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Depression Treatment Breakthroughs With a new generation of depression treatment breakthroughs, researchers are tackling this issue from more angles than ever before. These methods are designed to help you find the right drugs and prevent repeat relapses. If your depression isn't responding to antidepressants, psychotherapy can be beneficial. These include cognitive behavioral therapy as well as psychotherapy for interpersonal relationships. Deep Brain Stimulation Deep brain stimulation is a surgical method where electrodes inside the brain are placed to target specific regions of the brain that cause disorders and conditions such as depression. The electrodes connect to the device that emits electrical pulses to treat the disease. The DBS device, also known as a neurostimulator, can be used to treat other neurological conditions like epilepsy and Parkinson's disease. The pulsing of the DBS device can “jam” circuits that cause abnormal brain activity in depression, while leaving other circuits intact. Clinical studies of DBS for depression have shown significant improvement in patients suffering from treatment-resistant depression (TRD). Despite the positive results however, the path to a stable recovery from TRD differs for each patient. Clinicians rely on the subjective reports from interviews with patients and psychiatric rating scales that are difficult for them to interpret. Researchers from the Georgia Institute of Technology and Emory University School of Medicine have developed an algorithm that can detect subtle changes in the brain's activity patterns. This algorithm is able to distinguish between stable and depressive states. The research of the scientists was published in Nature Human Behaviour, exemplifies the importance of combining neuroscience, medical, and computer engineering disciplines to develop potentially life-changing therapies. During the DBS procedure, doctors insert a thin wire-like lead in the brain through a hole in the skull. The lead is equipped with a variety of electrodes on its tip that send electrical impulses to the brain. It is then connected to an extension wire that extends from the brain, through the neck and behind the ear down to the chest. The extension and the lead are connected to a stimulator powered by batteries implanted under the skin of the chest. The neurostimulator that can be programmed generates electric pulses to regulate abnormal brain activity in the areas targeted by DBS devices. In the study, the researchers employed DBS to target a specific region of the brain called the subcallosal cingulate cortex (SCC). The scientists discovered that when SCC was stimulated, it caused an increase in dopamine levels which may improve symptoms of depression. Brain Scanners A doctor can use different tools and techniques to diagnose depression, however brain scans are the most effective method. This technology makes use of imaging to monitor changes in brain activity on both the structural and functional levels. It can be used by a patient to identify the affected areas of their brain and determine what's happening in these regions in real-time. Brain mapping can also assist to predict which type of treatment will be most effective for an individual. Certain people respond better to antidepressant medication than others. However this isn't always the case. Psychologists and physicians can prescribe medication more accurately by using MRI to determine the effectiveness. It also helps increase compliance by allowing patients to view how their treatment is progressing. The difficulty of assessing mental health has hindered research despite its widespread prevalence. There is a wealth of information on depression, anxiety, and other disorders. However, it has been difficult to understand what causes them. New technology is now revealing the mechanisms behind these disorders. A recent study published in Nature Medicine, for example, classified depression into six distinct subtypes. This opens the way to a personalized treatment. Researchers employed fMRI technology in order to examine the brain activity of 801 people with depression, and 137 people who are not. They studied the activity and connectivity of brain circuits affected by depression, including those that regulate emotions and cognition. They looked at the brain scan of a subject at rest and when completing specific tasks. A combination of resting-state and task-based tests could predict whether people would respond or not to SSRIs. This is the first time a predictive test has been developed in psychiatry. The team is currently working on developing an automated tool which will provide these predictive results. This is particularly beneficial for those who don't respond to standard therapies like therapy or medication. In fact, as high as 60% of people suffering from depression aren't responding to the initial form of treatment they receive. Some of those patients are classified as treatment-resistant and can be difficult to treat with the standard treatment regimen However, there is hope that the advancement of technology will allow to improve treatment options. Brain Implants Sarah suffered from a debilitating form of depression that was debilitating. She described it as a blackhole that pulled her down. It was so strong that she could not move. She tried a range of medications but none gave her a lasting boost. She also tried other treatments like ketamine injections or electroconvulsive treatment, but these did not work either. Finally, she was able to undergo a procedure that would permit researchers to implant electrodes in her brain and give her a targeted jolt whenever she was about to suffer from a depressive attack. The procedure, called deep brain stimulation is used extensively to treat Parkinson's disease and has been shown to help some people with treatment-resistant depression. But it's not a cure; it simply aids the brain in dealing with the illness. It utilizes a device that can implant small electrodes into specific parts of the mind like a pacemaker. In a study published Monday in the journal Nature Medicine, two researchers at University of California at San Francisco (UCSF) explain how they made use of the DBS device for the first time to customize depression treatment for the patient. They described it as a “revolutionary” method that could pave way for customized DBS therapies to be offered to other patients. The team studied Sarah's brain circuitry, and found that her amygdala is the main cause of her depression episodes. They found that the ventral striatum, an area of her brain was responsible for calming her amygdala's overreaction. They then implanted the matchbox-sized gadget in Sarah's head, and then strung its electrode legs that resembled spaghetti to the two areas. If a sign of depression develops, the device signals Sarah's brain to send a small electrical charge to the amygdala, and to the ventral striatum. This shock is intended to prevent depression and encourage her to be more positive. It's not a cure, but it can make a significant impact for those who require it the most. In the future, this may be used to determine biological markers that indicate depression is on the horizon and give doctors the chance to prepare by increasing stimulation. Personalized Medicine Personalized medicine is an approach to adapting diagnosis, prevention and treatment strategies to specific patients based upon information gathered through molecular profiling, medical imaging, lifestyle information and more. This differs from conventional treatments designed for an average patient – one-size-fits-all solutions that may not be effective or efficient. Recent research has revealed a variety of factors which cause depression in various patients. These include genetic variation and neural circuitry dysfunctions as well as biomarkers, psychosocial markers, and many more. The purpose of psychiatry that is customized is to integrate these findings into the clinical decision-making process to ensure the best treatment. It also aims to facilitate the development and implementation of specific treatment plans for psychiatric issues like depression. The field of individualized psychiatry continues to grow, but several obstacles are currently preventing its clinical application. Many psychiatrists are not familiar with the pharmacological profile of antidepressants. This can cause a poor prescribing. It is also essential to take into consideration the cost and the complexity of the integration of multiomics into healthcare systems, as well as ethical considerations. Pharmacogenetics is a promising way to improve the effectiveness of personalized psychiatry. It makes use of the genetic makeup of a patient order to determine the appropriate dosage of medication. This can reduce the adverse effects of medications and boost treatment effectiveness, especially with SSRIs. It is crucial to remember that this is a possible solution, and further research is required before it is widely used. Other factors, like lifestyle choices and environmental influences are also important to take into consideration. Therefore www.iampsychiatry.com of pharmacogenetics in depression treatment must be carefully balanced. Functional neuroimaging is another promising method to guide the selection of antidepressants and psychotherapy. Studies have demonstrated that the levels of activation in certain neural circuits (e.g. ventral and pregenual anterior cingulate cortex) predict the response to psychotherapeutic and pharmacological treatments. Furthermore, some clinical trials have already used these findings to help select participants, targeting those with more activation levels and consequently showing more favorable responses to therapy.