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If your depression isn't responding to a first-line antidepressant your doctor might suggest increasing the dose or adding a different type of medication. They may also suggest psychotherapy.

Newer psychotherapy methods like augmented depression therapy offer empirical support and can help improve depression symptoms. These treatments aim at identifying and resolving specific ways in which depression interferes with daily life.

Transcranial Magnetic Stimulation (TMS)

TMS is a non-invasive brain stimulation that uses magnetic pulses to stimulate neurons that are responsible for mood. It is usually recommended to treat depression when medication has failed or is not suitable for a person. It is used to treat PTSD and, in some cases, combined with psychotherapy. TMS is an effective and safe treatment that does not cause serious side effects.

During the session, the healthcare professional will place an electromagnetic coil on your scalp over the region of the brain that regulates mood. In the case of rTMS, this is the dorsolateral prefrontal cortex (dLPFC). It is a tiny area located on the front of your head. The device will send electrical impulses to your brain. You will hear clicking sounds and feel tapping sensations. The healthcare expert will alter the settings to stimulate the areas you want of your brain.

The healthcare professional will measure the amount of energy needed to cause a thumb flick. This is important because it helps them to know how much power they are using and ensures the security of the patient. In the past, the pulses were given at 120 percent of the motor threshold. 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 help people with major depressive disorder (MDD) who do not respond to antidepressants. The study revealed that patients who were treated with rTMS saw significant improvements in symptoms like low mood and sadness as well as changes in appetite and loss of interest or enjoyment of activities. The study also revealed improvements that lasted a long period of.

Unlike other types of brain stimulation such as vagus nerve stimulation and electroconvulsive therapy, TMS does not interfere with psychotherapy. It is safe for women who are pregnant and has a low risk of seizures. However, some patients may experience pain or discomfort on their scalp under the magnet during the treatment.

Typical TMS treatments last about half an hour. Your provider will tell you how long the treatment will be and may pause the pulses in this period to let the magnet cool down.

Vagus Nerve Stimulation (VNS)

VNS (also known as Vagus Nerve Stimulation) is a treatment that makes use of controlled electrical signals that are timed to change brainwave patterns and lessen depression symptoms. The device is surgically implanted, and it uses tiny generators that are connected to a wire wrapped around the left Vagus nerve of the neck. The procedure is FDA-approved for people suffering from depression that is treatment-resistant who have not found relief from other treatments such as psychotherapy or medication. It is also approved for seizure control in certain epileptic patients.

Researchers compared the efficacy of VNS with a sham device in people with bipolar disorder that is resistant to treatment or depression. Patients in the VNS group received a moderate, low or high dose of electrical stimulation during the 22-week "acute phase." The primary goal was a change in the Inventory of Depressive Symptomatology Self-Report (IDS-SR30) score over the course of the study. Patients in the VNS groups improved significantly more than those in the sham groups. At the 12-month check-up the VNS group scored an average IDSSR30 of 9.3 while the group of sham scored 4.2.

The VNS treatment was well-tolerated, with the most common adverse effects being voice distortion or hoarseness, as well as an impression of weight on the chest. Other reported side effects included headaches, tingling, fatigue, and changes to speech or swallowing. Certain of these were more often in the higher dose groups, and others happened at all doses. The rate of AEs was similar to those seen in other studies, and generally cleared by the end the acute study period.

Psychiatrists from Ohio State Wexner Medical Center are frequently invited to participate in national discussions on the best method to treat depression and other mood disorders.  I Am Psychiatry  are involved in shaping the national standards of care and are currently a participant for the Centers for Medicare and Medicaid Services RECOVER multicenter clinical trial to further study VNS as a treatment for treatment-resistant depression. This is a crucial research endeavor, since the evidence available suggests that VNS can offer improving benefit and hope for this difficult-to-treat chronic population.

Electroconvulsive therapy (ECT)

ECT is an effective treatment for depression that is advanced and suitable for those who can't get better with medication. It's particularly helpful for those who are suicidal or cannot wait for their medication to take effect.

During the ECT procedure, doctors send small electric currents through the brain to cause a brief seizure. This is believed to alter brain chemical structure and speedily improve symptoms of certain mental health disorders. ECT has been in use since the 1930s. Despite the stigma attached to the treatment it has helped a lot of people.

Your psychiatrist will first need to conduct a thorough mental assessment before recommending ECT. Then, they will examine your medical history and conduct various tests, including an electrocardiogram (EKG), blood tests, and perhaps a chest X-ray. They will ask you to describe how you are feeling about ECT, and take into account any opinions from family members, friends, or advocates speaking on your behalf.

The ECT treatment is given while you sleep under general anesthesia. This means that you won't feel anything during the procedure. A mouthguard protects your teeth, and masks protect your face to supply oxygen. An anesthesiologist injects an anesthetic into your vein by using needle. After you have fallen asleep, electrodes are placed on one side or both of your heads depending on whether you are receiving unilateral or bilateral ECT. These pulses deliver small electrical impulses to the brain, causing an instant seizure. It lasts between 20 and 60 second and you will wake up soon after.

It's important to remember that you can revoke your consent to ECT at any time, even just before the first treatment. This is your right under Care Quality Commission (CQC) regulations, and your doctor should always take into account your wishes when deciding whether to use ECT for you.

Some people find that ECT is a viable option for them after they've tried other treatments and haven't seen any improvement, but it is also a viable option to treat mild depression or severe psychosis or if you're at risk to yourself or others and are unable to wait for treatment to begin working. The majority of patients will require several ECT sessions over a period of three to six weeks.

Light therapy

Light therapy can compensate for the lack of sunlight. This is a factor which may contribute to the development of seasonal affective disorder (formerly known as major depression). It can be used as a separate treatment or to complement other treatments like psychotherapy and medications. In light therapy, you sit next to the light box, which emits white light with bright colors. The light usually has between 10,000 and 2,500 light lux. Each time you undergo a treatment you will sit for around 30 minutes in front of the light source. The light may help improve your mood and ease other symptoms of SAD, such as feeling tired all the time and sleeping too much.

Although researchers don't know exactly how light therapy works to treat SAD, they do know that it has a direct effect on circadian rhythms. Circadian rhythms affect sleep patterns, hormones, and other functions. Light therapy can alter your internal clock by altering the release of melatonin an ingredient that regulates the sleep-wake cycle. It can also affect neurotransmitter functions through the alteration of serotonin production.

Several studies have shown that light therapy improves depression symptoms and boosts the effectiveness of antidepressant drugs. In addition, some studies have shown that light therapy is effective in treating bipolar disorder. These findings are encouraging, and they suggest that light therapy could be an option for those suffering from bipolar disorder and depression.

Talk to your doctor or mental health professional before you start using light therapy. They can guide you in choosing the right device and provide instructions on how to use. They can also tell you whether it interacts with other medications you are taking.

Light therapy is a safe treatment that has no negative side adverse effects. However, it is important to use it as prescribed by your physician. If you are experiencing severe depression, it's essential to seek treatment right away. Depression is a serious condition and can have grave consequences for your emotional and physical well-being. In severe instances, depression can lead to suicidal thoughts. If you're having suicidal thoughts, seek help immediately from an expert in mental health.