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Depression Treatment Breakthroughs Scientists are attacking depression from more ways than they did before. These treatments are designed to help you avoid relapses and identify the appropriate medication. Psychotherapy is an option if antidepressants do not work. This includes cognitive behavior therapy and psychotherapy with others. Deep Brain Stimulation Deep brain stimulation is a surgical method that involves the use of electrodes within the brain are used to target specific areas of the brain that can cause disorders and conditions such as depression. The electrodes are connected to an instrument that emits pulsing electric pulses to treat the disease. The DBS device is called neurostimulator. It is also used to treat other neurological disorders such as essential tremor, Parkinson's disease and epilepsy. The DBS device's pulsing could “jam up” circuits that cause abnormal brain activity in depression, leaving other circuits unaffected. Clinical studies of DBS have shown significant improvements 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 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 can detect subtle changes in brain activity patterns that can distinguish them from depressive versus stable recovery states. The study, published by Nature Human Behaviour in Nature emphasizes the importance of combining medical and neuroscience disciplines with computer engineering to develop potentially life-changing treatments. During DBS procedures, doctors insert a thin, wire-like lead into the brain through a small hole in the skull. The lead has a number of electrodes at its tip that transmit electrical impulses to the brain. It is then connected to an extension wire that extends from the brain, through the neck, behind the ear, down to the chest. The extension wire and the lead are connected to a stimulator powered by batteries implanted under the skin of the chest. The programmable Neurostimulator produces electrical currents that pulse to regulate brain activity within the regions that are targeted by DBS devices. The team used DBS in the study to target a specific brain region known as the subcallosal cortex (SCC). Researchers found that when SCC was stimulated, it caused an increase in dopamine levels which may improve symptoms of depression. Brain Scanners A doctor may use various tools and techniques to diagnose depression, but the most effective one currently available is a brain scan. This technology uses imaging to monitor changes in brain activity on both the structural and functional levels. It can be used to determine the regions of a patient's brain that are affected by the disorder and to determine what is happening in those regions in real-time. Brain mapping can also help to predict which type of treatment will be most effective for an individual. For example, some people are more responsive to antidepressant medications than others, however this isn't always the situation. By using MRI to evaluate the effectiveness of a medication, psychologists and physicians can be more precise when prescribing it to their patients. It also helps improve compliance by allowing patients to observe how their treatment is progressing. The difficulty of assessing mental health has hampered research despite its widespread prevalence. There is plenty of information available on depression, anxiety, and other conditions. However, it has been difficult to determine what causes them. However, advances in technology are beginning to reveal the mechanisms that cause these disorders. For instance, a study published in Nature Medicine sorts depression into six distinct biological subtypes. This opens the way to personalized treatment. Researchers utilized fMRI to study brain activity in 801 people with depression and 137 who did not. They studied the activation and connectivity of brain circuits affected in depression, including those which regulate cognition and emotions. They looked at a participant's brain scans during the time of rest as well as while performing specific tasks. The results showed that a combination of resting state and task-based measures could be used to predict whether or not someone would react to SSRIs. This is the first time a predictive test has been created in psychiatry. The team is currently working on developing an automated tool that will provide these predictive results. This is particularly beneficial for those who don't respond to standard therapies like therapy or medication. About 60% of those suffering from depression do not respond to the first treatment they receive. Some of these patients are referred to as treatment-resistant and are difficult to treat with the standard treatment regimen However, there is hope that the advancement of technology will allow to optimize treatment options. Brain Implants Sarah had lived with a debilitating depression, which she described as a black hole that pulled her down, a force of gravity so strong she could not move. She had tried a variety of medications however none of them gave her an enduring boost. She also tried other treatments like electroconvulsive therapy and ketamine infusions but both failed to work. Then, she decided to undergo a surgery that would allow researchers to implant electrodes in her brain and send her a targeted jolt every time she was about to suffer from a depressive attack. Deep brain stimulation is a method that is used extensively in the treatment of Parkinson's disease. It has also been proven to be helpful for some people who are resistant to treatment. It is not a cure, but aids the brain in coping. It utilizes a device that can implant tiny electrodes into specific parts of the mind, like the 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 a DBS device for the first time to tailor the treatment of depression for the patient. They called it a “revolutionary” new method that could open the door for a more flexible DBS therapies for other patients. For Sarah the team traced her brain's circuitry and found that her amygdala was a source of depression episodes. They discovered that a region deep in her brain —the ventral striatum- was responsible for soothing her amygdala's excessive reaction. Then, they implanted an apparatus the size of a matchbox into Sarah's skull, and then strung its spaghetti-like electrode legs down to the two brain regions. When a depressive symptom is observed, the device sends an electrical signal to Sarah's amygdala, and ventral striatum. The intention is to stop depression and motivate her to be more positive. It is not a cure for depression, however, it can make a huge difference for the people who require it the most. In the future it may be used to detect an indicator of a biological sign that indicates a depression is on the way, allowing doctors to prepare by turning up the stimulation. Personalized Medicine The concept of personalized medicine refers to customizing diagnosis, prevention and treatment strategies to individual patients based on information obtained through molecular profiling, medical imaging, lifestyle information and more. This differs from traditional treatments that are designed for the average patient. It is a one-size-fits-all approach which could not be efficient or efficient. Recent studies have revealed a myriad of factors that cause depression in a variety of patients. These include genetic variants neurocircuitry dysfunctions biomarkers and psychosocial markers as well as other factors. The goal of psychiatry that is personalized is to integrate these findings into the clinical decision-making process for optimal care. It is also meant to aid in the development and implementation of specific treatment plans for psychiatric issues like depression. Personalized psychiatry continues to progress, but several obstacles are currently preventing its clinical application. For example, many psychiatrists lack familiarity with the various antidepressants and their chemical profiles, which could result in a suboptimal prescription. Additionally the cost and complexity of integrating multiomics data into healthcare systems and ethical considerations have to be taken into account. One promising avenue to advance the personalized psychiatry approach is pharmacogenetics, which aims at utilizing a individual's unique genetic profile to determine the right dose of medication. It has been suggested that this could aid in reducing the risk of adverse effects of drugs and boost the effectiveness of treatment, particularly when it comes to SSRIs. It is important to recognize that this is a potential solution, and further research is needed before it is widely used. Other factors, including lifestyle choices and environmental influences are also important to consider. Therefore the integration of pharmacogenetics into depression treatment must be carefully and balanced. Functional neuroimaging can also be utilized to aid in the choice of antidepressants and psychotherapy. Studies have demonstrated that the activation levels in specific neural circuits (e.g. The response to psychotherapeutic or pharmacological treatment is determined by the ventral and pregenual anterior cortex. Moreover, depression treatment breakthroughs have already utilized these findings to help select participants, focusing on those with more activation levels and consequently having more favorable responses to therapy.