Depression Support Journal

The Future Of Depression Treatment

Depression is a very common problem. Many new approaches are being studied. There is plenty of reason to hope that the coming years will bring new and exciting treatments:

• New Drugs
• Alternatives To Electroconvulsive Therapy
• Complementary And Alternative Medicine

New Drugs

One problem in developing new drugs to treat depression is that we’re only beginning to understand depression’s specific biological causes.

Most antidepressants aim to enhance the functioning of nerve pathways involving two of the brain's chemical messengers, serotonin and norepinephrine. As good as this treatment can sometimes be, these two chemical messengers are only a small part of the story. There are other chemical messengers that probably influence mood. One of them, dopamine, has a role in the brain's reward system, contributing to pleasure and motivation. Drugs such as amphetamines and cocaine stimulate that system, which is one of the reasons these drugs are so addictive.

The chemical messengers glutamate and gamma-amino butyric acid (GABA) may also play a role in the ups and downs of mood, making them potential targets for future drug therapy.

The stress-response system is also under study. When you are stressed physically or emotionally, your body responds by changing the concentration of stress hormones circulating in your blood. This response in depressed people tends to be overactive, similar to a car that is revving too high. Researchers are searching for a way to retune thissystem.

The real future of depression treatment may be a better understanding of the chemical reactions inside cells (as opposed to the chemical communication between them). The genes inside every cell control the production of proteins that can trigger a cascade of chemical reactions that may ultimately lead to a change in mood.

A great hope is that new discoveries about what genes do (genomics) and the function of each protein that genes produce (proteomics) will help scientists identify biological causes of depression. With any luck, this will lead us to more specific treatment.

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Alternatives To Electroconvulsive Therapy

Repetitive transcranial magnetic stimulation. In recent years, health-care providers have tried using strong magnets to treat depression. Repetitive transcranial magnetic stimulation involves passing a magnet over the scalp, directing a magnetic field to a small part of the brain. There is no need for anesthesia, as there is no pain or discomfort. Repetitive transcranial magnetic stimulation takes less than an hour. It is done daily for about 10 days. Although there have been some promising results, the treatment is still being standardized, and it does not appear to be as effective as electroconvulsive therapy. But the treatment has not yet been standardized. It is not clear how many treatments are required or what part of the brain is best treated with the magnet.

Vagus-nerve stimulation. The vagus nerve is a very long nerve that starts in the brain and travels through the chest to the diaphragm, the muscle at the base of your chest that allows your lungs to expand during breathing. The vagus nerve is linked to parts of the brain that control mood and anxiety. In 1997, a process to treat seizures was approved that uses a small pacemaker-like device to stimulate the nerve. Researchers noticed that this stimulation also improved mood in some people. A few studies have shown vagus nerve stimulation to be effective in treating depression, though more research is needed. A major downside to vagus nerve stimulation is that it requires surgery to install the device. Some specialists now recommend the procedure and device for selected people who have treatment-resistant depression. But it is still rarely use because it is a relatively untried procedure.

Deep brain stimulation. In this technique, ultra-thin electrodes are implanted deep in the brain in order to stimulate a specific region. The technique has been used to treat neurological illnesses such as Parkinson’s disease, tremor and seizures. In recent years, researchers have offered it to a small number of severely depressed people who have not found relief with any other treatment. Some have improved, but research is in its earliest stages, so it is difficult to say how helpful this treatment might be. As with vagus nerve stimulation, surgery is required with deep brain stimulation.

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Complementary And Alternative Medicine

There has been enormous interest in the herbal remedy St. John's wort. Although this herb may be somewhat helpful in people who have mild depression, it is probably not as effective as standard treatments for severe depression.

Fish have also caught researchers’ attention. Omega-3 fatty acids, which are found in tuna, salmon and other fish, are an essential part of the diet because the body cannot produce them. Because these fatty acids are a component of nerve-cell membranes, some scientists believe that absorbing more of them may help support nerve function. Can eating more fish help people with mood problems? There is no clear evidence yet that it is a good treatment for depression. To treat a mood disorder, you would probably need to take large doses of omega-3 fatty acids as fish oil or in pill form.

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