During a compelling session at Psych Congress 2023 (September 6-10, 2023; Nashville, TN), leaders in psychiatry outlined the current challenges in major depressive disorder (MDD) and shared insights on the role of neuroplasticity in disease management.

MDD affects millions of people worldwide and is a leading contributor to suicide in the US. Effective antidepressant treatments are crucial to helping patients struggling with depression. Unfortunately, it is well-reported that a significant percentage of patients fail to respond to their first standard antidepressant treatment. This may be due to the limitations of current medications that predominantly target monoamines. Patients who do not respond to first-line therapies may have a decreased response to additional lines of antidepressant therapy, reduced chances of remission, and an increased risk of both reoccurrence and suicide.

In a panel presentation Saundra Jain, MA, PsyD, LPC, Steven Chan, MD, MBA, and Desiree Matthews, PMHNP-BC, shared evidence suggesting that neurocircuitry dysfunction, as a result of maladaptive neuroplasticity, is an important player in depression. Indeed, reduced neuroplasticity and synaptogenesis are associated with MDD.

The speakers reviewed research showing that harnessing neuroplasticity through learning and positive events may offer some defense against depression. Research has shown that enhanced connectivity in certain brain regions may decrease the risk of depression in certain populations. Attempts to increase brain activity are currently underway, using various digital techniques. For example, a skills-based application named Intellicare has been studied for its promising effects on depression and anxiety. In fact, an impressive array of mental health applications are currently available to consumers, and the implementation of digital therapeutics (DTx) shows promising results, especially when compared to traditional cognitive behavioral therapy (CBT) alone.

Digital mental health therapeutics offer many key advantages over traditional mental health visits, such as accessibility, convenience, approachability, and affordability. The speakers indicate that incorporating these digital tactics in the clinical setting may be an encouraging frontier in diagnosing, preventing, treating, and managing MDD.

While several treatments are currently being investigated, barriers to the widespread implementation of DTx remain. These include considerations such as digital literacy, technology affordability and access, interoperability and data sharing, and privacy or security concerns. In the meantime, the panelists encourage practitioners to explore available tools to enhance patient care.

Reference:
1. Jain S, Chan S, Matthews D. Harnessing the power of neuroplasticity in MDD: the evolving role of digital therapeutics. Presented at: Psych Congress; September 6-10, 2023; Nashville, TN.