Treatment options for depression have made significant progress in recent years. Some of the newest and most effective methods are listed below:
Therapy and interventions
Psychotherapy is a popular method of treating depression. The aim of therapy is to identify and change patterns of behaviour and thinking that can lead to depression. One specific type of psychotherapy, cognitive behavioural therapy (CBT), is particularly effective in managing depression. CBT focuses on identifying and changing negative thoughts and behaviours.
Mindfulness-based interventions: Mindfulness-based interventions, which focus on training individuals to be more aware of their thoughts and feelings in the present moment, have shown promise in treating depression. A study published in JAMA Psychiatry in 2020 found that mindfulness-based cognitive therapy (MBCT) was as effective as medication in preventing depression relapse over a two-year period.
Exercise: Exercise has long been known to have mood-boosting effects, but recent studies have found that it may be an effective treatment for depression as well. A study published in JAMA Psychiatry in 2020 found that aerobic exercise was as effective as medication in reducing depression symptoms over a 12-week period.
Digital interventions: With the rise of telemedicine and digital health, there has been increasing interest in using technology to deliver depression treatment. A study published in JAMA Network Open in 2020 found that a smartphone app that combined elements of CBT and behavioral activation was effective in reducing depression symptoms over an eight-week period.
A healthy lifestyle can also help treat and reduce depression. This includes regular exercise, meditation, a balanced diet and adequate sleep. A balanced diet can help increase serotonin production in the body, which can help improve mood. Regular exercise can help reduce body stress and increase the production of endorphins, known as "feel-good" hormones.
Antidepressants are often prescribed to treat depression. The most commonly prescribed class of antidepressants are selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (Seroxat), fluoxetine (Prozac) and citalopram (Cipramil). There are also other types of antidepressants, such as atypical antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs).
However, it is important to note that depression is a complex condition that can result from multiple factors. Serotonin is only one piece of the puzzle and there are other factors such as genetic, environmental and psychosocial factors that may also play a role. An article in Nature Molecular Psychiatry brings new evidence. "A systematic review of studies of serotonin levels in people with depression found no evidence that depressed people had lower serotonin levels or abnormal serotonin activity compared to non-depressed people." More on this in our article.
According to Fava, nearly two-thirds of patients treated with current antidepressants do not respond adequately, and those who do may not experience clinically meaningful results for up to eight weeks.
Neuromodulation technologies such as vagus nerve stimulation and repetitive transcranial magnetic stimulation (rTMS) are used in the treatment of depression.
How does TMS Therapy work, you can see here:
These technologies aim to stimulate the nervous system and induce changes in the brain that can improve depression.
Other new and fast-acting treatments
There are several new treatments for depression that work quickly, including a new protocol for TMS therapy and a new oral antidepressant.
The drug Auvelity is a combination of bupropion and dextromethorphan and targets the glutamate system. It was approved by the FDA in August 2022 and can take effect within a week. The approval could open the door for a new class of drugs that increase glutamate.
Ketamine: Ketamine is a drug that has been used for anesthesia and pain relief, but it has also been found to have rapid antidepressant effects in people with treatment-resistant depression. It works by blocking the NMDA receptor in the brain, which increases the activity of another receptor called AMPA. This leads to the release of a chemical called brain-derived neurotrophic factor (BDNF), which promotes the growth of new neurons and synapses in the brain.
Psilocybin: Psilocybin is a hallucinogenic substance found in certain types of mushrooms. It has been studied for its potential use in treating depression, anxiety, and other mental illnesses. Psilocybin acts on the serotonin receptors in the brain, which are also targeted by traditional antidepressants. Clinical studies have shown that psilocybin can produce rapid and sustained antidepressant effects, but more research is needed to determine its safety and effectiveness.
Transcranial magnetic stimulation (TMS) was approved by the FDA in 2008, but newer versions of the TMS protocol produce results in less than a week compared to six weeks for the older version of the protocol. The SAINT method is an accelerated TMS protocol where people receive ten treatments per day over five days. It has an 80% accuracy rate for treating depression.
Other promising treatments include optogenetics and stem cell therapy, which is being studied to see if they can activate new molecules to treat depression.
Several studies have looked at combining different types of treatments for depression to see if they are more effective than using just one type of treatment. For example, a study published in JAMA Psychiatry in 2020 found that a combination of cognitive behavioral therapy (CBT) and medication was more effective at reducing depression symptoms than either treatment alone.
Each person is different and responds differently to different therapies. It is important to talk to a doctor or therapist to find out which treatment method is best for you.