When you have tried therapy, adjusted medications, and given your treatment plan time to work, it can feel discouraging if depression symptoms continue. You may begin to wonder if this is simply how life will always feel. Many people reach this point and feel unsure about what to try next. If this sounds familiar, you are not alone.
At LightHeart Mental Health, we support individuals who are looking for additional options when depression has been difficult to treat. We offer advanced treatments such as TMS therapy and Spravato® in Seattle, offering new possibilities for relief.
Understanding how these treatments work and who they may benefit can help you make informed decisions about your care. With the right support, you can explore new paths in your mental health journey.
When traditional depression treatments aren’t enough
According to the National Alliance on Mental Illness (NAMI), about 300,000 adults in Washington live with a serious mental health condition. In addition, approximately 82,000 adolescents between the ages of 12 and 17 experience depression.1 Many individuals across the state are seeking support and exploring treatment options.
Most people begin depression treatment with therapy, medication, or a combination of both. For many, this approach brings meaningful relief. However, some individuals continue to experience symptoms even after trying multiple medications or therapeutic approaches.
This is often referred to as difficult-to-treat depression. It means that symptoms have not improved after trying at least two different antidepressant medications at appropriate doses and for a sufficient amount of time. If you are unsure whether this applies to you, it can be helpful to understand why depression sometimes requires additional or alternative treatment options.
What is difficult-to-treat depression?
Difficult-to-treat depression occurs when symptoms persist even after standard treatments have been tried. This can include ongoing sadness, low energy, changes in sleep, difficulty concentrating, or a loss of interest in activities that once felt meaningful. It does not mean that treatment has failed or that improvement is not possible. It simply means that a different approach may be needed.
Depression is complex, and each person’s experience is unique. Factors such as brain chemistry, co-occurring mental health conditions, chronic stress, and medical history can all influence how someone responds to care. When traditional treatment options have not brought enough relief, advanced therapies such as TMS or Spravato® may offer a different path forward.
What is TMS therapy?
Transcranial magnetic stimulation (TMS) is an FDA-cleared, non-invasive treatment for major depressive disorder. It uses targeted magnetic pulses to stimulate underactive areas of the brain involved in mood regulation.
During a TMS session at our Seattle locations, a magnetic coil is gently placed against the client’s scalp. The device delivers focused pulses to specific brain regions linked to depression. Over the course of treatment, these pulses help promote more balanced brain activity.
Unlike medication, TMS does not move through the bloodstream. Instead, it works directly on the brain’s neural pathways. This can make it a valuable option for individuals who have not experienced enough relief from antidepressants or who are looking for a non-medication treatment approach.
If you are searching for a TMS provider near you, LightHeart Mental Health offers TMS therapy in the Seattle area. Our team can help determine whether TMS may be an appropriate next step based on your treatment history and individual needs.
What is Spravato®?
Spravato® is a prescription nasal spray that contains esketamine. It is approved for adults with treatment-resistant depression and works differently from traditional antidepressants.
While most antidepressants target serotonin, Spravato® affects the brain’s glutamate system. This system plays a role in neural communication and mood regulation. By influencing this pathway, Spravato® can help reduce depressive symptoms, sometimes more quickly than standard medications.
Unlike daily oral antidepressants, Spravato® treatment is administered in a medical office under supervision. Clients are monitored during and after each session to ensure safety and comfort.
If you would like a better understanding of how Spravato® works, explore our detailed guide on Spravato® treatment for depression and how it may help individuals living with difficult-to-treat depression.
See full prescribing information on Spravato®.
TMS vs. Spravato®: Which is right for you?
Choosing between TMS and Spravato® depends on your symptoms, medical history, and treatment goals. Both treatments are designed for individuals with difficult-to-treat depression, but they work in different ways.
TMS may be recommended if:
- You prefer a non-medication approach
- You have experienced side effects from antidepressants
- You are looking for a noninvasive brain-based treatment
Spravato® may be recommended if:
- You have not responded to multiple antidepressants
- You are open to supervised in-office medication treatment
- You and your provider determine it is clinically appropriate
Providers evaluate several factors before recommending either TMS or Spravato®, including symptom severity, medical history, and prior treatment response. The goal is always to create a personalized plan that fits your needs and mental health goals.
What to expect during treatment
Learning what the treatment process may look like can help reduce any uncertainty and build confidence going into treatment.
TMS sessions
A typical session of TMS therapy in Seattle at our offices lasts about 20 to 40 minutes. During the session:
- You remain awake and alert
- A magnetic coil is placed against your scalp
- You may feel a tapping sensation on your head
- No anesthesia or sedation is required
Most people receive TMS several days per week over the course of multiple weeks. Your treatment schedule is determined by your provider based on your individual needs. Many clients are able to return to their daily routines shortly after their appointment.
TMS is available for adults and may also be offered to adolescents ages 15 to 21 as an add-on to an existing treatment plan, when clinically appropriate.
Spravato® sessions
Spravato® sessions take place in the office and follow a structured process:
The medication is self-administered under the supervision of a healthcare provider.
You remain in the office for monitoring, typically for about two hours.
Providers check your blood pressure and observe for possible side effects.
You will need to arrange transportation home after the session.
Spravato® is often given twice per week at the beginning of treatment, with the frequency adjusted over time based on your response. You and your provider will work together to determine what schedule and approach best support your needs.
Both treatments involve ongoing check-ins to monitor progress and determine whether adjustments are needed.
TMS and Spravato® at LightHeart Mental Health in Seattle
If you have been searching for Spravato® or TMS providers near you, it can feel overwhelming to sort through your options. LightHeart Mental Health offers both Spravato® treatment and TMS therapy in Seattle as part of our approach to depression treatment.
Our team provides consultations to determine whether TMS or Spravato® may be appropriate based on your symptoms, treatment history, and goals. We take time to answer your questions and help you understand each option clearly so you can make an informed decision about your care.
If you are ready to explore next steps, call 425.800.5688 to schedule an appointment at the LightHeart Mental Health location closest to you.
For new clients, please click here to schedule an appointment. For existing clients, please click here and find your office location to contact your office directly.
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