Sober Synthesis

Research Validated Psychotherapies: These are different doors to enter with a psychotherapist to motivate/initiate and reinforce change (neuroplasticity). 

• Cognitive Behavioral Therapy (CBT) focuses on addressing both the unhelpful thought patterns and the behaviors that contribute to depression. Acceptance Commitment Therapy (ACT) is a variation of CBT.
• Behavioral Activation Therapy teaches clients to identify and engage in rewarding activities.
• Interpersonal Psychotherapy is a structured and relatively brief form of therapy that stresses attachment patterns and relationship issues.
• Dialectic Behavioral Therapy (DBT) is mostly based on CBT. The key difference is that it asks individuals with depression to acknowledge and accept their negative thoughts and behaviors. Through the practice of validation, individuals can come to terms with their negative emotions, learn to cope with stress and regulate their reactions to it, and even improve their relationships with others. Incorporates mindfulness practices.
• Psychodynamic Therapy focuses on helping clients become aware of their unconscious conflicts, many of which have their source in the past. Therefore, considerable time is often spent exploring childhood experiences and past relationships with significant others, particularly parents.
• Problem-solving Therapy involves defining personal problems, generating solutions, and determining whether a solution works.
• Group psychotherapy can be as effective, and sometimes more effective, than individual psychotherapy.

Medications

• Selective serotonin reuptake inhibitors (SSRIs) help regulate the amount of serotonin that is active in the synapses between neurons.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) address levels of both serotonin and norepinephrine. 
• Norepinephrine/dopamine reuptake inhibitors (NDRIs) help regulate both norepinephrine and dopamine levels.

Brain Plasticity & SSRIs: Breakthrough on How Antidepressants Work – Why They Take Weeks To Kick-In (scitechdaily.com)

• Extensive research validates that a combination of psychotherapy and medication is most effective with moderate to severe depression. 

Depression Treatments for Adults (apa.org)

Somatic Interventions: Professional/medical interventions that may be alternative treatment options when medication is either contraindicated or has had minimal effect. 

• Transcranial Magnetic Stimulation (TMS)
  • TMS pushes electrical charge into nerve cells to alter their activity and communication. TMS increases or decreases neural activity in certain regions, with the goal of shifting brain activity from patterns associated with depression to patterns associated with healthier brain function.
  • 30-64% of patients report an improvement in symptoms of depression.
• Electroconvulsive therapy (ECT)
  • A medical procedure that involves passing a mild electric current through your brain, causing a short seizure. This procedure is proven to have strong positive effects on severe, treatment-resistant mental health conditions, including depression. 
  • Between 70 and 90% of individuals who receive ECT treatment report an improvement in their depression. However, without continued treatment such as medication or maintenance ECT, many patients may relapse.
• Vagus Nerve Stimulation (VNS)
  • VNS alters nerve activity in the body by sending mild electrical pulses through the vagus nerve to the brainstem. This pulse is then sent throughout the brain to change the way brain cells function, much like a pacemaker.
  • VNS study results appear promising, with estimates ranging from a 50-70% response rate.

ECT, TMS and Other Brain Stimulation Therapies | NAMI: National Alliance on Mental Illness

Medical Use of Psychedelics

• Psilocybin 
  • Psilocybin is being extensively studied for the treatment of major depression and addiction.
  • Psilocybin closely resembles serotonin and powerfully activates 5HT2A receptors, leads to increased neuronal growth in the prefrontal cortex). 
  • Has hallucinative properties that often produce mystical experiences.
  • Can lead to profound changes in perception, cognition, and mood.
• Ketamine
  • Ketamine is a dissociative anesthetic and NMDA receptor (memory formation) blocker used for depression treatment.
  • Ketamine creates a sense of dissociation from emotions and is currently legal for medical use depression and PTSD.
  • May lead to shifts in circuity and plasticity so depression doesn’t feel as heavy.

Understanding & Conquering Depression – Huberman Lab

 Proposed questions for thought/sharing:

1. For those that were at last week’s meeting, did you try and/or renew any self-help strategies discussed last week? Were any helpful? 
2. If you have participated or are participating in psychotherapy, have taken or are taking antidepressants, and/or have participated or are participating in any alternative/additional professional intervention, what has been helpful to support your recovery/wellness? Why?

Disclaimer

This summary is for general informational purposes only and does not constitute the practice of medicine or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed.