New Hope for Depression Sufferers
There are nearly 3 million people that suffer from depression around the world. Depression is a medical condition that affects mood and the ability to function. Due to the current health issues that many people are facing during a pandemic, a new focus on mental health is rising. New research gives hope to people suffering from depression by continuing relevant research on depression as a mental illness, exploring different methods of treatment and promoting alternative treatment options.
As a global community, facing different health crises, mental health issues are becoming more prevalent. More people are beginning to be diagnosed with a form of depression. It is estimated that 1 in 6 people will experience symptoms of depression (Watson and Odle). Symptoms of depression can begin at any age, but most appear during the teen years to early adulthood. There are many types of depression, the two most common forms are major depressive disorder and persistent depressive disorder. Major depressive disorder is a mood disorder that often manifests with depressed moods, lack of interests in activities, diffculty concentrating and thoughts of death and suicide. Persistent depressive disorder symptoms are feelings of sadness, anger, guilt and low self-esteem. These symptoms are not as severe as the symptoms in major depressive disorder but long lasting (Watson and Odle).
A diagnosis of depression is confirmed when a person has been feeling sad or down for more than a two week period. A doctor may want the patient to fill out a questionnaire or run other tests to ensure there are no other medical conditions. Since there are many forms of depression, the diagnosis that is given is dependent on the patients' symptoms and possible causes. Depression can affect anyone regardless of age or gender. With the number of depression diagnoses rising, research confirms that depression should now be categorized as a form of mental illness that affects millions of people around the world. "According to the latest data from the World Health Organization (WHO) statistics in 2019, there are more than 350 million people with depression worldwide, with an increase of about 18% in the last decade" (Wang et al). There are also findings that more adolescents and young people are reporting high levels of depression symptoms. This could be a result of many factors such as trying to navigate through an important part of life with stressors that they may have never experienced, the use of technology and more of a sedentary lifestyle (Cohen et al). Therefore, as the number of people being diagnosed with depression continues to increase, research has begun to take a different approach in the study of depression. In the last 10 years, depression research has become one of the most valuable areas of human research" (Wang et al). Researchers are using the new developments from their studies on depression to evaluate their findings in comparison to previous studies. "As researchers continue to explore, the study of depression is changing day by day" (Wang et al).
Clinical studies have shown that there are many factors that contribute to depression and how it affects people. Research suggests that "​​Depression stems from a combination of biological, environmental, and psychological factors" (Watson and Odle). With a different perspective on factors that can potentially cause depression, scientists have begun to analyze the brain and its functions in mood disorders.
Studies suggest that depression affects how the brain regulates the body's function. "Researchers have discovered differences in the brains of people with depression, as well as in the function of chemical messengers called neurotransmitters" (Watson and Odle). Doctors are hoping that the new studies involving the brain will lead to more viable treatments that are based on individual patients rather than one treatment option for all. Using previous studies on how the brain is affected by depression, a group of doctors at the Baylor College of Medicine in Houston have conducted studies on how people are affected by depression. Their findings conclude that no two people have the same experiences with depression and its symptoms. They also discovered that the brain responds to electrodes that are placed in targeted areas within the brain. A study with two patients was conducted. Both patients had electrodes strategically placed in specific areas of the brain. After the electrodes were placed and activated, doctors recorded patients' reactions. Most patients reported that they had a significant improvement with their symptoms of depression (Peyton).
The most important finding in the study of depression is that it is a treatable illness. Unfortunately, if left untreated depression can become worse and last for longer lengths of time. An estimated 90% of people that are treated for depression show signs of improvement. After a diagnosis, treatment options are available that can help the person suffering from depression symptoms. "Once diagnosed, depression can be treated in a number of ways. Usually, the medical doctor and/or mental health professional will work with the patient to draw up an appropriate treatment plan" (Bjornlund, Lydia D.).
Currently there are many options for treatment. Depending on the diagnosis of the patient, treatments can vary from self help, medication or even brain stimulation therapy. The traditional form of treatment that is widely used is medication. Typically the form of medication used are antidepressants. "Antidepressants are the most common treatment for MDD and are among the most prescribed medications. While they have demonstrated effectiveness, MDD patients vary significantly in their response to the various treatments (Kleinerman et al). Antidepressants can take a few weeks to improve the brain's chemistry and improve the patient's symptoms. Some antidepressants are known to have side effects that begin to reduce over usage time. Not all patients respond to the same antidepressants, so over time a doctor may need to change the medication, dosage or find a combination of medications.
Another typical treatment method that doctors might prescribe is talk therapy. Talk therapy is a form of counseling. Counselors help patients discover the root of the problem and provide skills or strategies that help cope with depression triggers. Talk therapies can be done one on one or group sessions with a trained therapist. This form of treatment is specialized for the person participating in talk therapy.
Research is also helping doctors explore nontraditional forms of treatment for depression. In clinical studies, researchers test nontraditional therapies that show success in treating depression. Examples of nontraditional treatments are: herbal agents, anti-inflammatory therapies, device-based treatments, cardiovascular exercise, and complementary and alternative medicine.
Herbal agents are a natural option for patients. They can be self prescribed. These herbal agents can consist of an increase in consumption of essential fatty acids, probiotics, and amino acids. Anti-inflammatory systems therapies have also been successful. Research shows that inflammation can be linked to brain disorders. Patients suffering from depression have an increase in inflammation in the brain, providing anti-inflammatory therapy provides the brain relief and in turn reduces symptoms of depression. Another example of a nontraditional treatment option is device-based treatment. This treatment is a nerve stimulation that is delivered to the brain with a device and a small port in the scalp. Electrical currents are sent to targeted areas in the brain. As researchers learn more about brain chemistry, another form of treatment that is gaining new attention is cardiovascular exercise. "Cardiovascular exercise, resistance training, mindfulness, and yoga have been shown to decrease severe depressive symptoms when used as adjuncts for patients with treatment-resistant depression, or as monotherapy to treat patients with milder depression" (Dokucu and Janicak). As doctors try to find the right treatment for their patients, "The use of complementary and alternative medicine (CAM) has increased among patients with psychiatric disorders, as it has in the general population, over recent decades" (Freeman, Marlene P.). Complementary and alternative medicine (CAM) are a combination of medicines and other health practices to treat depression. An example of CAM would be prescription antidepressants along with acupuncture.
Although there are many traditional and nontraditional treatment options for depression, current clinical studies are discovering alternative treatments that doctors are willing to try. Offering personalized treatment to patients ensures that the doctor or mental health provider can make informed decisions on what options would be best.
There is a need for more research using alternative treatment. There are studies that show that 10% to 30% of patients suffer from treatment resistant depression, in which case patients do not respond to typical antidepressants. These patients require a variety of treatment strategies in order to find the method that best works for them (Al-Harbi). Treatment resistant depression is hard to treat and requires a strategic plan to treat their symptoms. Studies also conclude that the pharmaceutical treatments have a longer effect that negatively affects patients. "One in three patients with MDD develops resistance to the antidepressant drugs. More importantly, current pharmacological treatments do not improve the cognitive dysfunctions associated with the mental disorder, even when combined with psychotherapy" (Garcia-Gutierrez, Maria S., et al). Due to the need for treatment in special cases, doctors are willing to try alternative treatment methods for patients that are no longer responding to traditional forms of treatment. Due to this behavior pattern and resistance build up from the pharmaceutical drugs that many take "A non-response or poor response to two treatment attempts with first-line antidepressants that primarily target one or more of three monoamine neurotransmitters pathways (serotonergic, noradrenergic, dopaminergic) suggest that more complex neurobiological mechanisms may be involved in TRD (Kverno and Mangano).
Positive results are being found within the current clinical studies exploring alternative methods to treat depression. A new method in the preliminary stages is Vagus nerve stimulation therapy. "Vagus nerve stimulation therapy that consists of a small device about the size of a quarter. The device implanted just below the collarbone sends out mild pulses to a nerve in the neck (UWIRE). VNS therapy was created as a form of treatment for seizure disorders. The device sends stimulation to the vagus nerve that is located in the frontal cortex of the brain which affects mood (UWIRE). During clinical trials with the use of this small device, doctors observed after nerve stimulation therapy session patients seemed to feel happier.
With mounting evidence that medication is not the only option for patients diagnosed with depression, alternative treatment is essential in the quest to treat depression. Clinical trials have proven that brain function and chemistry is a key factor in the approach for treatment of depression. Another alternative method that researchers have been observing is the use of ketamine and psilocybin. "Evidence from ketamine and psilocybin and neurological stimulation research that sustained remission requires the involvement of multiple neurotransmitter systems, increased cellular energy, BDNF, and transcription factors that lead to neuroplasticity, neurogenesis, and recovery of function" (Kverno and Mangano). Observations in the ketamine and psilocybin treatments show the brain having a rapid response to the therapy. The response time in average patients have been two hours after therapy administration. This therapy would require a maintenance stage of therapy, where patients would continue treatments one to two times a month.
Depression is an illness that is affecting more and more people regardless of their gender or age. Living with depression can be manageable. Providing different options to treat depression is giving hope to people that are suffering from depression or know someone that is. The focus and continuous study of depression is providing doctors with alternative medical treatments that can be prescribed to patients. Although there are break through cases of success with current methods of treatment, the focus on mental illness needs more attention and research findings need to be shared globally.