Depression, or major depressive disorder, is a psychiatric diagnosis that touches millions. Its reach is vast, affecting rich and famous celebrities to blameless and kindhearted loved ones. Depression has become even more poignant in the wake of the global pandemic, which greatly exacerbated the prevalence of mental disorders, leading to a cycle of loneliness, hopelessness, and what many experts are now calling “deaths of despair.”
Once thought to be merely a result of dysregulated brain chemicals, researchers, psychiatrists, and other mental healthcare professionals have begun to conceptualize depression as more than just a “mental health” issue. As individuals and communities grapple with the physical, social, spiritual, and mental health consequences of this condition, professionals like the ones at Neuro Wellness Spa are fervently exploring innovative treatments to combat depression at all levels and offer a glimmer of hope to those who are living with depression. In this article, we offer a comprehensive list of treatments for depression to help you understand your options and guide you toward remission of your depression symptoms.
Antidepressants Are Not Your Only Option
Antidepressant medication is typically the first thing that a doctor will recommend to a patient who is experiencing symptoms of depression. The most common type of antidepressants, selective serotonin reuptake inhibitors, or SSRIs, work by blocking the reabsorption of serotonin into the body, resulting in higher overall levels of serotonin. While antidepressants can be effective for some, they’re not effective for everyone, and they’re not perfect for everyone. It’s important to know that antidepressants are not the only option when it comes to treating depression. In fact, there are a number of different ways to treat depressive symptoms that don’t involve any medication.
If you’re experiencing symptoms of depression, have been diagnosed with major depressive disorder or another mental illness, and feel that your medication is ineffective or causing unwanted side effects, you are not alone. Although standard antidepressants and talk therapy are standard treatment options for depression, many people (over half of patients) still experience symptoms after trying these conventional treatments. While medications and talk therapy can be very effective, it’s important to know there are alternative depression treatments that have been proven to be just as, if not more, effective.
Transcranial Magnetic Stimulation (TMS), Magnetic E-Resonance Therapy (MeRT), lifestyle changes, herbal remedies, and light therapy are all examples of complementary and alternative therapies that have been proven to help treat depression. These treatments can be used alone or in conjunction with other medications and talk therapy to help patients feel better.
It’s important to talk to a doctor or mental health professional about any alternative treatments you are thinking about trying for your depression. Do not stop taking the medication without consulting a doctor first. Let’s take a look at some of the most effective complementary and alternative treatment options for depression.
Antidepressant Medication
Antidepressant medications are the most commonly prescribed medications in the country. They are used to treat various forms of depression and related mental health conditions. There are several different types of antidepressants, each with unique mechanisms of action and potential side effects. Let’s take a look at three of the most common antidepressants.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are among the most commonly prescribed antidepressants. They include medications such as fluoxetine (Prozac), sertraline, (Zoloft), and escitalopram (Lexapro). These medications work by increasing the availability of serotonin in the brain. SSRIs are used to treat mild depression, moderate depression, and severe depression alike.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs, or serotonin-norepinephrine reuptake inhibitors, are a slightly different class of antidepressant medications. Examples of SNRIs include venlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine (Pristiq). Unlike SSRIs, which primarily increase serotonin levels, SNRIs work by simultaneously boosting the levels of both serotonin and norepinephrine in the brain. This dual mechanism of action can treat depression symptoms in patients with mild, moderate, and severe depression.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs, or monoamine oxidase inhibitors, are a type of antidepressant medication. They work by increasing the levels of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. Examples of MAOIs include phenelzine (Nardil) and tranylcypromine (Parnate). MAOIs are not prescribed as often as they used to be, however, because they require strict dietary restrictions and can have interactions with other medications. They are usually prescribed when other antidepressants have been ineffective.
Tricyclic Antidepressants
TCAs, or tricyclic antidepressants, are a class of widely prescribed antidepressant medications. Examples of TCAs include amitriptyline (Elavil), nortriptyline (Pamelor), and imipramine (Tofranil). TCAs are also an older antidepressant medication, however, despite their age, TCAs have proven effective in treating depression and other mood disorders. However, their usage has declined in recent years due to the advent of newer antidepressant classes, such as SSRIs, which tend to have fewer side effects.
Atypical Antidepressant Medication
Atypical antidepressants are yet another class of antidepressant medication commonly prescribed to treat depression. Atypical antidepressants are called so because they work to relieve symptoms in a manner that is different from most other antidepressants. The most commonly prescribed atypical antidepressant is bupropion (Wellbutrin), for example, acts as a norepinephrine-dopamine reuptake inhibitor (NDRI), increasing the availability of these neurotransmitters. Aside from Wellbutrin, other atypical antidepressants include mirtazapine (Remeron), trazodone (Desyrel), and vortioxetine (Brintellix/Trintellix).
Antidepressant medications are usually the first-line treatment for depression. Through the help of medications and the psychiatrists prescribing them, antidepressants have helped countless people regain their mental wellbeing. Drugs like SSRIs, SNRIs, TCAs, MAOIs, and atypical antidepressants have been proven to be effective for many individuals in managing their symptoms, however, it is important to recognize that medication is not the only solution.
If you or a loved one have not found success with antidepressant medication, don’t give up. There are other forms of depression treatment. At Neuro Wellness Spa, we are strong proponents of the idea that alternative forms of treatment can play a crucial role in comprehensive care and that a patient should not settle for anything less than a complete remission of symptoms. In the following section, we will explore real, medically reviewed treatment options that are not currently considered first-line defenses but hold great potential in improving outcomes for individuals with depression.
TMS Therapy (Transcranial Magnetic Stimulation)
Transcranial magnetic stimulation, or TMS, is an FDA-approved, non-invasive, zero downtime treatment for depression. The TMS device uses gentle magnetic pulses, similar to an MRI machine, to stimulate very specific parts of the brain responsible for mood and emotions. It is sometimes referred to as physical therapy for the brain.
Where other brain stimulation therapies use electroconvulsive shocks that often leave intense lingering side effects, TMS has almost zero side effects. TMS is an FDA-approved treatment for major depressive disorder that is covered by most insurance.
During TMS treatment, patients recline in a treatment chair and remain awake and alert. A technician positions the TMS magnet over the patient’s head to deliver gentle pulses to specific areas of the brain responsible for depression. Patients report that the magnetic pulses feel like gentle taps on the head. A course of TMS treatment typically involves 5 treatments per week for 6 weeks and then 2 treatments per week for 3 weeks. Each treatment session is about 20 minutes.
TMS is non-invasive, meaning it does not require surgery, and non-systemic, so it does not affect the entire body. And unlike other treatments that stimulate the brain, TMS does not require sedation so patients can drive themselves to and from their TMS appointments and return to their daily routines including work and school immediately after each session.
While treating depression with TMS, patients recline in a private treatment room and may relax, read, work, or watch television during TMS treatment. Since its FDA clearance in 2008 for depression and in 2018 for OCD, TMS is also a promising treatment for a range of other mental health conditions. Notably, TMS is a safe and effective treatment option for cigarette cessation, anxiety, cognitive impairment, and addiction relapse prevention and more research is emerging every day.
How Effective is TMS?
The goal of mental health treatment is to achieve full remission. Patients should not tolerate lingering symptoms after treating depression with oral medication. TMS is twice as effective as traditional antidepressant medication. TMS targets specific places in the brain that are responsible for mood, to improve a patient’s mood at the source.
Unlike medications which can take 6-8 weeks to exert their full effects, most patients experience improvement in 2 weeks with TMS therapy. For over a decade, over 70% of Neuro Wellness Spa patients have experienced symptom relief with TMS therapy. Only about 15% of patients suffer a depressive recurrence within one year after completing a course of TMS therapy.
What are the Side Effects of TMS?
Although antidepressant medications used for treating major depressive disorder can work for some people, most people even on the right dose struggle with GI distress, sleep disturbance, weight gain, fatigue, and sexual dysfunction. Unlike medications, which affect the entire body, TMS therapy treats the brain directly. With TMS, there are little to no side effects, with the most common side effect being temporary and mild scalp discomfort during active treatment.
MeRT (Magnetic e-Resonance Therapy)
Magnetic e-Resonance Therapy combines the technologies of TMS (FDA-cleared treatment) with qEEG and EKG to deliver customized treatment for each patient’s unique brain pattern. More simply, it is a highly targeted version of TMS therapy. Like TMS, MeRT is non-invasive and non-systemic and can treat a wide variety of mental health and brain-related disorders including depression.
The MeRT treatment process begins by assessing the communication quality between neurons in the brain using EEG. By measuring and analyzing your brainwave activity, MeRT assesses the communication quality between the neurons in your brain and custom designs treatment protocols to optimize brain function. Then, MeRT enables patients and their doctors to nurture the area of the brain that needs attention by delivering highly personalized TMS treatment protocols. Using neuroscience and machine learning, MeRT visibly reshapes brainwave activity and strengthens functionality to improve health outcomes.
Because MeRT treats and optimizes each patient’s unique brainwaves, not their diagnosis, MeRT is a safe and highly effective therapy for depression and is used off-label for a broad range of conditions affecting mental health and cognition, including autism, PTSD, TBI, dementia, ADHD, insomnia, and more. Although MeRT uses FDA-cleared technology, it is a cash-pay procedure at the present time.
A typical MeRT treatment session lasts approximately 40 minutes. Like TMS, MeRT is an outpatient procedure after which patients may immediately return back to their daily life, including work and school. During treatment, patients recline in a private treatment room and can read, relax or watch television. Overall, patients tolerate MeRT treatment very well. The most commonly reported side effect is a temporary, mild headache at the site of stimulation.
Ketamine Therapy
Ketamine was first introduced as an FDA-approved anesthetic in the 1960s. It has since been designated by the FDA as a “breakthrough therapy” to treat mood, anxiety, and pain.
Ketamine works in several ways at the same time including by stimulating brain-derived neurotrophic factor (BDNF), resulting in enhanced neuroplasticity. Ketamine is also an NMDA receptor antagonist that interacts with glutamate, the most common excitatory neurotransmitter in the brain. Researchers have observed increased synaptic connections and the growth of neurons. It is this neuronal growth and increase in neuronal activity that has been shown to improve mood and cognition in as little as one hour.
There are two main types of ketamine therapy: intravenous Spravato and IV ketamine.
Spravato Ketamine Treatment
Spravato, also known as esketamine, is an intranasal treatment given as a nasal spray that is FDA-approved for the treatment of adults with treatment-resistant depression or suicidal ideation. Each treatment lasts about two hours during which the patient self-administers the Spravato nasal spray under the supervision of a healthcare provider. After the patient administers the nasal spray, there is a two-hour observation period where they can rest comfortably while blood pressure is monitored. Typically, Spravato is administered twice weekly for four weeks then once weekly for four weeks followed by maintenance treatment which can be once every other week.
IV Ketamine Treatment
IV ketamine is given as an infusion into the bloodstream. It is a much more intense experience than esketamine nasal spray, and patients cannot drive home and need to arrange a safe ride. Neuro Wellness Spa no longer offers IV Ketamine and Spravato treatments.
How Effective is Ketamine Therapy?
Esketamine’s (Spravato’s) response rate is more than twice that of traditional antidepressants and ketamine works rapidly, in hours to days compared to weeks with traditional antidepressants. Most patients with depression or severe depression experience positive results after their first treatment and subsequent treatments help prolong the positive effects.
Ketamine therapy is also particularly beneficial for patients struggling with trauma or chronic pain, especially if comorbid with depression symptoms. Research has shown that ketamine therapy helps patients to disengage from their routine thought patterns, heal unhealthy neural pathways and achieve clarity. Ketamine has also been found to have transformative effects on an individual’s worldview. Ketamine produces a sense of disconnection from one’s ordinary reality and usual self that may induce or enhance feelings of creativity, purpose, perspective, serenity, insight, inspiration, gratitude, empathy, connection with others and the world, openness to new ideas, psychological rebirth, reduced fear of death and traveling outside of one’s self, among others. Contact Neuro Wellness Spa to learn more about this groundbreaking new treatment.
Non-medical Alternative Depression Treatments
Psychotherapy
Psychotherapy is probably the most common complementary treatment for treating depression. Psychotherapy, also known as talk therapy, is one of the most effective treatments for depression. It involves talking to a therapist about your thoughts, feelings, and experiences in order to help you understand and manage them better.
There are several different types of psychotherapy, but all of them involve talking openly and honestly about your thoughts and feelings.
The most common types of psychotherapy include:
- Cognitive behavioral therapy (CBT): CBT is a type of psychotherapy that helps you identify negative thoughts and behaviors and replace them with more positive ones.
- Interpersonal therapy (IPT): IPT is a type of psychotherapy that focuses on your relationships with others. It can help you understand and manage the way your depression affects your relationships.
In cognitive behavioral therapy, the therapist will help you to identify the negative thoughts and behaviors that are contributing to your depression. They will then work with you to replace these with more positive ones.
In interpersonal therapy, the therapist will focus on your relationships with others. They will help you to understand how your depression affects your relationships and how your relationships can affect your depression.
You can expect different approaches in your cognitive behavioral therapy and interpersonal therapy, but the goal of both is to help you manage your depression in a more positive way and reroute your negative thinking patterns.
The licensed psychotherapists at Neuro Wellness Spa will work with you to determine which combination of modalities will help you meet your mental health treatment goals; contact us today to learn more.
Exercise
Exercise is perhaps the most overlooked depression treatment. Numerous studies have demonstrated the positive impact of exercise on mental health. Regular physical activity, such as aerobic exercises, has been shown to increase the production of endorphins, which are natural mood-enhancing chemicals in the brain. Exercise also helps to reduce inflammation, regulate stress hormones, improve sleep patterns, and enhance overall well-being, all of which contribute to alleviating symptoms of depression. Although it’s not always as easy as taking a pill, getting active will help to improve your mood, reduce stress, increase energy levels, and promote feelings of well-being.
Research has shown that exercise can be as effective as medication in treating depression. However, it is important to make sure that you are doing the right type and amount of exercise for you. Some people find that a regular aerobic exercise routine is the most helpful. This could involve going for a run, a walk, or a swim three to five times per week. Others prefer a more moderate approach, such as taking a yoga class or going for a brisk walk every day. Still others prefer intense strength training exercises like weight lifting. Recreational or team sports are another great way to get exercise and foster social connection at the same time. Regardless of how you exercise, depressed patients usually find exercise to improve symptoms almost immediately.
It is important to find an exercise routine that you enjoy and that you can stick to. If you are not sure what type of exercise is right for you, talk to a doctor, mental health professional, or even a fitness professional.
Dietary Changes
Making certain dietary changes can also help to improve your mood and reduce symptoms of mental illness and depression. Fruits, vegetables, whole grains, and other anti-inflammatory foods have been shown to improve mood, condition and even help fight depression symptoms.
Additionally, it can be helpful to consider omega-3 fatty acids. These are found in oily fish, such as salmon, mackerel, and sardines. They can also be found in flaxseed oil, chia seeds, and hemp seeds. Omega-3 fatty acids are thought to be beneficial for mental health because they help to reduce inflammation. They can also help to improve brain function and protect against cognitive decline. If you do not like fish, consider taking a fish oil supplement. You can also get omega-3 fatty acids from flaxseed oil, chia seeds, and hemp seeds. These can be added to smoothies, salads, or soups.
In addition to omega-3 fatty acids, there are other nutrients that are thought to be beneficial for mental health. These include magnesium, vitamin D, and probiotics. Magnesium is found in dark leafy green vegetables, nuts, and seeds. It is also found in some types of fish, such as salmon and tuna. Vitamin D is found in fatty fish, such as salmon and tuna. It is also found in mushrooms and eggs. Probiotics are live bacteria that are found in yogurt and some types of cheese. They are also available in supplement form.
Making sure that you are getting enough of these nutrients can help to improve your mood and reduce symptoms of depression.
Herbal Remedies
When it comes to complementary and alternative therapies, there are several herbal remedies and herbal supplements that are thought to be effective in treating major depression.
One of the most commonly used herbs for depression is St. John’s Wort. This herb has been shown to be as effective as an alternative treatment of depression for treatment-resistant depression. Other herbs that are sometimes used to treat severe depression include ginkgo biloba, ashwagandha, SAM-e, and CBD.
Genetic testing can help identify mutations in your unique genome that could indicate that you could benefit from folate and B12. Of the 20,000 genes in your body, the MTHFR gene is the one that helps you process folate and vitamin B12, the B vitamin needed to make DNA. As both DNA methylation and folate are important to mental health, DNA mutations in the MTHFR gene can put people at a higher risk for many common mental health problems, including depression. If you are one of the 40% of people with a mutation for reduced MTHFR activity, small changes to your diet and lifestyle could make a big difference in your overall health.
You should talk to your doctor before taking any herbal remedies. This is because they can interact with other antidepressant medications that you are taking and can put your physical health in jeopardy.
Light Therapy
Light therapy, also known as phototherapy, involves exposure to bright light. This type of therapy is often used to treat seasonal affective disorder (SAD), but it can also be effective in treating non-seasonal depression. Light therapy can be done using a special light box that emits bright light. The light box is usually used for 30 minutes to an hour each day. You can also get exposure to bright light by spending time outdoors in natural sunlight.
Acupuncture and Vagus Nerve Stimulation
Acupuncture is a traditional Chinese medicine technique that involves the insertion of thin needles into the skin. The needles stimulate nerve cells and stimulate different areas of the brain and body. Acupuncture is thought to be effective in treating a number of different conditions, including depression, for reasons that aren’t entirely explained by the medical community. It is thought that acupuncture can help to balance the levels of serotonin and other neurotransmitters in the brain.
Vagus Nerve Stimulation (VNS) is FDA-approved for treatment-resistant depression. A pulse generator placed in the upper left side of the patient’s chest sends electrical impulses to the brain, helping to control sleep and mood.
Related: Yes, there are FDA-approved ways to treat depression without a pill.
Which Alternative Depression Treatment Is Best for Me?
When it comes to physical health and mental health, it’s important to be proactive. Of course, it’s normal to feel sad, anxious or stressed from time to time. But if you’re not sure why you’re feeling this way or if the feelings are just not going away, it’s worth talking to a professional. Especially if your symptoms of depression become debilitating and cause you psychological stress, then it is recommended you reach out to a mental health professional. They will be able to inform you of the treatments for depression available to best reduce your symptoms so you can benefit from improved mental well-being. If you think you might need help, don’t wait to get it. If you’re not feeling like yourself or if your symptoms are interfering with your day-to-day life, it’s definitely time to seek help.
If your depression medication is not working adequately, there are several alternative treatments offered at Neuro Wellness Spa that can help. Our mental health professionals can help you determine the best course of action when it comes to treating your depression while considering your specific treatment needs, circumstances, preferences, and goals. To learn more about psychiatric medications, or any of our complimentary treatments for depression such as talk therapy, TMS therapy, or MeRT, or to schedule a consultation, contact us today.