Depression Treatment

Mental illness affects millions of Americans. When treatments such as medication and counseling do not provide relief, Prisma Health offers several safe, effective ways to treat depression and other mental illnesses.

Three common options include:

  • Electroconvulsive therapy
  • Ketamine infusion
  • Transcranial magnetic stimulation

Getting Started

A consultation can be made by contacting the Department of Psychiatry & Behavioral Medicine at 864-455-8988. During your consultation, you will meet with a psychiatrist to determine if one of these treatments is right for you.

Electroconvulsive Therapy

About ECT

ECT stands for “Electroconvulsive Therapy”. Many advancements have been made to ECT since its first use in the 1930s. Today, ECT involves a series of treatments in which an electric current causes a seizure while you are asleep under anesthesia. In addition to treating depression, ECT can also be used to treat bipolar disorder, catatonia, and other psychotic disorders. ECT may be recommended if your illness is severe, life-threatening, and/or if other treatment options have failed.

Safety Concerns

Of all the procedures performed under general anesthesia, ECT is one of the safest. Severe heart and/or lung problems make the procedure more risky. Before starting ECT, patients undergo a medical evaluation and lab testing.

What to Expect

ECT can be performed in an inpatient or outpatient setting. Prisma Health- Upstate offers ECT for inpatients at Greenville Memorial Hospital. Outpatient ECTs are performed at Baptist Easley Hospital.

Typically, patients start out getting three treatments a week (Monday/Wednesday/Friday). The number of ECT treatments required varies for each person, but most people start to see improvement after 6- 12 treatments. Treatments are then slowly tapered in order to prevent symptoms from returning.

When you arrive for ECT, a doctor and nurse will ask you some questions to make sure you are ready for your treatment. A nurse will also start an IV by putting a needle into a vein in your arm. This is how you will receive medications during the procedure.

Once you are ready for your treatment, the ECT team will connect you to devices that monitor your heart rate, blood pressure, and oxygen level. Electrodes will also be placed on your head. These monitor your brain activity.

A medication is then given to make you go to sleep. Once asleep, you are given a medication to relax your muscles. This medicine prevents your whole body from moving during the treatment. Your doctor induces a seizure using a small amount of electrical current after you are completely asleep and relaxed.  Most seizures last 15 to 70 seconds before your body stops it on its own. Sometimes, a medication is given to stop the seizure.

The actual treatment lasts just a few minutes, recovery from anesthesia takes longer. You may wake up a little tired and confused. Other common side effects may include headache, nausea, and muscle aches.  Because of these side effects, you must have a responsible adult accompany you and drive you home from the procedure.

Side Effects

Side effects from ECT may include headache, nausea, and muscle aches. They usually are managed with medications during the procedure or with over-the-counter pain relievers at home. Another side effect that you may experience is memory loss. Confusion and memory loss tend to stop within weeks to months after finishing your treatments. Patients should not drive or make major decisions until ECT treatment ends.

Results

ECT is one of the most effective treatments for depression. In fact, ECT is 70-90% effective in treating depression. In addition, results often are more rapid than other treatment options. Sadly, fear and misconceptions about ECT prevent some people from trying it.

Meet the Team

Dr. Adam Hart
Medical Director for ECT Services

Other members of the ECT team include specialized nurses, anesthesiologists, and nurse anesthetists.

Getting Started

A consultation can be made by contacting the Prisma Health Department of Psychiatry at 864-455-8988. During your consultation, you will meet with a psychiatrist to determine if ECT is right for you.

Most insurance companies cover ECT.

Patient Testimonials

I had been doing medication and treatment trials for nearly 8 years when I finally agreed to try ECT. No medication or prior treatment had worked long-term. So I didn’t have the highest of hopes for ECT. I’ve never been happier to have been wrong. ECT lifted me out the deep, dark hole my depression had thrown me into and brought me back into the light”.

“I was at a very low point with my depression. I was aware they were still performing ECT treatment but I didn’t realize I was a candidate until it was presented to me at a time when I felt like there were no other options. ECT has helped immensely”.

“It was like the ECT flipped a switch in my brain and allowed me to think positive thoughts again. The positive thinking brought feelings of hope. I not only wanted to feel better, I believed I could. My family told me I began to smile and laugh again.”

“I think there are a lot of stereotypes and misunderstandings about ECT. I would say it has truly saved my life. It’s not something you need to be afraid of. I am thankful to have had these treatments.”

“I’m treated like a person, with genuine respect by caring and knowledgeable professionals”.

“I can write and talk all day about how these people have changed me and my life for the better, but the truth is that I will never be able to adequately express my gratitude”.

“Everyone has been caring and compassionate. The staff have really helped by being supportive and alleviate the stress of the procedure”.

Ketamine Infusions

About Ketamine

Ketamine is a medication that has been used for anesthesia since the 1970s.  In the 1990s, researchers realized that ketamine could have a positive impact on one’s mood. Compelling evidence now exists that supports the use of intravenous ketamine to treat depression and suicidal thoughts. Though it is not yet approved for this use, studies show that ketamine may improve depressive symptoms within hours of receiving an infusion. Ketamine infusions may be recommended if your depression is severe and resistant to other treatments.

What to Expect

Prisma Health offers ketamine infusions at the Center for Perioperative Optimization (CPO), located at the Verdae Medical Center.  Clients usually receive six infusions of ketamine over 2-3 weeks.

Once you arrive for your treatment, a needle ( or “IV”)  will be inserted into a vein in your arm.  We suggest wearing a short sleeve shirt or sleeves that can be pushed above the elbow. This allows you to remain comfortable in your clothes while you are receiving the medicine. The ketamine will then be given through your IV by a board certified anesthesiologist. The infusion lasts 40-60 minutes. During this time, you may have bizarre thoughts or feel like you are in a dreamlike state. Your blood pressure, heart rate, and oxygen level will be monitored while you receive the infusion.

You may feel like you are having bizarre thoughts after your infusion too – these usually resolve within 4 hours. Unusual sensations, blurred vision and/or drowsiness may also occur. Because of these, you must have a responsible adult accompany you and drive you home from your infusion. Patients often notice their depression lifting within hours of the infusion.

Results

Ketamine can rapidly improve depression, although relapse is common. Continuing prescribed anti-depressants, in addition to receiving ketamine infusions, may be helpful in treating your depression. It is also important to see your regular psychiatric provider while undergoing treatment.

Getting Started

A consultation can be made by contacting the Prisma Health Department of Psychiatry at 864-455-8988. During your consultation, you will meet with a psychiatrist to determine if ketamine infusions are right for you. The psychiatrist will then refer you to the anesthesia team at the Center for Perioperative Optimization (CPO).

Insurance does not cover ketamine infusion therapy. That means patients pay all treatment costs.

Transcranial Magnetic Stimulation 

Transcranial magnetic stimulation (TMS) is an outpatient procedure for depression. With TMS, a small electrical pulse passes through a metal coil on the scalp, creating a magnetic field that stimulates parts of the brain linked to depression.

Most patients receive one treatment a day (Monday–Friday) for about 36 total treatments. Each noninvasive session lasts 35–40 minutes.

No anesthesia is needed. Patients can drive after each treatment. Side effects include headache, scalp pain and short-term hearing issues.

Many insurance companies cover TMS.

How to schedule a consultation

To learn more or schedule a consultation for ECT, ketamine infusion, or TMS call 864-455-8988.