How Is Major Depressive Disorder Treatment?

What if there was a non-pharmacological approach to the treatment of patients with major depressive disorder (MDD)? And if this treatment has the potential to be even more successful than the current pharmacological approaches? William M. Sauvé, MD, clinical director of the military program at Poplar Springs Hospital in Petersburg, VA, believes that the opportunity may be in the magnetic and electrical brain stimulation. In your opinion, physicians should take a more aggressive approach in terms of major depressive disorder treatment .

One approach is transcranial magnetic stimulation (TMS). TMS, an electromagnetic coil is placed against the scalp to deliver pulses with a duration of four seconds, 10 pulses each having a therapeutic dose of 90-120% of the motor threshold for about 30-50 minutes per session, five times week for a total of 4-6 weeks. Sauvé, said the current meta-analysis of TMS (which is approved by the FDA) shows a small to moderate benefit in the treatment of depression. In addition, Sauvé said, "TMS can be used in clinical practice for patients with mild to moderate resistance to treatment."

Another non-pharmacological approach for the major depressive disorder treatment  involves the use of electroconvulsive therapy (ECT). In ECT, a small electrical charge potential is oriented towards the frontal cortex, stimulating cortical and subcortical tissue. However, up to 95% of this electrical activity is derived from the skull itself. ECT is usually an average of 6-12 treatments, and can be used in emergency situations such as suicidal tendencies. Current treatment TEC produces a response in patients after only a few sessions and the highest response rate of any treatment of depression.

Unfortunately, the relapse rate is high after remission and there is no evidence to support that treatment with the drug could mitigate this effect. In addition, memory loss occurs frequently after treatment. However, Sauvé says, "unilateral right (stimulation) may have less memory effects that bilateral." Sauvé also noted that, "neurostimulation therapies are promising also include transcranial direct current stimulation, magnetic therapy and deep brain stimulation." According Sauvé, there is also evidence to suggest that light therapy, which is commonly used to treat seasonal depression can actually be an effective treatment for depression in general.

With information from multiple disciplines on the positive benefits of exercise, Sauvé also urges physicians to incorporate a treatment exercise program to increase efficiency in depression. For patients with MDD who are considered in recovery, Sauvé says physicians should consider using cognitive therapy based on mindfulness skills sessions 8 weeks to educate patients on strengthening self-pity, reduce evasion, increase acceptance and reduce rumination. It can be administered either in groups or by electronic means.

Interestingly Sauvé estimates that mindfulness therapy could be used as a tool for patients with MDD as a way to help deal with their emotions. He said patients with MDD have difficulty distinguishingbetween a 'sad mood "and" deep dark depression "and are often terrified when they feel sad feelings surface. He believes that if patients become more aware of what is going on with your body through the practice of mindfulness and awareness of himself, could learn to tell the difference between emotion and severe depression.