4 Things to Know About Treatment-Resistant Depression

Depression is a complex and deeply personal condition that affects millions of people. At Friendswood Psychiatry & TMS Clinic in Friendswood, we believe in a comprehensive approach to treatment, addressing the biological, psychological, and lifestyle factors that contribute to depression. Our goal is to help patients regain a sense of well-being and control over their lives. We offer various treatments , including medical therapies, supportive talk therapy, and lifestyle interventions. Here’s a closer look at our depression treatment options and how they can help. Medical Services Transcranial Magnetic Stimulation (TMS) Transcranial Magnetic Stimulation (TMS) offers a noninvasive alternative for those who haven’t responded to traditional medication or want a drug-free alternative. This treatment uses magnetic pulses to stimulate the brain regions involved in mood regulation, often the dorsolateral prefrontal cortex . The pulses stimulate electrical activity in nerve cells, releasing chemical messengers and strengthening nerve circuits over time. The TMS procedure is straightforward and comfortable. During each session, patients relax in a chair while a specialized device delivers magnetic pulses to the scalp. The treatment lasts about 30 to 40 minutes and typically involves six to twelve sessions spread over three to six weeks. TMS has a lower side effect profile compared with antidepressants, as the treatment is targeted to specific brain areas rather than acting across the whole brain. Some patients may experience temporary mild scalp discomfort or headaches, but these are temporary. Moreover, TMS can provide long-lasting depression relief , even when other treatments have failed. Psychiatric Evaluation & Medication Management Our psychiatric evaluations allow us to gain a complete understanding of your symptoms, medical history, and personal experiences. Accordingly, we can develop a comprehesive treatment plan that is tailored specifically to your needs . During evaluation sessions, you will meet with our medical doctor, who will carefully assess your mental health and discuss any diagnostic findings with you. Once an evaluation is completed, medication management appointments are scheduled to explore your treatment options. These sessions provide a dedicated space to discuss potential medications, their benefits, and possible side effects. Other therapies, such as different forms of psychotherapy, may be integrated into your medication management plan if they are deemed beneficial for your overall treatment goals. Genetic Testing for Medication Response Because every person’s body processes medication differently, genetic testing can provide valuable insights into which medications may be most effective. This test is performed using a simple cheek swab , which is then analyzed to determine how your genes influence medication metabolism. By understanding your genetic profile , we can more accurately predict which medications are likely to work best for you, reducing the frustration of trial-and-error prescribing. This approach not only helps improve treatment outcomes but also minimizes the risk of side effects , making the process of finding the right medication smoother and more effective. Talk Therapy Cognitive Behavioral Therapy (CBT) One of the most effective forms of therapy for depression is Cognitive behavioral therapy (CBT). Depression often leads to negative thought patterns , where individuals feel hopeless, unworthy, or stuck in a cycle of self-criticism. CBT helps patients identify and challenge these thoughts, replacing them with more constructive, realistic perspectives. Beyond addressing thought patterns, CBT also focuses on behavioral changes . Depression often causes people to withdraw from activities, isolate themselves, or avoid responsibilities—behaviors that can make symptoms worse. By working to modify these behaviors, CBT helps individuals regain a sense of control over their lives. Over time, this therapy fosters lasting improvements in mood, energy levels, and overall well-being. Motivational Interviewing For many individuals with depression, lack of motivation is a significant obstacle to recovery. Tasks that once seemed simple—getting out of bed, maintaining relationships, or engaging in self-care—can feel overwhelming. Motivational interviewing is a therapeutic approach designed to help people overcome ambivalence and reconnect with their own reasons for wanting change. Instead of using a structured, directive approach, MI is more collaborative . It involves open-ended conversations that explore personal values, goals, and strengths. Supportive Therapy Sometimes, what individuals need most is a safe space to talk, process emotions, and receive encouragement. Unlike structured therapies like CBT, supportive therapy is more flexible and patient-driven . It allows individuals to discuss their feelings, challenges, and life experiences in a nonjudgmental setting. This form of therapy is particularly helpful for those going through difficult life transitions, grief, or chronic stress, as it provides consistent emotional support throughout. Faith-Based Therapy Faith-based therapy can be a valuable part of the healing process for those who find strength in their spiritual beliefs for those who find strength in their spiritual beliefs. Depression can sometimes make people feel disconnected from their sense of purpose, leading to existential distress . Faith-based therapy integrates religious or spiritual values into the therapeutic process, offering guidance that aligns with a patient’s belief system and personal values . This approach can especially benefit those who wish to explore how their faith can support their emotional healing journey. Lifestyle Management Nutrition & Exercise Review Nutrition and exercise play a significant role in brain health and overall mental functioning. Studies show nutritional deficiency is associated with depression risk . Poor diets can also contribute to physical problems that further impair someone’s quality of life. At our clinic, we review your current habits and offer practical recommendations to support mental well-being through nutrition. Exercise, in particular, has been shown to have powerful antidepressant effects. Even mild physical activity, such as walking or stretching, can boost endorphins , improve energy levels, and reduce stress. By finding an approach that feels manageable, we help patients incorporate movement into their routine in a way that supports both emotional well-being. Sleep Optimization Sleep disturbances are common in depression—some individuals struggle with insomnia , while others experience excessive sleepiness and fatigue . Poor sleep not only worsens mood but also affects concentration, energy, and overall resilience. At our clinic, we work with patients to identify sleep patterns that may be contributing to depression and develop strategies for improvement. This might include adjusting bedtime routines, addressing underlying sleep disorders, or finding ways to manage nighttime anxiety.  Depression Relief at Friendswood Psychiatry Clinic If you’re interested in any of our services and want to find out more, schedule a free consultation today. We’re here to help you understand each service in more detail, including costs, insurance and anything else you might wish to know.

Postpartum Depression and TMS Bringing a baby into the world is a life-changing experience, but for many new mothers, it comes with unexpected challenges, including postpartum depression (PPD). This condition affects millions of women globally and can significantly impact a mother’s ability to bond with her child and even influence the emotional well-being of her baby. This article will explore PPD and the potential of Transcranial Magnetic Stimulation (TMS) to help struggling mothers. Understanding Postpartum Depression Postpartum depression (PPD) is a serious condition that affects some women after childbirth. Symptoms of PPD can vary but often include: Extreme sadness Fatigue Loss of interest in activities Difficulty bonding with the baby Irritability Changes in sleep or appetite Postpartum depression (PPD) doesn’t just impact mothers—it can also have serious effects on their babies. Studies reveal that children of mothers with PPD are more likely to experience behavioral and emotional challenges . Unfortunately, this knowledge can amplify PPD symptoms, as mothers may feel overwhelmed with guilt or anxiety about the potential impact on their children. Data suggest that postpartum depression affects 10% to 15% of new mothers globally. The prevalence may vary based on factors like socioeconomic status, support systems, and individual history of mental health issues. Despite being relatively common, PPD often goes undiagnosed or untreated due to stigma, lack of awareness, or limited access to resources. The causes of postpartum depression are multifaceted. Biological factors include hormonal changes during and after pregnancy. For example, estrogen and progesterone levels drop sharply after childbirth, potentially affecting mood-regulating brain chemicals. Psychological factors, such as a history of depression or anxiety, also contribute. Additional stressors like sleep deprivation , lack of support , or life changes associated with parenthood can exacerbate these challenges. What Is TMS? Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment for depression that uses magnetic fields to stimulate specific areas of the brain. The U.S. Food and Drug Administration (FDA) approved TMS in 2008 for treating major depressive disorder (MDD) , particularly for individuals who haven't responded to other treatments like medications or therapy. TMS is performed in an outpatient setting , meaning no anesthesia is required. During a session, a technician places a device with an electromagnetic coil against certain brain regions. This coil generates magnetic pulses that create electrical currents in the brain, stimulating nerve cells in brain areas that may be underactive in individuals with depression. Each session typically lasts 30 to 40 minutes , and patients can resume to normal activities immediately afterward. A full course of TMS usually involves three to five sessions per week, over several weeks. How Does TMS Work for Postpartum Depression? TMS works by targeting specific areas of the brain that are less active in people with depression. One key area is the dorsolateral prefrontal cortex (DLPFC), which plays a role in mood regulation, decision-making, and emotional responses. Brain scans show the DLPFC may be dysfunctional in PPD. TMS encourages neuroplasticity —the brain's ability to reorganize itself by forming new neural connections. By enhancing neuroplasticity, TMS helps the brain "reset" patterns of activity linked to depressive symptoms, leading to improved mood and positive ways of thinking. For PPD, TMS offers a promising approach by addressing the underlying neurological factors contributing to the condition. Unlike medications, which alter brain chemistry, TMS directly influences brain activity. This targeted approach reduces the risk of side effects and allows for more precise treatment . Effectiveness of TMS for Postpartum Depression Research supports the effectiveness of TMS for treating postpartum depression. A study published in the Brain Stimulation Journal examined the use of repeated TMS in pregnant and postpartum women with major depressive disorder. The results showed that over 70% of participants experienced significant improvement in their symptoms, and many maintained these benefits over time. Another study published in the Journal of Affective Disorders found TMS improved both depression and anxiety in women with PPD. These mood improvements were sustained three and six months after their treatment, and no serious side effects were reported. TMS is particularly beneficial for individuals who have not responded to traditional therapies like antidepressants or psychotherapy. By offering a new pathway for treatment, TMS provides hope for those who might otherwise feel stuck in their struggle with depression. Is TMS Safe for Postpartum Depression? TMS is generally considered safe, with minimal side effects. Some people may experience headaches or dizziness during or after sessions. However, these side effects are typically temporary and resolve on their own. In rare cases, there have been reports of seizures , hearing loss , and mania following TMS. As such, patients must have a thorough screening before undergoing TMS therapy to ensure they are suitable for treatment. For postpartum mothers, one of the most significant advantages of TMS is that it does not involve medications. This means it doesn't introduce chemicals into the body that could pass into breast milk and affect the baby. Mothers can continue breastfeeding without worrying about potential risks associated with drug-based treatments. Additionally, studies suggest that TMS is safe for women during the peripartum period , including pregnancy and the period after birth. It does not pose risks to the developing fetus or the newborn, making it a suitable option for mothers concerned about the well-being of their children. Exploring TMS at Friendswood Psychiatry Clinic At Friendswood Psychiatry and TMS Clinic , we provide comprehensive mental health services, including TMS therapy, for individuals experiencing depression and other mood disorders. We’re located in Friendswood and are a leading TMS provider in Texas , offering safe and compassionate care to support the unique healing needs of each patient. If you or someone you know is struggling with PPD and you want to know more about our services as a potential solution, be sure to get in touch with one of our team members. You can schedule a free consultation , and we’ll provide you with everything you need to know about this potentially life-changing treatment and how it could serve you.

Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) are both effective treatments for mental health disorders, particularly when conventional methods have failed. While both involve stimulating brain cells, they differ significantly in approach, side effects, and suitability for different patients. Understanding these differences can help you make an informed decision about which treatment may be right for you. What Is TMS Therapy? TMS is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in specific areas of the brain, such as the dorsolateral prefrontal cortex , which are associated with mood regulation and cognition. These areas may be underactive or dysfunctional in people with mental health disorders. By increasing electrical activity, TMS promotes the release of neurotransmitters (chemical messengers) and enhances the activation of these regions. TMS also improves functional connectivity , which refers to the communication between different brain areas. This increased connectivity can help form new patterns of thinking and behavior. During a TMS session, a magnetic coil is placed on the scalp over the target brain regions. Patients remain awake, and the procedure is performed on an outpatient basis, allowing them to return home after their session. A typical session lasts 30 to 40 minutes, and most patients require 20–30 sessions over four to six weeks for optimal results. TMS is particularly effective for individuals who haven’t experienced relief from traditional treatments like medication or therapy. It is most commonly used to treat depression , obsessive-compulsive disorder (OCD) , and addiction , but it is being explored for several other conditions. What Is ECT? ECT is a more invasive treatment that uses controlled electrical currents to induce a brief seizure in the brain. The procedure is performed under general anesthesia, with two electrodes placed on the scalp to deliver the electrical currents. Each session lasts about an hour, including preparation and recovery, while the seizure itself lasts 30–60 seconds. ECT stimulates widespread brain activity and the release of neurotransmitters, often providing rapid relief for severe cases of depression, bipolar disorder, or catatonia. While the exact mechanism of action is not fully understood, ECT’s ability to produce fast results makes it a lifesaving option for individuals with treatment-resistant depression (TRD) or life-threatening symptoms. TMS vs. ECT: Key Differences Treatment Process TMS: Non-invasive and performed on an outpatient basis. Patients remain awake during the session, and no anesthesia or recovery time is required. The treatment is spread out over several weeks. ECT: Requires general anesthesia and is typically administered 2–3 times a week for 6–12 sessions. Recovery time is needed after each session due to the effects of anesthesia and the seizure. Effectiveness TMS: Effective for moderate to severe mental health disorders, with noticeable improvements after a few weeks of treatment. It is especially suited for individuals who have not responded to conventional medication. ECT: Ideal for severe mental health disorders with potentially life-threatening symptoms where rapid relief is essential. Side Effects TMS: Side effects are generally mild and temporary. Common issues include headaches, scalp discomfort, and lightheadedness. Rarely, TMS may cause seizures or hearing issues. ECT: Side effects are more intense and may include short-term memory loss, confusion, fatigue, muscle soreness, and headaches. In rare cases, ECT can cause long-term memory problems or cognitive issues. Who Is a Good Candidate for Each Treatment? Mental Health Conditions TMS: Recommended for moderate to severe depression and OCD when other treatments have failed. It is also useful for individuals struggling to quit smoking or other potentially life-threatening addictions. ECT: Typically reserved for severe, treatment-resistant depression (TRD), bipolar disorder, schizophrenia, and catatonia. Treatment History TMS: Suitable for those who have tried antidepressants or talk therapy without success. It is also a good option for people struggling to overcome addiction despite multiple therapies. ECT: Often considered when multiple other treatments, including TMS, have failed or when a faster response is critical. Medical Eligibility TMS: Does not require general anesthesia, making it safer for patients with certain medical conditions. ECT: Since it involves anesthesia, additional medical evaluations may be required for individuals with cardiovascular or respiratory issues. Explore TMS Treatment Options at Friendswood Psychiatry Clinic At Friendswood Psychiatry Clinic, we offer advanced treatments like TMS to support your journey toward improved mental health. Our compassionate team designs personalized treatment plans tailored to your unique needs, ensuring the best possible outcomes. To provide a holistic approach, we also offer talk therapies that can be integrated into your program, helping you achieve lasting well-being and a better quality of life. If you’d like to learn more, be sure to book a free consultation with one of our team members.

When you understand that nutrition and mental health are connected, you can nurture your body and mind with a balanced diet that supports emotional resilience.

Explore the types of behavioral health services available near Friendswood and how you can use them to improve your mental health and wellness.