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Innovative Depression Treatments Many people suffering from depression are unable to find a treatment they can tolerate. Some sufferers have a low response to medications or experience intolerable adverse effects. The health benefits inherent to scaled-up effective treatment coverage are estimated to be substantial (table 2). The discounted value of these benefits is $399 billion for depression and $169 billion for anxiety disorders. Transcranial Magnetic Stimulation (TMS) TMS utilizes a magnet field to deliver brief pulses of current to certain brain regions that are believed to be overactive in depressed patients. The therapy is noninvasive and does not require anesthesia. It is also highly effective and well-tolerated compared to antidepressant medications. For TMS treatment the patient sits in a dental chair and remains awake. A trained technician puts a small device that has a magnetic coil to the front of the head. The coil's pulses are rapid and the person could hear or feel a clicking noise on their scalp. Each magnetic pulse is known as 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 is not painful, but the magnetic field is affecting cells in the cortex's outer layer. It depolarizes the cortical neurons and the transynaptic effect may affect deeper regions of brain that are involved in mood. For instance, higher-frequency TMS over the left DLPFC can stimulate mesolimbic neurons that modulate emotional responses. TMS can be used as an adjunct to psychiatric drugs Some insurance plans will cover the treatment. It is important to inquire with your insurance provider to find out what benefits your specific policy covers. In clinical studies, TMS showed significant and long-lasting improvements in depression symptoms when compared to a placebo. Patients can receive up to 30 TMS sessions over the period of just a few weeks. Patients who suffer from more severe depression may need a longer treatment course. Some newer treatments of TMS utilize a lower frequency pulse that's less likely cause adverse reactions like seizures. While the procedure is still experimental but it's an effective treatment alternative for patients who are not responding to antidepressants or psychotherapy. Electroconvulsive Therapy (ECT) ECT helps to restore the brain's natural chemical balance. It is one of most efficient and safe treatments for depression. It can also be used to treat other mental health conditions such as schizophrenia. The ECT procedure is carried out by medical professionals and occurs in a special suite at the hospital, or in an outpatient treatment center. Before the procedure, a general anaesthetic will be administered to ensure you don't feel any discomfort. The ECT team will utilize monitoring equipment to gauge your heart rate, blood-pressure and oxygen levels, as well as brain waves. You will be provided with a muscle relaxant that will keep you calm, as well as a mouth guard to safeguard your teeth. Two metal discs are placed on the head, one on each side or in your forehead. The anaesthetist then gives you a shot of medication that will put you to sleep. You will be woken up in the ECT room. A member of the ECT staff will be available to answer any questions you might have. Before you receive the treatment you will be required to sign a consent form. It is a good idea to bring a friend or relative with you when you learn about ECT because it could be difficult to process all the information at once. It is recommended that you wait at least 24 hours before being required to make a decision about the treatment. During the procedure, you may be able to experience brief seizures or fits, which last just 40 seconds to 2 minutes. The ECT doctor will adjust the intensity of your electric pulses depending on the way you react. You will likely have short sessions of ECT. Usually 6-12 sessions are scheduled twice a week. There isn't a single theory of how ECT works however it appears to trigger the release of certain chemicals that help your brain cells communicate with each and each other. It also seems to alter the way parts of your brain develop. ECT is very effective in treating severe depression, suicidal ideas, catatonia secondary to depression, and other mental health disorders. Research has shown that approximately half of those who receive ECT improve and remain well for an entire year or longer. It is especially helpful for those who haven't responded to medication and other psychosocial treatment. Deep brain stimulation (DBS) Deep brain stimulation is a surgical technique which involves the placement of electrodes in the brain. The electrodes are connected to tiny devices that send electrical impulses to the region of your brain that controls symptoms. The electrical pulses can help ease your symptoms and improve your quality of living. DBS can treat many conditions such as movement disorders like Parkinson's or essential tremors, as well as psychiatric conditions such as obsessive-compulsive disorder and depression. It also helps reduce seizures in epilepsy sufferers. It can also help treat severe pain from nerve and brain conditions. DBS is a highly effective treatment for a lot of patients suffering from TRD and can be combined with other treatments such as ECT. However, it is important to remember that not all patients benefit from DBS. Some patients do not experience any improvement in their symptoms, while others may even have worsening of their depression. This non-response is likely due to a mix of factors, including factors related to the patient such as personality traits or psychiatric comorbidity, and clinical factors, such as an inaccurate diagnosis or poor DBS treatment. Researchers utilized a machine learning algorithm to classify the changes in LFPs recorded during intraoperative DBS. The results indicated that changes in beta power were associated with a decrease in depressive symptoms. These findings suggest DBS can be used as a predictor of antidepressant effects. However more research is needed to verify this theory. Although DBS is a well-established treatment for movement disorders and a growing number of psychiatric illnesses but it is not widely known as an effective treatment for depression. The FDA has approved DBS for reducing seizures in people suffering from epilepsy that is difficult to treat. Moreover, studies are in progress to determine if DBS can be used to treat depression. You should discuss the DBS procedure with a neurologist before undergoing it. Your neurologist will examine you and recommend the most appropriate treatment option for you. He or she will also inform you about the potential risks and benefits of DBS. In finding the right depression treatment should inquire about any tests or preparations you might require prior to the procedure. You may require a blood test, imaging and other tests before the procedure. Cognitive behavioral therapy (CBT). Cognitive behavioral therapy has been shown to be effective through various outcomes studies. It is most often utilized as a treatment on its own but it may be combined with medication in some cases. CBT is a form of psychotherapy which helps you change negative thoughts and behaviors contributing to depression. It is based upon the idea that how you see and react to situations is more important than the situation itself. It is an extremely active type of psychotherapy and emphasizes problem-solving and identifying and changing maladaptive thinking patterns. The goal of CBT is to help you become your own therapy by helping you understand and change the ways you think and behave. It incorporates exercises and homework during as well as outside of the session to help you develop new skills. CBT is focused on current issues and problems and not on past experiences or the root causes. It requires some knowledge about your past in order to be able to address and address issues in the present. CBT is a short-term therapy that typically lasts 6 to 20 sessions. It is an empirically based therapy and its duration is determined by whether you meet the goals you set at the beginning of the therapy. It is an active and demanding therapy that requires the highest level of commitment and hard work from you. There are many other types of cognitive behavioral therapies that could be beneficial for you, including acceptance and commitment therapy, which helps you to take positive actions even when you are experiencing negative emotions or thoughts; dialectical behavior therapy, that is designed to deal with chronic suicidal thoughts and self-injury; and interpersonal psychotherapy, that focuses on resolving relationships that contribute to your depression. There are a variety of exciting new treatments that could be game-changing to people with depression. Certain treatments are available. For example deep brain stimulation. A surgeon implants electrodes into your brain to send zaps that alter the electrical activity contributing to your symptoms. Many other advancements are still in research, such as the development of a personalized treatment for depression. This could eliminate the need to trial and error to determine what works for you.