If you know someone who has been battling depression for a long time, and medications have failed to work, maybe the doctors at University of Florida Health Psychiatry can help.
Thankfully, people in North Central Florida can benefit from some of the safest, advanced depression treatments in the nation, including transcranial magnetic stimulation, or TMS, or electroconvulsive therapy, or ECT.
Psychiatrists Brent Carr, M.D., and Richard Holbert, M.D., helped answer some common questions posed by patients potentially facing advanced depression.
“What are some signs of advanced depression?”
According to Holbert, symptoms of advanced depression can range widely among patients.
“Patients with depression can stop eating or overeat. They can have difficulties concentrating, focusing and performing their daily routines,” he says.
Carr describes the traditional signs of depression as a loss of joy or pleasure and suicidal thoughts. “We are always on the lookout for symptoms that indicate people are almost willing to hibernate or shut down.”
He notes that while some patients do not manifest typical depressed mood, you can see it in their lack of concentration. “This can go on for weeks or even years if left untreated,” Carr adds.
“What are the treatment options for advanced depression at UF Health?”
UF Health Psychiatry offers two kinds of treatments for the most complicated depression cases, TMS and ECT. Carr is the medical director of ECT services, and Holbert is the medical director for TMS treatment. The difference between ECT and TMS is that ECT induces a controlled seizure while the patient is under anesthesia, whereas TMS uses a magnet to modulate brain activity while a patient is awake and fully conscious.
Carr considers ECT to be the gold standard for advanced depression treatments. “It works. That’s why I’m here. I’ve seen it work miracles,” he says.
Holbert agrees, “Approximately 90 percent of patients who receive ECT get at least some improvement, while approximately 70 percent of TMS patients report some type of improvement.”
“How invasive are the procedures?”
Both doctors describe the treatments as fairly low-key. For ECT, Carr says, “Patients come in, receive anesthesia, wake up and leave feeling a little groggy.”
While ECT is considered an outpatient procedure, people usually need a day to recover.
In contrast, TMS, also an outpatient procedure, allows people to return to work, school or their daily routine on the same day.
The mention of ECT may still bring up images of “shock therapy” used in the early 20th century, but today’s procedure is completely different, making it a low-risk procedure for the treatment of advanced depression.
Dr. Carr says he has to dispel some myths when it comes to people’s perception of the treatment. “With advances in medicine, we are now able to offer ECT as a truly safe and effective treatment,” says Carr.
“Are these treatment options safe for women who are pregnant?”
Holbert says that many physicians consider ECT a good treatment choice for patients who are pregnant. “The advantage is that the treatment doesn’t go across the placenta and affect the growing fetus,” he says.
TMS has also been used for pregnant women with severe depression in research studies, but it has not yet been FDA-approved for the treatment of pregnant women.
“Why should I choose UF Health Psychiatry?”
According to Carr, UF Health Psychiatry offers the best all-around patient service. “Our team is always happy to meet with families and discuss the treatment options that will offer the most personalized treatment plan for each person,” he explains.
In addition to receiving care from an attentive and collaborative treatment team, patients at UF Health Psychiatry should know that the UF department of psychiatry is nationally recognized for its medical research.
Carr says, “We have the resources and opportunities, through research, to develop some of the most advanced and novel treatment options for people who are coping with mental illnesses.”
Holbert adds, “We have a number of patients who come to us from all over the state of Florida, and beyond, to receive the level of care and the latest therapy options we can provide.”
“How do I know if ECT or TMS is right for me?”
Choosing a treatment plan should not be a hard first step toward recovery. The treatment team at UF Health Psychiatry will help make the decision as simple as possible. Everyone’s situation is considered on a case-by-case basis because advanced depression treatment plans should be specific to each patient. First, treatment options are fully discussed, and then, doctors and patients make treatment choices together.
ECT and TMS are offered at three locations in Gainesville and can be done on an outpatient basis.
For more information, visit UFHealth.org/depression or call 352-265-5481.
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