Advanced Depression Treatment If your depression doesn't respond to a first-line antidepressant your doctor may try increasing the dosage or adding a different medication They may also recommend psychotherapy Modern psychotherapy techniques like augmented depression therapy have scientific support and can help improve depression symptoms These therapies are focused on finding and resolving specific ways depression interferes with daily life Transcranial Magnetic Stimulation TMS TMS is a noninvasive brain stimulation technique that utilizes magnetic pulses to stimulate the brain's neurons that control mood It is frequently advised to treat depression if medications have failed or are not appropriate for a particular person It can also be used to treat PTSD and is often combined with psychotherapy TMS is a safe and effective treatment that doesn't trigger severe side effects During the session, a health professional will install an electromagnetic coil over the part of your brain which controls mood In the case of rTMS it is the dorsolateral prefrontal cortex dLPFC It is a tiny area that is located in front of your head You will hear a click sound and feel a thumping sensation as the device sends pulses to your brain The healthcare professional will adjust settings to stimulate specific areas of the brain The healthcare professional will assess the intensity of the pulses by measuring the amount of energy needed to induce the thumb to twitch This is crucial because it allows them to determine the amount of power they are using and ensures the security of the patient In the past, pulses were delivered at 120 percent of the threshold of motor However, the current research is focused on accelerating TMS therapy to reduce the duration of treatment and increase response rates In a controlled, randomized study researchers have demonstrated that TMS can benefit people suffering from major depressive disorder MDD who are unable to respond to antidepressants The study revealed that patients treated with rTMS showed significant improvement in symptoms like depression, sadness, changes in appetite, and decreased enjoyment or interest in activities The study also showed that the effects lasted for a long time Contrary to other forms of brain stimulation like vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy It is also safe for women who are pregnant and has a very low risk of having seizures Some patients may feel pain or discomfort on their scalps beneath the magnet while they are receiving treatment Typical TMS treatments last about half an hour Your doctor will inform you how long the treatment will be and may pause the pulses in this period to allow the magnet to cool down Vagus Nerve Stimulation VNS VNS also known as Vagus Nerve Stimulation is a treatment that uses timed electrical signals in order to alter brainwave patterns and reduce depression symptoms This device is surgically implanted and uses a small generator that's connected to a wire that is wound around the left Vagus nerve at the neck The procedure is FDA-approved for treatment-resistant depression in people who have not received relief from other treatments such as psychotherapy or medication It's also approved for seizure control in a few epileptic patients Researchers evaluated the effectiveness of VNS with a sham-device for patients with bipolar disorder or unipolar disorder that is resistant treatment depression Patients in the VNS group received a moderate, low or high dose of electrical stimulation throughout the 22-week "acute phase" The primary endpoint was the changes in the Inventory of Depressive Symptomatology IDS-SR30 Patients in the VNS group improved significantly more than those in the sham group At a 12-month follow-up, those in the VNS group had a mean IDS-SR30 score of 93 points, while those in the sham group had a score of 42 points The VNS treatment was well-tolerated The most frequent side effects were voice alteration hoarseness, a feeling of numbness, and a sensation in the chest Other reported side effects included the feeling of tingling, headache fatigue, fatigue and changes in speech or swallowing Certain of these adverse effects occurred more frequently in higher dose groups, while others were seen at all doses The rate of AEs was similar to those seen in other studies, and generally eliminated by the end of the acute study period Psychiatrists from Ohio State Wexner Medical Center are regularly invited to participate in national discussions on the best way to treat depression and other mood disorders Our experts are helping to shape national standards of health care We are also a part of a multicenter clinical trial called RECOVER which is being conducted by the Centers for Medicare amp; Medicaid Services The aim of this study is to assess VNS for treatment-resistant depression This is a significant research endeavor, since the evidence available now suggests that VNS could provide better benefits and hope for this difficult to treat chronic patient Electroconvulsive Therapy ECT ECT is a potent treatment for depression that isn't improving by taking medication It is especially helpful for those who are suicidal or who are unable to wait for their medication to take effect During ECT doctors use small electrical impulses through the head to trigger a short seizure The brain is reportedly altered by this chemical structure and improve the symptoms of mental health issues ECT has been in use since the 1930s Despite the stigma attached to the treatment it has helped many people https//wwwiampsychiatrycom/depression-treatment will first have to perform a thorough psychiatric evaluation before recommending ECT They will review your medical records and conduct several tests, including an electrocardiogram, blood tests and maybe a chest X ray They will also inquire what you think about the possibility of having ECT and consider any views from friends, family, or other advocates who are either supporting or advocating for you The ECT treatment is given when you're asleep under general anesthesia, so you will not feel anything during the procedure A mouth guard is used to protect your teeth, while masks protect your face to allow oxygen An anesthesiologist injects a local anesthetic into your vein using needle After you fall asleep, electrodes are placed on either one side or both of your head based on whether you are receiving unilateral or bilateral ECT These deliver small electrical pulses to the brain that cause a short seizure It lasts only 20 to 60 second and you will wake up soon after You can withdraw your consent to ECT at any time, even before the first treatment You have a right to revoke your consent under the Care Quality Commission CQC and your doctor must always consider your wishes when deciding whether or not to use ECT Certain people find ECT is a good option for them after they've tried other treatments but did not see any improvements, but it is also a viable option for mild depression or severe psychosis or if you're a danger to others or yourself and can't wait for medication to take effect The majority of people require several ECT sessions spread out over three to six weeks Light therapy Light therapy is a way to compensate for the lack of sunlight, a factor that could contribute to major depressive disorder that has seasonal patterns formerly called seasonal affective disorder It can be used as a stand-alone treatment or in conjunction with other treatments, such as psychotherapy and medications During light treatment, you sit next to the light box, which emits white light with bright colors The light is usually between 2,500 and 10,000 in lux During each treatment session you are seated for approximately 30 minutes near the light The light could aid in improving your mood and alleviate other symptoms of SAD like being tired most of the time and having trouble sleeping Although researchers aren't sure how light therapy can help treat SAD but they do know that it has a direct influence on the circadian rhythms Circadian rhythms are biological cycles that affect the patterns of sleep, hormone levels, and other vital functions Light therapy can alter the internal clock of your body by influencing the release of melatonin It is a chemical which regulates sleep-wake cycles It can also affect neurotransmitter functions by affecting serotonin production Numerous studies have demonstrated that light therapy improves depression symptoms and boosts the effectiveness of antidepressant medication Additionally, some studies have demonstrated that light therapy is effective in treating bipolar disorder These results are encouraging and they suggest that light therapy may be an option for those with depression and bipolar disorder Consult your physician or a mental health professional before you start using light therapy They can help you find the right device for your needs and offer guidelines on how to utilize it They can also tell whether it interacts with other medications you're taking Light therapy is a safe treatment that does not cause any negative side effects You should only use it when your doctor prescribes It is important to seek treatment as quickly as you can if you're suffering from depression that is severe Depression is a serious condition and can have grave consequences for your physical and emotional well-being In severe cases, it can even cause thoughts of suicide Seek immediate assistance from a mental health professional in the event that you feel suicidal