No single treatment works best for all people who live with depression. The treatment options that will help you feel better depend on many individual factors, including your own unique biology.
Biomarkers are biological factors, such as substances, test results, and genes, that can provide clues about your health. They are among the most promising tools driving a broader shift known as precision psychiatry, in which treatment is matched to your individual health profile. Other tools include detailed health history and even social and environmental factors.
Identifying biomarkers may soon help doctors determine how to best diagnose and treat depression in a particular person. Precision medicine is already becoming mainstream in other areas of health care, such as cardiology and cancer treatment.
But it’s important to note that most biomarkers for depression are still under investigation and not yet part of routine clinical practice. It remains unclear whether they’ll prove reliable or even useful for routine care.
Precision Psychiatry: The New Frontier
Treatment for depression and other mental health conditions is quickly changing. Traditionally, doctors have been using the same treatment options for all patients with the same mental health diagnosis. You and your doctor may find the right treatment or combination of treatments through an often-slow process of trial and error.
Now, doctors are beginning to combine advanced medical technologies with personalized lab tests and health history assessments to better zero in on the treatment that’s right for you.
Take something as simple as blood tests. Most people get routine blood tests each year during an annual physical exam. Common tests your doctor may order for you include a complete blood count (CBC) and a comprehensive metabolic panel.
But if you have depression, you and your health care provider might consider requesting additional blood tests. Sometimes other conditions, like anemia or thyroid disease, can cause depression. Blood tests for these conditions could provide biomarkers that identify these conditions or help rule them out as factors affecting your mental health.
A Closer Look at Your Brain
New technological tools and methods can help doctors understand possible abnormal activity in your brain associated with depression.
Your doctor can take brain scans with technologies such as functional MRI (fMRI) and the electroencephalogram (EEG) to examine how your brain works.
The fMRI uses a machine with giant magnets to track your brain structure and activity. For an EEG to test electrical activity in your brain, electrodes are attached to your scalp so your doctor can track signals sent between your brain cells. Doctors visually analyze EEG results to better understand your brain activity.
Another method called quantitative EEG (qEEG) allows doctors to analyze EEG data for biomarkers associated with depression.
Doctors may examine biomarkers called "spectral event features" from your brain scans. These are measurable characteristics associated with bursts of high-power brain activity that may indicate depression.
Doctors can use your brain scans to identify patterns of unusual or sporadic high-intensity brain activity associated with depression. This may be especially helpful in predicting your response to certain antidepressant treatments like repetitive transcranial magnetic stimulation (rTMS). In rTMS, an electromagnetic coil attached to your scalp sends magnetic pulses to activate nerve cells in your brain.
What is your depression 'biotype'?
New research using brain imaging and artificial intelligence has found six different "biotypes" among people living with depression. Biotypes refer to different brain patterns common in people living with depression or anxiety.
Identifying your "biotype" may help you and your health care provider figure out the best treatment options for you.
Be Patient
Even with precision psychiatry forging a new path, it may take a few tries to find an antidepressant medication or other treatment option that works for you. This is normal, but the process can be frustrating and, in some cases, worsen your depression.
Almost one-third of adults with major depressive disorder do not experience remission after trying at least two different antidepressants. A new antidepressant can take up to a month or longer for its positive effects to kick in.
Some medications may cause negative side effects. It may feel like your quality of life gets worse rather than better during the waiting period.
Be patient and remind yourself that the potential benefits make it worth the wait.
