makes you feel better. Brain stimulation In just a few short years scientists have found new ways to target specific brain areas and change their function quickly. These techniques can also be used to treat physical ailments as well as some mental disorders. One approach is called rTMS, which uses electromagnetic pulses to stimulate the brain. It's similar to magnetic pulses in MRIs, but not powerful enough to cause seizures. The method is achieved by stimulating a specific part of the head using the use of a non-painful magnetic. The pulses alter the way that brain signals are processed and allows you to feel better. The therapy can take as little as 3.5 minutes and isn't a problem with your normal activities. There may be a slight headache following the treatment. Another treatment involves implanting electrodes in the brain to send painless zaps of electricity. Deep transcranial stimulation (deep-TMS) is a treatment that has been used to treat OCD and stop smoking cigarettes. Recent studies suggest that it may reduce depression symptoms in some people. The mechanism of this treatment isn't fully understood however it appears to be able to alter the balance of certain neurotransmitters. Other methods of brain stimulation that are not invasive are also advancing. For instance, a recent study found that patients suffering from severe depression who were resistant to antidepressants, responded to an electromagnet treatment known as SAINT. It's personalized to each patient's brain anatomy and uses high-dose patterns of magnetic pulses. The treatment is delivered within a few hours whereas previous treatments needed regular sessions for months or weeks. The researchers utilized fMRI to locate the precise region of the brain being stimulated in every patient. They also examined the small differences in how the brain's different regions were activated which allowed them to discern the directional flow of signals. They found that in patients suffering from depression the brain's anterior cingulate cortex sent signals to an area known as the subgenual cingulate cortex. But these messages were often misdirected and the more severe depression, the more of these incorrect signals were.