“Something old, something new…” part of an old saying that aptly describes some of the happenings in mental health today. The advances that started in the “Decade of the Mind (1980-1990),” led millions of people previously suffering from depression and other mental health issues to get symptom relief through advances in medication. The introduction of Prozac (1986) to the pharmaceutical market started what could easily be called a cultural revolution, albeit subtle, that challenged previously held notions of our collective sense of existence. Now, over twenty years later, earlier, non-medical forms of mental health treatment are making a comeback on a large scale. At the same time, brand new technology bordering on science fiction has led to a non-invasive office procedure being recently approved by the FDA for the treatment of some forms of depression.

Modern treatment for mental illness includes various types of psychotherapy, also referred to as “talk therapy.” There are several types of psychotherapy, each school with both proponents and detractors. The Veterans Health Administration, the largest provider of mental healthcare in the United States is offering two psychotherapies specifically chosen because of the growing body of research showing their effectiveness. Pioneered by Albert Ellis, PhD and Aaron Beck, PhD cognitive-behavioral therapy (CBT) is the name for a group of therapies based on the idea that our thoughts, rather than our external circumstances, cause our feelings and behaviors. Cognitive therapy targets the way we think so we can feel and/or act better even if the situation does not change. In other words, if we can change the way we think, we can improve the way we feel and improve our ability to function. The VA is implementing time-limited cognitive-processing therapy (CPT) and post-exposure therapy (PET) to help veterans who are suffering from Post Traumatic Stress Disorder (PTSD) and other anxiety and mood disorders. Both CPT and PET have been shown to offer significant improvement in many symptoms that could otherwise be disabling. The therapies are done individually, as opposed to in a group, and last 10-12 weeks. Returning veterans will be particularly well served with these treatment modalities given the mood and anxiety symptoms reported following combat, separation from family and other events. CBT is available in many mental health care settings and is provided by trained, licensed professionals.

Transcranial Magnetic Stimulation (TMS) is a non-systemic and non-invasive form of neuromodulation: weak electric currents are induced in the brain tissue by magnetic fields (electromagnetic induction) created by positioning powerful magnets around the head at specific locations to excite neurons in the brain causing release of chemical neurotransmitters. Neurotransmitters, such as serotonin and norepinephrine are believed to be responsible for mood symptoms. Repetitive Transcranial Magnetic Stimulation is known as rTMS and can produce longer lasting changes. As of October 8, 2008, the US Food and Drug Administration (FDA) approved an rTMS device for use in adult patients with major depression who have previously tried medication and not improved satisfactorily. To date, no major side effects have been reported after almost a decade of research and clinical applications. Although still limited in availability and not yet covered by major insurance plans, TMS offers a novel alternative to the treatment of depression.

Treatment options for mental illness are expanding and becoming more readily available as the stigma of mental illness is decreasing. In the context of pressure to provide cost-effective healthcare, the delivery of mental health treatment continues to evolve. As new technologies are studied, older treatments are being revisited with the goal of emphasizing recovery of the individual with mental illness. It may be getting closer to the time when “something blue…” may not be part of that old saying.