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Depression Treatment BreakthroughsWith a new generation of depression treatment breakthroughs, scientists are taking on this disease with greater precision than ever before. These approaches will help you locate the right medication and prevent repeat relapses.If your depression isn't responding to antidepressants, psychotherapy may be beneficial. This includes cognitive behavior therapy and psychotherapy with others.Deep Brain StimulationDeep brain stimulation is a surgical method where electrodes inside the brain are placed to target specific areas of the brain that can cause conditions and diseases like depression. The electrodes are connected to a device that emits electrical pulses to treat the disease. The DBS device is referred to as a neurostimulator and is also used to treat other neurological disorders, such as Parkinson's disease, essential tremor and epilepsy. The DBS device's pulsing could "jam up" circuits that trigger abnormal brain activity in depression, while leaving other circuits unaffected.Clinical studies of DBS have demonstrated significant improvements for patients suffering from treatment resistant depression (TRD). Despite the positive results however, the path to a stable recovery from TRD is different for each patient. Clinicians must rely on their own subjective reports from patient interviews as well as ratings scales for psychiatric disorders, which can be difficult to interpret.Researchers from the Georgia Institute of Technology and Emory University School of Medicine have developed an algorithm that can detect subtle changes in brain activity patterns. This algorithm can distinguish between stable and depressive states. The scientists' research was published in Nature Human Behaviour, exemplifies the importance of combining neuroscience, medical and computer engineering fields to develop potentially life-changing therapies.During the DBS procedure, doctors place a thin wire-like lead in the brain through a hole in the skull. The lead is fitted with electrodes that transmit electrical signals to the brain. The lead is connected to an extension cable that extends from the head, behind the ear and down to the chest. The extension and the lead are connected to a battery-powered stimulator implanted under the skin of the chest.The programmable neurostimulator produces electric pulses to regulate abnormal brain activity in the areas targeted by the DBS devices. The team used DBS in their study to target a brain region known as the subcallosal cortex (SCC). The researchers found that when SCC was stimulated, it caused an increase in the levels of dopamine, which may improve symptoms of depression.Brain ScannersA doctor may use various tools and techniques to diagnose depression, but the most effective one available today is a brain scan. This technology makes use of imaging to observe changes in brain activity at 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 be used to determine which treatment will be most effective for an individual. For example, some people are more responsive to antidepressant medications than others, but this isn't always situation. Physicians and psychologists can prescribe medications more precisely by using MRI to assess the effectiveness. It can also help improve compliance by allowing patients to see how their treatment progresses.Despite its widespread use, research in mental health has been hindered by the difficulty in measuring it. There is plenty of information available on depression, anxiety, and other illnesses. However it's been a challenge to pinpoint the causes. New technology is now uncovering the underlying causes of these disorders.A recent study published in Nature Medicine, for example, classified depression into six distinct subtypes. This will lead to individualized treatment.Researchers employed fMRI technology in order to analyze brain activity of 801 people with depression, and 137 people who are not. They looked at the activation and connectivity of brain circuits that are affected in depression, including those that regulate emotions and cognition. They examined 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 if an individual would respond to SSRIs. This is the very first time that a predictive test in psychiatry has been developed. The team is currently working to develop an automated tool that can provide these predictions.This is particularly helpful for those who do not respond to conventional treatments such as therapy and medication. As high as 60% of people with depression are not responding to their first treatment. Some of these patients can be difficult to manage using an established treatment plan.Brain ImplantsSarah suffered from a debilitating type of depression that was debilitating. She described it as a dark hole that dragged her down. It was so strong that she could not move. She tried a range of drugs, but none provided a lasting boost. She also tried other treatments, such as ketamine injections and electroconvulsive treatments, but they also failed. Then, she decided to undergo a surgery that would permit researchers to implant electrodes in her brain, and then send her a specific shock whenever she was likely to have a depressive episode.Deep brain stimulation is a technique which is extensively used to treat Parkinson's disease. It has also been shown to be beneficial for patients who are not able to receive treatment. It's not a cure, but assists the brain to cope. It's based on a device which implants tiny electrodes in certain areas of the brain, like a pacemaker for the mind.In a research study published Monday in the journal Nature Medicine, two researchers at University of California at San Francisco (UCSF) explain how they used the DBS device for the first time to create a custom the treatment of depression for a patient. They described it as a "revolutionary" approach that could allow custom DBS treatments to be made available to other patients.The team looked into Sarah's brain's neuronal circuits and discovered that her amygdala may be the main cause of her depression episodes. They discovered that the ventral striatum the deepest part of her brain was responsible for calming her amygdala's overreaction. Then, they implanted an apparatus the size of a matchbox into Sarah's skull and strung its electrode legs, shaped like spaghetti, down to those two regions.Now, when a symptom of depression occurs the device tells Sarah's brain to send a small electrical charge to the amygdala and to the ventral striatum. The intention is to prevent depression and encourage her to be more positive. It's not a cure but it can make a huge difference for those who need it the most. In the future, this may be used to identify biological indicators that indicate depression is on the horizon and give doctors the chance to prepare by increasing the stimulation.Personalized MedicinePersonalized medicine is a method to tailor prevention, diagnosis and treatment strategies to individual patients, based on the data gathered from molecular profiling. medical imaging, lifestyle data etc. This differs from traditional treatments that are geared towards the average patient. guidelines for treating depression is one-size-fits-all solutions that may not be effective or efficient.Recent studies have uncovered several factors that cause depression in various patients. These include genetic variants and neural circuitry malfunctions biomarkers, psychosocial markers and biomarkers, among others. The goal of individualized psychiatry is to incorporate these findings in the clinical decision-making process for the best treatment. It is also intended to facilitate the development of specific treatment methods for psychiatric conditions such as depression, aiming at a better utilization of resources and improving patient outcomes.Personalized psychiatry continues to progress however, there are many obstacles still preventing its clinical application. Many psychiatrists are not familiar with the pharmacological characteristics of antidepressants, which could lead to suboptimal prescribing. Additionally, the complexity and cost of integrating multiomics data into healthcare systems, as well as ethical considerations need to be taken into account.Pharmacogenetics is a promising method to improve the effectiveness of personalized psychiatry. It makes use of the genetic makeup of a patient in order to determine the appropriate dose of medication. It has been suggested that this could aid in reducing drug-related side effects and increase treatment efficacy, especially when it comes to SSRIs.It is crucial to remember that this is a potential solution, and further research is needed before it is widely adopted. Other factors, including lifestyle choices and environmental influences, are also important to think about. The integration of pharmacogenetics and lifestyle choices in depression treatment should therefore be carefully balanced.Functional neuroimaging is a further promising tool for guiding the choice of antidepressants and psychotherapy. Studies have demonstrated that the pretreatment levels of certain neural circuitries (e.g. ventral and pregenual anterior cingulate cortex) predict the response to both pharmacological and psychotherapeutic treatments. Furthermore, some clinical trials have already used these findings to guide their selection of participants, targeting those with more activation levels and consequently showing more favorable responses to treatment.