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Depression Treatment Breakthroughs Scientists are taking on depression from a variety of angles than ever before. These approaches are designed to aid in avoiding relapses and find the right drug. If your depression isn't responding to antidepressants then psychotherapy could be effective. These include cognitive behavioral therapy as well as interpersonal psychotherapy. Deep Brain Stimulation Deep brain stimulation is a surgical technique that involves the use of electrodes within the brain are used to target specific regions of the brain that cause conditions and diseases like depression. The electrodes connect to a device that emits pulsing electric pulses to treat the condition. The DBS device, also known as a neurostimulator is used to treat other neurological conditions like epilepsy and Parkinson's disease. The pulsing of the DBS device could “jam” circuits that cause abnormal brain activity in depressed patients while keeping other circuits in place. Clinical trials of DBS for depression have demonstrated 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 ratings scales that can be difficult for them to interpret. Researchers from the Georgia Institute of Technology and Emory University School of Medicine have developed an algorithm to detect subtle changes in brain activity patterns. This algorithm can distinguish between stable and depressive states. The researchers' research was published by Nature Human Behaviour in Nature emphasizes the importance of combining medical and neuroscience disciplines with computer engineering to come up with potential life-changing treatments. In DBS, doctors insert a thin wire-like lead into the brain through a tiny hole in the skull. The lead is outfitted with electrodes that send electrical signals to the brain. The lead is connected to an extension cable that runs from the head, behind the ear and then down to the chest. The extension and lead are connected to an implanted battery-powered stimulator beneath the skin of your chest. The Neurostimulator can be programmed to produce electrical currents that pulse to control abnormal brain activity in the areas that are targeted by DBS devices. The team utilized DBS in the study to target a specific brain region called the subcallosal cortex (SCC). Scientists discovered that stimulation of the SCC resulted in a rise in dopamine, which could aid in the treatment of depression. Brain Scanners A doctor can employ various methods and tools to diagnose depression, but the most effective one available today is a brain scan. This technology uses imaging to monitor changes in brain activity on both the functional and structural levels. It can be utilized by a patient to pinpoint the affected areas of their brain and to determine what's happening in these regions in real-time. Brain mapping can also be used to predict which type of treatment will be the most effective for an individual. For instance, certain people are more responsive to antidepressant medications than others, but this isn't always case. Psychologists and doctors can prescribe medications more accurately if they use MRI to determine the effectiveness. It can also help to increase compliance by allowing patients to observe how their treatment progresses. The difficulty in measuring mental health has hindered research despite its wide-spread prevalence. There is an abundance of information about depression anxiety, depression, and other conditions. However it's been a challenge to understand what causes them. New technology is now uncovering the causes of these conditions. For instance, a study published in Nature Medicine sorts depression into six distinct biological subtypes. This opens the way to individualized treatment. Researchers used fMRI to examine brain activity in 801 people with depression and 137 without. They looked at the activity and connectivity of brain circuits affected by depression, including those that control cognition and emotions. They looked at a participant's brain scan at the time of rest as well as while performing specific tasks. A combination of resting-state and task-based tests was able to predict whether someone would respond or not to SSRIs. This is the first time a predictive test has been created in the field of psychiatry. The team is currently working on an automated test that will provide these predictive results. This is particularly helpful for those who don't respond to conventional therapies like therapy or medication. In fact, more than 60% of people suffering from depression don't respond to the first treatment they receive. Some of these patients could be difficult to manage with the standard treatment regimen. Brain Implants Sarah had lived with a debilitating depression that she described as a black hole that pulled her down, a force of gravity so strong she could not move. She tried a variety of medications, but none provided a lasting boost. She also tried other treatments like electroconvulsive therapy and ketamine injections but both failed to work. Then, she decided to undergo a procedure that would allow researchers to implant electrodes in her brain, and then give her a targeted shock whenever she was likely to have a depressive episode. Iampsychiatry is a method that is widely used in the treatment of Parkinson's disease. It has also been shown to be helpful for some people who are resistant to treatment. It is not a cure, but assists the brain to cope. It relies on a device that places tiny electrodes in certain areas of the brain. It's like a pacemaker for the brain. In a study published Monday in the journal Nature Medicine, two researchers at University of California at San Francisco (UCSF) describe how they made use of the DBS device for the first time to create a custom the treatment for depression for patients. They called it an “revolutionary” new approach that could open the way for the development of customizable DBS treatments for other patients. The team examined Sarah's brain's circuits, and discovered that her amygdala may be the reason for her depressive episodes. They discovered that the ventral striatum, a deep part of her brain, was responsible for calming her amygdala's reaction. Then, they implanted an implant the size of a matchbox inside Sarah's skull and hung its spaghetti-like electrode legs down to those two regions. When a symptom of depression develops the device instructs Sarah's brain to send a tiny 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 however it can make a significant difference for those who need it the most. In the future, this will be used to detect biological markers for depression and give doctors the chance to prepare by increasing the stimulation. Personalized Medicine Personalized medicine is a method to tailor prevention, diagnosis, and treatment strategies for specific patients, based on the information gathered through molecular profiling. Medical imaging, lifestyle information, etc. This is different from conventional treatments, which are designed to meet the needs of an average patient. Recent research has revealed a range of factors that can cause depression among different patients. These include genetic differences and neural circuitry disorders as well as biomarkers psychosocial markers and others. The purpose of psychiatry that is customized is to integrate these findings into the clinical decision-making process to ensure optimal care. It also aims to help develop specific treatment methods for psychiatric conditions such as depression, with the aim of achieving better utilization of resources and improving patient outcomes. The field of personalized psychiatry is growing however, there are many obstacles still preventing its clinical application. For instance many psychiatrists aren't familiar with the various antidepressants and their profile of pharmacology, which can result in a suboptimal prescription. In addition, the complexity and cost of integrating multiomics data into healthcare systems, as well as ethical considerations must be considered. Pharmacogenetics could be a promising approach to advance the field of personalized psychotherapy. It uses the genetic makeup of a patient in order to determine the appropriate dose of medication. This can help reduce the side effects of medications and boost treatment effectiveness, especially with SSRIs. It is important to note that this is a possible solution and further research is required before it can be widely accepted. Furthermore, other factors like lifestyle choices and environmental influences are crucial to consider. The integration of pharmacogenetics and lifestyle choices in depression treatment should therefore be carefully considered. Functional neuroimaging can also be used to aid in the choice of antidepressants and 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 psychotherapeutic and pharmacological treatments. Furthermore, some clinical trials have already utilized these findings to help select participants, focusing on those with higher activation levels and therefore showing more favorable responses to therapy.