Depression is a common psychological problem that affects more than 17 million adults and 3.2 million adolescents in the United States, all of whom suffer from severe depression. For these people, finding effective treatments is not easy. Fortunately, scientists are exploring some new avenues aimed at getting people with depression back on their feet faster and with fewer side effects. Right now, doctors aren’t sure which drug is best for you. This results in many patients with depression trying multiple medications before finding the right one. Most antidepressants (the class of drugs doctors typically use to treat depression) take weeks or even months to work. This means you have to wait a long time before you know whether the treatment is effective. Moreover, about 30% of people still do not get better after trying several drugs. Doctors call this condition treatment-resistant depression. Because of this long and uncertain process, depression continues to impair your quality of life. According to the latest data from the National Institute of Mental Health, depression causes severe suffering and difficulty for more than 63% of adults and more than 70% of adolescents. Depression can also increase your risk of considering or attempting suicide. Here are some of the novel directions scientists are working on and how they can help you escape depression. ##Fast-acting antidepressants If you are depressed or suicidal, fast-acting antidepressants can make you feel better within a few hours. The FDA in 2019 approved a nasal spray called esketamine, the first fast-acting antidepressant for treatment-resistant depression. In 2020, the FDA approved it for the treatment of depression, including suicidal tendencies. Esketamine, which can be used alongside traditional antidepressants, is adapted from an older drug called ketamine. Ketamine was originally an anesthetic that can put people into unconsciousness. Ketamine can also provide quick relief from depression, but it has many serious side effects. For example, it can cause out-of-body experiences and hallucinations. Some people also abuse ketamine. Esketamine has similar side effects and abuse risks. However, a research review published in the journal Frontiers in Neuroscience in 2021 noted that its side effects are usually mild or moderate and do not last long. Scientists believe that esketamine improves depression by increasing levels of glutamate in the brain, a chemical that allows brain cells to communicate with each other. Researchers are also studying other new drugs that affect glutamate or GABA, another chemical signal, in the brain. Scientists hope these new drugs will have fewer side effects than existing drugs. The FDA has given breakthrough therapy status to several experimental, fast-acting antidepressants. This means the FDA will expedite the development of these drugs because they may be more effective than existing treatments for serious conditions like depression. ##More accurate antidepressant selection Nowadays, doctors choose antidepressants mainly based on guesswork. The latest research may provide tools that allow doctors to choose the most appropriate treatment options for an individual’s situation. Here are some tests and tools that can reduce trial and error in antidepressant treatment: **Blood tests. ** Recent research shows that blood tests measuring levels of certain proteins can predict whether a certain antidepressant will work for you. **Genetic testing. ** By testing some specific genes and how they affect your response to a certain drug, it can help your doctor provide you with the best treatment. In one recent study, people who were tested for 10 genes to guide treatment choices were more likely to recover than people who were randomly selected for treatment without testing. **Brain imaging. ** Researchers are testing SPECT (single positron emission computed tomography) and PET (positron emission tomography) to see if these imaging tools can help doctors choose the right drug for you. They can show activity levels in different areas of your brain. A recent review of studies found that looking at how your brain uses glucose, or sugar, with PET can help predict whether antidepressants will improve your depression. **Artificial intelligence (AI) that reads brain scans. ** Some scientists hope to treat depression using AI programs that can recognize patterns in EEG (electroencephalogram) scans. These scans measure your brain’s electrical activity. A study published in 2020 in the journal Nature Biotechnology found that an artificial intelligence program could use a person’s EEG data to predict whether the most commonly used antidepressants would be effective for them. ##Causes of Depression Understanding the causes of depression may provide clues to new treatments. Here are some biological processes that may be involved in depression: **Inflammation. ** Inflammation is your body’s natural response to fight infection and injury. But when it happens in places it shouldn’t or gets out of control, it can cause or worsen many different conditions, including depression. One of the largest studies of depression and inflammation published in the American Journal of Psychiatry in 2021 confirmed the connection between the two. They found that people with depression had higher levels of inflammation than people without mental illness. This result was obtained after ruling out other factors that may influence depression. This means that anti-inflammatory drugs may be helpful in antidepressant treatment. Additionally, lifestyle changes that reduce inflammation, such as exercise and a healthy diet, may also help improve depressive symptoms. **The gut-brain connection. ** There are hundreds of billions of bacteria and microorganisms living in your gut. Some of them are beneficial and some may be harmful. When their balance is disrupted, it can cause a number of health problems, including depression and inflammation. Some new research finds that probiotics can help restore the balance of your gut microbes while also reducing symptoms of depression. Probiotics are live bacteria that can be found in fermented foods like yogurt or in supplements. They have few side effects. Scientists also need to study more about how probiotics work for people with depression. Some studies have found that they work best when you take them with antidepressants. Research also suggests that different strains or species of probiotics may be helpful for different symptoms of depression. In the meantime, you can try taking probiotics for a month to see if it improves your mood. However, do not stop taking any prescribed medication without your doctor’s approval.
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