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Michigan Advanced Psychiatry

TMS vs. ECT: Which Is Right for Me?

Interworking display of the brain.

Are you or a loved one searching for an innovative treatment for severe depression? Both electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are powerful options for those who haven’t found relief with other treatments.

When comparing ECT vs. TMS therapy, it’s important to know both are FDA-approved and involve stimulating brain cells to alleviate symptoms. However, there are key differences in how they work, their side effects, and the treatment experience. Read on to learn more about these depression treatments to determine which may be right for you.

What Is ECT?

Modern electroconvulsive therapy (ECT) has been used for nearly a century to treat severe depression, bipolar disorder, and other mental health conditions. The procedure involves sending small electrical currents through the brain to trigger a brief, controlled seizure. This activity is thought to reset brain chemistry and provide relief from severe symptoms.

The procedure is performed under general anesthesia in a medical facility to ensure patient safety and comfort. Electrodes are placed on the scalp, typically on one side of the head or both. Each session lasts only a few minutes, but the preparation and recovery time can extend the visit. Treatments are usually administered two to three times a week over several weeks.

Pros of ECT

Cons of ECT

  • Requires anesthesia and a hospital setting.
  • Common side effects: memory loss (temporary or, in rare cases, permanent) and confusion.
  • May disrupt daily activities due to recovery time after treatment.

What Is TMS?

Transcranial magnetic stimulation (TMS) is a newer, non-invasive treatment that targets specific areas of the brain associated with mood regulation. Using a magnetic coil placed against the scalp, TMS generates focused electromagnetic fields that stimulate neuronal activity in the prefrontal cortex—the region often underactive in people with depression. Unlike ECT, TMS does not require anesthesia or work by inducing seizures. TMS therapy is ideal for those who prefer a less intensive option for treatment-resistant depression.

During a TMS session, the patient remains awake and seated comfortably in a chair. Each session lasts approximately 20 minutes, and the patient can immediately resume daily activities afterward. A typical course of treatment involves five sessions per week over a six-to-eight-week period. Response rates are as high as 70% and remission rates as high as 50%, especially with the newest TMS technology known as deep TMS. 

Pros of TMS

  • Non-invasive and generally painless, with no anesthesia required.
  • No memory loss or cognitive side effects. Some studies indicate it can actually improve cognitive performance.
  • Patients can resume normal activities immediately after sessions.

Cons of TMS

  • Multiple sessions are required for effectiveness.
  • Mild side effects, including scalp discomfort or headache, may occur.
  • Not suitable for individuals with metal implanted near the head or those who have a history of seizures.

Which Treatment Is Right for You?

Deciding between ECT and TMS depends on the severity of your symptoms, your medical history, and your preferences regarding side effects and procedure intensity. The chart below outlines key differences between the two treatment options to help you make an informed decision. 

Aspect ECT TMS
Invasiveness Invasive (requires anesthesia) Non-invasive
Side Effects Memory loss, confusion Mild headaches, scalp discomfort
Setting Hospital or specialized facility Outpatient clinic
Treatment Time Minutes, but recovery required 20-40 minutes, no recovery time
Effectiveness Rapid for severe cases Gradual improvement over weeks

 

ECT may be the right choice if you are dealing with life-threatening depression, severe suicidal ideation, or conditions that require immediate relief. Its rapid efficacy makes it a valuable option in crises or for those who have tried multiple medications without success. However, ECT requires a hospital setting, anesthesia, and longer recovery time. Severe memory loss is not common, but it’s important to be aware of the risk. 

On the other hand, TMS might be better suited if you are seeking a less invasive treatment with minimal downtime. TMS is particularly appealing to those who have not responded to medication but want to avoid the risks and longer recovery time with ECT. 

Ultimately, the decision should be made in consultation with a mental health professional who can evaluate your unique circumstances, medical history, and treatment goals. At Michigan Advanced Psychiatry, our team specializes in TMS therapy and is dedicated to helping you find the best path toward relief and recovery.

Next Steps: Explore TMS at Michigan Advanced Psychiatry

At Michigan Advanced Psychiatry, we specialize in TMS therapy to help individuals find relief from treatment-resistant depression. If you’re seeking a non-invasive, effective treatment option, our experienced team is here to guide you.

Contact us today to schedule a consultation and take the first step toward reclaiming your life. For our Ann Arbor, MI location, call (734) 436-4886. To schedule an appointment at our Troy, MI location, call (248) 885-8887.

If you’re located in the Fort Wayne, IN area, visit our partner website today to explore treatment options near you. 

 

Why Your Depression Won’t Go Away: And What To Do About It!

Psychiatrist taking note during consultation with patient.

When you’re battling depression, staying positive can feel impossible. But even when your treatment doesn’t seem to work, you should not give up hope on healing. Every person experiences depression symptoms differently, and certain treatments work better for different people.

Read on to learn why your depression might not be going away, with the insights of experienced psychiatrists and treatment specialists. Uncover leading options to treat your symptoms, like TMS therapy, that are proven to help treatment-resistant depression.

How Long Does Depression Normally Last? 

Depression doesn’t have a set timeline—it’s different for everyone. For some, it may last only a few weeks, especially with early intervention and the right treatment. However, others may find themselves in a battle that lasts for months or even years. This is particularly true for people with what’s called chronic depression or treatment-resistant depression, where symptoms persist despite trying various treatment options.

Typically, an episode of major depression can last anywhere from two weeks to six months without treatment. But it’s important to understand that depression isn’t always a “one-time” occurrence. Many people experience recurrent episodes throughout their lives, often triggered by stressful events, changes in health, or other underlying factors.

If your depression has been lingering for longer than a few months or if treatments you’ve tried aren’t working, this may be a sign to explore more specialized therapies, such as Transcranial Magnetic Stimulation (TMS) or medication adjustments. It’s also vital to remember that seeking help sooner rather than later can significantly impact how long you experience depressive symptoms.

What Makes Depression Symptoms Not Go Away?

There are several reasons why depression symptoms may persist, even after trying different treatments. Understanding these factors can help you and your healthcare provider find a more effective approach to your care.

Incorrect Diagnosis

Depression can sometimes be misdiagnosed, especially if other mental health conditions, such as anxiety, bipolar disorder, or PTSD, are present. These conditions can overlap with depression and may require different treatment strategies. If your depression hasn’t responded to traditional therapies, it’s worth discussing with your doctor whether another underlying condition could be contributing.

Ineffective Medication or Dosage

Antidepressants aren’t one-size-fits-all. It can take time to find the right medication and dosage for each individual. Some people may need a higher dose or an entirely different class of medication to see improvements. If you’ve been on a certain medication for a while and haven’t noticed changes, it’s important to revisit this with your psychiatrist.

Underlying Medical Conditions

Chronic health issues like thyroid disorders, diabetes, and autoimmune diseases can affect your mood and contribute to ongoing depression. If these underlying medical conditions aren’t properly managed, they can make it harder for depression treatments to work effectively.

Lifestyle and Environmental Factors

Your environment and lifestyle plays a significant role in your mental health. If you’re surrounded by stress, toxic relationships, or unresolved trauma, these factors can make it difficult for treatments to fully alleviate your symptoms. In these cases, therapy can be particularly helpful in addressing the root causes of emotional pain.

In addition to therapy, lifestyle changes can make a powerful difference in improving your mental well-being. Simple adjustments, like following an exercise regimen, or maintaining a balanced diet, can significantly boost mood and reduce stress. 

Exercise releases endorphins that naturally lift mood, while a nutrient-rich diet supports brain health. Adding mindfulness practices like meditation or deep breathing can also help in managing stress responses. These small but impactful changes, combined with therapy, can help strengthen emotional resilience and enhance the benefits of treatment.

Treatment-Resistant Depression

For some individuals, depression becomes treatment-resistant, meaning they don’t respond to typical interventions like medication or talk therapy. This doesn’t mean you’re out of options. Innovative treatments such as TMS therapy or Spravato are specifically designed to help people with treatment-resistant depression find relief when other methods haven’t worked.

How To Know If You Have Treatment-Resistant Depression

Treatment-resistant depression (TRD) can be incredibly frustrating, especially when you feel like you’ve tried everything but nothing seems to work. However, it’s important to understand whether what you’re experiencing is truly TRD or if adjustments to your treatment plan might help.

You may have treatment-resistant depression if:

  1. You’ve Tried Multiple Medications
    If two or more antidepressants haven’t worked, despite being taken for the right duration and dosage, you may have TRD.
  2. Symptoms Keep Coming Back
    Your symptoms improve but quickly return, even with medication or therapy. This pattern can signal TRD.
  3. Therapy Alone Isn’t Enough
    If regular therapy hasn’t brought lasting relief, despite your efforts, TRD could be the reason.
  4. Ongoing Symptoms Despite Treatment
    Persistent symptoms like fatigue or hopelessness that don’t improve with medication or lifestyle changes may indicate TRD.
  5. Lifestyle Changes Haven’t Helped
    Even with efforts to exercise, sleep better, or reduce stress, your depression persists.

If these signs resonate with you, advanced treatments like TMS or Spravato could be the next step.

Why TMS Therapy Is a Powerful Option for Treatment-Resistant Depression

Transcranial Magnetic Stimulation (TMS) therapy has emerged as a breakthrough for people with treatment-resistant depression (TRD), offering hope where traditional treatments have fallen short. Unlike medications or talk therapy, TMS is a non-invasive, drug-free option that targets specific areas of the brain linked to mood regulation. This makes it an appealing choice for those who have not responded to antidepressants or who have experienced unwanted side effects from medication.

One of the key advantages of TMS therapy is its ability to directly stimulate the prefrontal cortex—the part of the brain responsible for controlling mood. In people with depression, this region is often underactive, contributing to ongoing symptoms. TMS works by using magnetic pulses to activate these areas, helping to restore normal brain function and alleviate depressive symptoms. As a result, many individuals who have not found relief with standard treatments experience significant improvement with TMS.

Another reason TMS is so powerful for treatment-resistant depression is its success rate. Numerous studies have shown that people with TRD often achieve lasting relief through TMS therapy, even when other methods, like medication, have failed. Additionally, TMS comes with minimal side effects. Unlike medications that can cause weight gain, drowsiness, or sexual dysfunction, the most common side effects of TMS are mild scalp discomfort or headaches, both of which typically subside shortly after treatment.

TMS is also convenient. Each session lasts only about 20-40 minutes, and since it’s an outpatient procedure, there’s no need for downtime or recovery. You can easily fit TMS therapy into your routine and return to your normal activities right after each session. For those seeking a more targeted and non-invasive treatment for depression, TMS therapy offers a powerful alternative that’s helping many regain control of their mental health.

Contact for Treatment at Michigan Advanced Psychiatry 

At Michigan Advanced Psychiatry, we specialize in providing compassionate, advanced care for those struggling with treatment-resistant depression. If you’ve tried other treatments without success, TMS therapy or other innovative options might be the key to finding relief. Don’t wait to take control of your mental health—reach out today and start your journey towards a brighter, more hopeful future.

Call us at 248-885-8887 to schedule a consultation and explore the best treatment options for your needs. If you’re unsure whether our treatments are right for you, we encourage you to take our quick self-assessment to learn more about your next steps.

When To See a Psychiatrist

A psychiatrist taking notes with a patient in the psychiatrist’s office. | Michigan Advanced Psychiatry

With the demands and pressures of this fast-paced world, caring for your mental health is more important than ever. The responsibilities of work, family, and social life can sometimes feel overwhelming, and it’s not uncommon to struggle with emotional or psychological challenges. 

At Michigan Advanced Psychiatry, we understand that deciding to seek help can be daunting. Knowing when to see a psychiatrist is crucial for healing and achieving a balanced, fulfilling life. We’ve created this blog to help you recognize when it might be time to seek professional help from a psychiatrist, who will assist and support your mental well-being.

Understanding the Role of a Psychiatrist

Before delving into the signs that indicate it might be time to see a psychiatrist, it’s essential to understand what a psychiatrist does. Psychiatrists are medical doctors who specialize in the diagnosis, treatment, and prevention of mental health issues. Unlike therapists, counselors, or psychologists, psychiatrists focus on the psychological and physical aspects of mental disorders. As a result, they can prescribe medication and provide an approach to mental health diagnoses that includes medical and therapeutic strategies.

Determining whether to see a psychiatrist or psychologist depends on your specific needs and the nature of your mental health concerns. If you’re experiencing symptoms that might require medication, such as moderate to severe depression, anxiety, or mood disorders, then you may want to reach out to a psychiatrist. On the other hand, if your primary need is talk therapy or counseling to address emotional or behavioral issues without the need for medication, a therapist or psychologist can provide effective treatment. 

For many individuals, a combination of both is most beneficial. Often, people will have a psychiatrist managing medication and a psychologist or therapist providing ongoing therapy. Ultimately, the choice may also depend on your diagnosis and personal treatment preferences. Discussing your symptoms with a general practitioner can help guide you toward the right specialist.

Signs That It Might Be Time to See a Psychiatrist

It is important to listen to your body and to pay attention to your behaviors and feelings when determining your medical care needs. This is especially true when it comes to caring for your mental health. Below, we have outlined some of the signs of different mental health issues warranting a need for treatment: 

Signs of Depression

  • Persistent sadness and hopelessness 
  • Disinterest in activities you once enjoyed 
  • Sadness on most days lasting more than a couple of weeks that disrupts daily life
  • Thoughts that you would rather not be alive, or wish you could go to sleep and not wake up

Signs of Anxiety 

  • Constant worry 
  • Restlessness 
  • Heart palpitations 
  • Frequent panic attacks 

Other Signs of Psychiatric Need

  • Changes in sleep patterns 
  • Insomnia 
  • Difficulty managing daily responsibilities or stress
  • Substance abuse
  • Self-harm 
  • Severe mood swings 
  • Struggles in relationships
  • Social isolation 

Recognizing these symptoms and reaching out for help can make a significant difference in your mental health and overall well-being. If you are experiencing any of these symptoms, especially self-harm or suicidal thoughts or tendencies, psychiatric treatments can make all the difference in helping you find hope and the support you need. 

*If these thoughts are intense or persistent, OR if they include thoughts about wanting to take action to end your life, this is an emergency. Please utilize the nearest hospital or dial the national suicide and crisis line at 988

What to Expect When Seeing a Psychiatrist

Psychiatrists dedicate themselves to helping you overcome your mental health challenges. As a result, you can expect a thorough and compassionate approach to your mental health needs when you visit. During your first appointment, the psychiatrist will conduct a comprehensive evaluation. This evaluation includes discussing your symptoms, medical history, family medical history, and relevant life events. 

Following the evaluation, your psychiatrist will work to assess your emotional and psychological challenges. Based on that assessment, they may provide a diagnosis and discuss potential treatment options. Your psychiatrist will also schedule follow-up appointments to monitor your progress, adjust treatments if necessary, and support your ongoing mental health journey. 

At Michigan Advanced Psychiatry, our providers and medical team are committed to offering professional, empathetic care to help you achieve a healthier and more balanced life.

Treatments 

When it comes to treatment, there are multiple options that psychiatrists can offer. Everybody’s mental health situation is unique, and not all treatments can provide identical solutions for everyone. As a result, treatment options for mental health are diverse and often tailored to individual needs. 

Psychotherapy approaches, such as Cognitive Behavioral Therapy (CBT) and talk therapy, are fundamental in addressing various mental health issues. These therapy techniques focus on helping individuals modify destructive thought patterns and improve coping strategies. When psychiatrists implement these techniques, it is often in combination with medication or interventional treatments. 

Medications play a crucial role in psychiatry, as they address the physical and chemical aspects of mental health illnesses. The main classifications of medication utilized in psychiatric treatment include: 

  • Antidepressants 
  • Stimulants
  • Anxiolytics
  • Sedatives
  • Antipsychotics
  • Hypnotics
  • Mood stabilizers

These medications target specific symptoms and aid in the treatment of mental health disorders such as anxiety, depression, bipolar disorder, and OCD.

For patients who do not respond to first-line treatments, there are trusted, innovative options that offer a pathway to relief. Therapies like Transcranial Magnetic Stimulation (TMS), Spravato, vagus nerve stimulation, Electroconvulsive Therapy (ECT), and deep brain stimulation can be powerful tools in helping individuals overcome mental health issues. These methods are safe and FDA-approved for treatment and aim to enhance treatment success and patient well-being. 

Taking the First Step Towards Help

When taking the first step toward finding a psychiatrist, start by seeking recommendations from family, friends, and your primary care doctor. Their experiences and insights can guide you towards reputable professionals who may align with your needs. 

Once you have your recommendations, take the time to contact their offices to inquire about their availability, treatment approaches, and whether they offer initial consultations. Each psychiatrist has a unique approach and style, so exploring various options can help you identify one whose methods and personality resonate with you. This process ensures that you find a psychiatrist who not only understands your specific needs but also makes you feel comfortable and supported in your mental health journey.

Michigan Advanced Psychiatry is Here to Guide You

At Michigan Advanced Psychiatry, we provide authentic and trusted treatment options to those in the Ann Arbor and Troy communities. We are determined to help you succeed on your mental health journey. If you have questions or would like to book an appointment, please give us a call at (248) 885-8887.

If you are located in the Fort Wayne, IN area, we invite you to visit our partner website and explore treatment options near you.

I Have Treatment-Resistant Depression. What Do I Do?

Woman looking out window in hopes of a depression cure. | Michigan Advanced Psych

When traditional depression treatments fail to work, it can feel like nothing ever will. If you’ve been diagnosed with treatment-resistant depression (TRD), know that you are not alone. There are treatments available that offer remission of symptoms.  

At Michigan Advanced Psychiatry, we specialize in innovative treatments like Transcranial Magnetic Stimulation (TMS) and Spravato to help individuals like you find the relief you deserve. If you have treatment-resistant depression or are battling another mental health condition, there are options for finding lasting symptom relief.  

Understanding Treatment-Resistant Depression

A treatment-resistant depression diagnosis is given when a person does not respond adequately to at least two different antidepressant treatments. It can be frustrating and disheartening, but understanding this condition is the first step towards finding the right solution.

Research shows that approximately 30% of those diagnosed with major depressive disorder (MDD) and who have tried medications, such as SSRIs and SNRIs, will develop treatment-resistant depression. The condition is not a super-rare abnormality, and no one should have to struggle in silence.

Why Traditional Depression Treatments May Fail

Traditional depression treatments fail to work for certain people due to a complex relationship between their own biology and individual response to medications. The following overview provides several reasons why standard treatments might not work for everyone.

  1. Biological Differences: Each person’s brain chemistry is unique, and what works for one individual may not work for another. Studies show that people with TRD are more likely to have physical health conditions, such as autoimmune diseases, heart disease, and thyroid disease. 
  2. Incorrect Diagnosis: Sometimes, the initial diagnosis may miss underlying conditions such as bipolar disorder or anxiety, which can complicate treatment results.
  3. Medication Issues: Some people may metabolize medications differently or experience intolerable side effects, making it difficult to find an effective dose.

Advanced Treatment Options

If traditional antidepressants haven’t worked, there are advanced treatment options available to you. At Michigan Advanced Psychiatry, we offer two cutting-edge therapies that are proven to provide relief to those who haven’t been successfully treated. 

For more information on the mental health conditions we are able to treat, click here

Transcranial Magnetic Stimulation (TMS) Therapy

Transcranial Magnetic Stimulation (TMS) is a non-invasive and drug-free treatment that uses magnetic pulses to stimulate nerve cells in the brain. Our patients have experienced profound relief from their TRD symptoms when traditional medications weren’t enough. Here’s some reasons why TMS therapy might be a good fit for you. 

Proven Efficacy 

TMS has been shown to be effective in individuals who have not responded to other treatments. Clinical research demonstrates that TMS can significantly reduce symptoms of depression in individuals with treatment-resistant depression. Many patients who have tried multiple medications without success have found relief with TMS.

Long-Lasting Relief

The majority of patients experience relief from depression for more than a year. Some find remission that lasts indefinitely. Regardless of duration, most patients experience some level of improvement in their mood and overall quality of life.

FDA-Approved Treatment 

TMS is a FDA-approved treatment for depression and anxious-depression, highlighting its safety and efficacy. It is not invasive, requires no medications, and has minimal side effects. 

It is important to know that TMS is not the same as ECT (electroconvulsive therapy or “shock” therapy). These are very different procedures with TMS having far fewer side effects and therefore tends to be much more favorable to patients.

Flexible Scheduling

Patients can return to their normal routines immediately after each TMS session, making it a convenient option for those with busy schedules or responsibilities.

TMS sessions are brief and typically last about 20 minutes. At Michigan Advanced Psychiatry, we can schedule around your daily activities to minimize disruption to your life. You can return to your normal routines immediately after each TMS therapy session, making it a convenient option for those with busy schedules or responsibilities.

And since TMS does not require anesthesia or sedation, there is no recovery period needed post-treatment. Patients are able to drive themselves to and from sessions.

Spravato Treatment

Spravato is a FDA-approved nasal spray designed specifically for treatment-resistant depression. It works differently than traditional antidepressants and can provide rapid relief of symptoms. There are many benefits of Spravato, with some of the most common ones listed below. 

  1. Rapid Relief: Many patients experience improvement in their depression symptoms within hours to days after their first treatment. 
  2. Targeted Treatment: Spravato targets NMDA receptors in the brain, offering an alternative pathway to relief.
  3. Medical Supervision: The treatment is administered in a controlled clinical setting with the supervision of experienced medical staff. At Michigan Advanced Psychiatry, we provide patients with the support and amenities they need to make them feel comfortable throughout each treatment session. 
  4. Enhances Therapy Outcomes: Spravato works very well with forms of psychotherapy, such as talk therapy or cognitive behavioral therapy. Therapy and Spravato treatment combined help patients achieve the best and lasting results. 
  5. Works with Antidepressants: Clinical trials have shown that Spravato, combined with an oral antidepressant, significantly reduces depressive symptoms compared to a placebo. This treatment is especially beneficial for those who need quick relief from severe symptoms.

What to Expect During Treatment

Understanding what to expect alleviates the anxiety associated with starting a new treatment like TMS therapy or Spravato. Here’s a brief overview of what to expect from treatment at Michigan Advanced Psychiatry or Indiana Advanced Psychiatry

The foundation of treatment is your first appointment. We’ll assess your medical history, previous treatments, and overall health to determine the best approach. Your treatments can be covered by insurance, and one of our team members will assist you with the insurance eligibility process. 

Based on our evaluation, we’ll determine which treatment option will work the best to treat your symptoms. For TMS therapy, treatment lasts between six to eight weeks, with sessions occurring five days per week. The initial treatment course with Spravato is typically over the course of eight weeks.

Our team will closely monitor your progress and adjust treatments as needed to ensure the best results. If you are interested in working with a therapist during your treatment, we can help you find a trusted one close by. 

Contact Michigan Advanced Psychiatry Today

At Michigan Advanced Psychiatry, we are dedicated to providing compassionate, cutting-edge care for those battling treatment-resistant depression. Contact us today to schedule a consultation and take the first step towards a brighter, more hopeful future. Call 248-885-8887 to schedule an appointment

If you are looking for more information to determine if our treatments are right for you, we invite you to take our self-assessment. 

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