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Innovative Depression Treatments Many sufferers of depression struggle to find an effective treatment for them. Some sufferers have a low response to medications or experience intolerable adverse effects. Table 2 shows that the intrinsic health benefits of scaling up effective coverage are significant. The discounted value of these benefits is $399 billion for depression and $169 billion for anxiety disorders. Transcranial magnetic stimulation (TMS) TMS utilizes magnetic fields to deliver short pulses of electric current to specific brain regions that are overactive in patients suffering from depression. The treatment is non-invasive, and does not require any anesthesia. It's also extremely effective and well tolerated compared to antidepressant medication. To treat TMS one sits in a dentist-like chair and is awake. A trained technician places a small device with a magnetic coil against the front of the head. The coil is able to pulse quickly and the person could hear a clicking sound or feel tapping sensations on the scalp. Each magnetic pulse (measured in hertz or Hz) is called 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 but the magnetic field affects the cells of the outer layer. It depolarizes cortical neuronal cells, and the resulting transynaptic changes can affect deeper brain regions that are involved in mood. For example, higher frequency TMS in the left DLPFC can increase mesolimbic neurons that modulate emotional responses. Certain insurance plans offer TMS as an addition to psychiatric medications. It is recommended to check with your insurance provider to determine what your plan covers. In clinical studies, TMS produced significant and lasting improvements in depression symptoms versus a placebo. During a TMS treatment program the patient can undergo up to 30 sessions over the course of a few weeks. Patients with more severe depression may need an extended treatment program. Some of the newer TMS treatments employ a lower frequency pulse, which is less likely to trigger adverse effects such as seizures. While the method is still experimental, it is a promising treatment alternative for patients who do not respond to psychotherapy or antidepressants. Electroconvulsive Therapy (ECT) ECT helps to restore 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 disorders such as schizophrenia. The ECT procedure is performed in a hospital or an outpatient treatment center. It is performed by medical experts. Before the procedure, a general anaesthetic will be administered to ensure that you do not 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 given a muscle relaxant and a mouthguard to protect your teeth. Two discs of metal (bilateral ECT) or one disc (unilateral ECT) are placed on your head on either side or in the middle of your forehead. The anaesthetist injects you with a medicine to put you to sleep. You will be awakened in the ECT room. A member of the ECT staff will be able to answer any questions that you may have. You will be asked to sign a consent form prior to when you undergo the treatment. It is a good idea to have a friend or relative with you when you learn about ECT treatment, as it may be difficult to take in all the information in one go. You must be given at least 24 hours to consider the treatment prior to having to decide. During the procedure, you'll have brief seizures or fits lasting between 40 seconds to 2 minutes. The ECT doctor will alter the amount of electrical pulses you receive based on your response. You will likely have short courses of ECT. Usually 6-12 sessions are scheduled two times a week. There is no single theory about how ECT works, but it seems to cause the release of certain chemicals that help your brain cells communicate with one other. It also appears to alter the way certain parts of your brain develop. ECT is effective in treating suicidal thoughts, severe depressions and catatonia secondary depression as well as other psychiatric disorders. Research shows that half of people who receive ECT improve and remain healthy for a year or more. It is particularly beneficial for those who haven't been able to respond to medications or other psychosocial treatments. cognitive behavioral therapy for depression (DBS). Deep brain stimulation is a surgical method that involves implanting electrodes into the brain. The electrodes are attached to a small device that sends electric pulses into the area of your brain which controls symptoms. The electrical pulses can help relieve your symptoms and improve your quality of life. DBS can treat a variety of conditions including movement disorders such as Parkinson's or essential tremors as well as mental disorders like obsessional-compulsive disorder and depression. It can also reduce seizures in people suffering from epilepsy. It is also used to treat pain caused by brain and nerve conditions. DBS is an option to be used in conjunction with ECT or other treatments for TRD. However, it is important to note that not all patients benefit from DBS. Some patients may not see any improvement in symptoms, while others may experience worsening depression. This lack of response is likely to be due to a combination of factors, including patient-related factors such as personality traits or psychiatric co-morbidity, and clinical factors, such as an inaccurate diagnosis or poor DBS targeting. The researchers used a machine learning algorithm to identify changes in LFPs that were measured during intraoperative DBS exposure. The results showed that an improvement in depression symptoms was correlated with changes in beta power. These results suggest that DBS could be used to predict the severity of antidepressant effects. However more research is needed to confirm this theory. 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 recognized as a treatment for depression. The FDA has approved DBS to help reduce seizures in people suffering from difficult-to-treat epilepsy. Studies are currently being conducted to determine whether DBS can be used in treating depression. Before undergoing DBS it is recommended that you discuss your options with a psychiatrist or neurologist. Your neurologist will examine you and suggest the best treatment option for you. He or she will inform you about the benefits and risks of DBS. It is also important to inquire about any preparations or tests you may need to do before the procedure. It is likely that you will require an imaging test, blood test and other tests before the procedure. Cognitive behavioral therapy (CBT). Cognitive behavioral therapy has been proven to be effective through various outcomes studies. It is typically employed as a stand-alone treatment, however it can be combined with medications in certain instances. CBT is a form of psychotherapy which helps you change negative thoughts and behaviors that contribute to depression. It is based upon the theory that the way you think about and respond to situations is more significant than the actual situation. It is a very active form of psychotherapy that is focused on solving problems, and finding and changing the maladaptive thinking patterns. The purpose of CBT therapy is to assist you to become your own therapy. It accomplishes this by assisting you to change your thinking and act. It utilizes exercises and at-home sessions as well as out of session to teach new skills. CBT is focused on current issues and challenges and not on past experiences or the root causes. It requires some knowledge about your past in order to be able to deal with and address issues that are currently affecting you. CBT is typically a short-term treatment, lasting between 6-20 sessions. It is an empirically based therapy and its duration is determined by whether or not you reach the goals established at the beginning of the therapy. It is an intensive and demanding therapy that requires the highest level of commitment and dedication from you. There are a myriad of 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 experience negative thoughts or emotions as well as dialectical behavior therapy, which is designed to address self-injury and suicidal thinking; and interpersonal psychotherapy, that focuses on resolving issues with relationships that contribute to your depression. There are a variety of exciting new treatments in the pipeline which promise to revolutionize treatment for those suffering from depression. There are some treatments that are already available. For instance deep brain stimulation. A surgeon inserts electrodes into your brain to send impulses that alter the electric activity that triggers your symptoms. Other advancements are being studied, including the development of a personalized medication for depression. This could reduce the need for trial and error to find the best treatment for you.