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Depression Treatment Breakthroughs Scientists are attacking depression from a variety of ways than they did before. These strategies are designed to help you find the right drugs and avoid repeat relapses. If your depression isn't responding to antidepressants then psychotherapy could be beneficial. This includes cognitive behavioral therapy as well as interpersonal psychotherapy. Deep Brain Stimulation Deep brain stimulation is a surgical procedure in which electrodes inside the brain are placed to target specific regions of the brain that can cause conditions and diseases such as depression. The electrodes connect to an instrument that emits pulsing electrical pulses to treat the condition. The DBS device is referred to as neurostimulator. It is also used to treat other neurological disorders, such as essential tremor, Parkinson's disease epilepsy, and essential tremor. The pulses of the DBS device could “jam” circuits that cause abnormal brain activity in depressed patients while leaving other circuits intact. Clinical studies of DBS for depression have revealed significant improvement in patients suffering from treatment-resistant depression (TRD). Despite the positive results, TRD recovery is not the same for every patient. Clinicians rely on subjective reports from interviews with patients and psychiatric rating scales that can be difficult for them to interpret. Researchers from the Georgia Institute of Technology, Emory University School of Medicine and the Icahn School of Medicine at Mount Sinai, have developed an algorithm that detects subtle changes in brain activity patterns and can differentiate between stable and depressive recovery states. The study, published in Nature Human Behaviour, exemplifies the importance of combining neuroscience, medical and computer engineering fields to create potentially life-changing treatments. In DBS the doctors insert a thin wire-like lead into the brain through a tiny hole in the skull. The lead is outfitted with electrodes that transmit electrical signals to the brain. The lead is connected to an extension cable that runs from the head, through the ear and down to the chest. The lead and the extension are connected to a stimulator powered by batteries implanted beneath the skin of the chest. The Neurostimulator can be programmed to produce electrical current pulses to regulate brain activity in the areas that are targeted by DBS devices. In the study, the team used DBS to target a particular region of the brain called the subcallosal cingulate cortex (SCC). Scientists discovered that stimulating the SCC resulted in an increase in dopamine, which could help alleviate depression symptoms. Brain Scanners A doctor may employ a variety of tools and techniques to diagnose depression, but the best one available today is brain scans. This technology uses imaging in order to observe changes at structural and function levels of brain activity. It can be used to identify the areas of a client's brain that are affected by the disorder, and to determine what is happening in those areas in real-time. Brain mapping can also assist to predict which type of treatment will be the most efficient for a particular person. Some people respond better antidepressant medications than others. However it's not always the case. Physicians and psychologists can prescribe medication more accurately if they use MRI to assess the effectiveness. It can also help improve compliance by allowing patients to observe how their treatment progresses. Despite its widespread prevalence, research in mental health has been hampered by the difficulty in measuring it. There is plenty of information available on depression as well as anxiety conditions. However it's been a challenge to understand what causes them. Technology is now uncovering the causes of these conditions. A recent study published in Nature Medicine, for example classified depression into six distinct subtypes. This paves the way toward individualized treatment. Researchers utilized fMRI to study the brain activity of 801 individuals with depression and 137 who did not. Researchers looked at the activation of brain circuits that are affected by depression, such as those that control cognition or emotions. They examined the brain scan of a subject at rest and during specific tasks. The results showed that a combination of resting state and task-based measurements could be used to determine if a person would respond to SSRIs. This is the first time a predictive test has been created in the field of psychiatry. The team is currently working on developing an automated tool that will give these predictive results. This is particularly helpful for those who do not respond to standard treatments like therapy and medication. About advanced depression treatment of people suffering from depression do not respond to the first treatment they receive. Certain patients may be difficult to manage with the standard treatment regimen. Brain Implants Sarah was suffering from a debilitating type of depression that was debilitating. She described it as a blackhole that dragged her down. It was a force so strong that she was unable to move. She had tried a variety of medications however none of them gave her an enduring boost. She also tried other treatments, such as electroconvulsive therapy and ketamine injections, but they too did not work. Finally, she agreed to undergo a procedure that would permit researchers to implant electrodes into her brain and send her a specific shock whenever she was likely to suffer from a depressive attack. The process, also called deep brain stimulation is widely used to treat Parkinson's disease. It has been shown to help those suffering from treatment-resistant depression. It's not an effective treatment, but it helps the brain cope. It is based on a device that places tiny electrodes in certain areas of the brain, such as a brain pacemaker. In an article published in Nature Medicine on Monday, two researchers from the University of California at San Francisco explain how they utilized the DBS to tailor the treatment for depression for a specific patient. They called it a “revolutionary” new method that could open the way for a more flexible DBS treatments for other patients. The team examined Sarah's brain circuitry, and found that her amygdala is the main cause of her depression episodes. They found that a spot deep in her brain —– the ventral striatum -which was responsible for calming her amygdala's excessive reaction. Then, they implanted an implant the size of a matchbox inside Sarah's skull and hung its electrode legs, shaped like spaghetti, down to those two regions. If a sign of depression develops the device tells Sarah's brain to send a small electrical charge to the amygdala and to the ventral striatum. The jolt is designed to stop the development of depression and to help guide her into a more positive mindset. It's not an effective treatment for depression, but it makes a big difference for those who require it the most. In the future, it could be used to detect an indicator of a biological sign that indicates a depression is on the way, allowing doctors to prepare by boosting the stimulation. Personalized Medicine Personalized medicine is a method to customizing diagnosis, prevention and treatment strategies to specific patients based on the information obtained through molecular profiling, medical imaging, lifestyle information and more. This differs from traditional treatments designed for the typical patient. This is one-size-fits-all solutions that may not be effective or efficient. Recent research has revealed a range of factors that cause depression in a variety of patients. These include genetic variation and neural circuitry dysfunctions as well as biomarkers, psychosocial markers and other. The aim of personalized psychiatry is to incorporate these findings into the decision-making process for clinical care to ensure optimal care. It is also designed to aid in the development of individual treatment strategies for psychiatric disorders such as depression, aiming at a better utilization of resources and enhancing the outcomes of patients. The field of individualized psychiatry continues to grow but there are a few obstacles still preventing its clinical application. Many psychiatrists aren't familiar with the pharmacological profiles of antidepressants. This can result in a suboptimal prescription. It is also essential to think about the cost and difficulty of integrating multiomics into healthcare systems and ethical issues. Pharmacogenetics could be a promising approach to improve the effectiveness of personalized psychotherapy. It makes use of the genetic makeup of a patient in order to determine the appropriate dosage of medication. This can help reduce the side effects of medications and boost the effectiveness of treatment, particularly with SSRIs. It is crucial to remember that this is a potential solution, and more research is required before it can be widely used. Additionally, other factors like lifestyle choices and environmental influences are important to take into consideration. Therefore, the integration of pharmacogenetics into depression treatment must be and balanced. Functional neuroimaging is another promising method for guiding the choice of antidepressants as well as psychotherapy. Studies have shown that the levels of pretreatment activation in specific neural circuitries (e.g. ventral and pregenual anterior cingulate cortex) predict the response to both pharmacological and psychotherapeutic treatments. Additionally, certain clinical trials have already utilized these findings to guide their selection of participants, focusing on those who have more activation levels and consequently having better responses to therapy.