Many of the veterans who come to us for depression have already been in treatment. They’ve tried antidepressants, spent time in therapy, received care through the VA, and in some cases have been doing these things for years. The problem is that the depression hasn’t improved enough.
At Deep Centered Mental Health, we offer two additional treatments for depression when more traditional approaches haven’t worked: Transcranial Magnetic Stimulation (TMS) and SPRAVATO® (esketamine). Both are currently available at our Austin and Dallas locations.
We also work closely with the VA and accept VA Community Care Network (VA CCN) coverage, including TriWest. Our team is familiar with the referral and authorization process and can help veterans understand what is needed to receive care with us.
Depression and Mental Health Among Veterans
PTSD gets a lot of attention when we talk about veterans and mental health. Depression is also common, and the two often overlap. Veterans may be dealing with anxiety, sleep problems, grief, or difficulties adjusting to civilian life at the same time. You can learn more about our approach to PTSD and trauma treatment.
These problems don’t always show up immediately after military service. Depression or trauma-related symptoms can become more noticeable months or years later, or return during a difficult period of someone’s life.
By the time a veteran talks with us about TMS or SPRAVATO, there is usually a treatment history to go over. Often, one or more antidepressants have been tried without enough improvement. Medication side effects can complicate treatment. And therapy can be helpful without fully addressing the depression.
When depression continues despite appropriate treatment, it may be considered treatment-resistant depression. TMS and SPRAVATO treat depression differently from standard antidepressant medications, which is why they can become options at this point in treatment.
TMS for Veterans With Depression
Transcranial Magnetic Stimulation (TMS) uses magnetic pulses to stimulate areas of the brain involved in mood. It is noninvasive and does not use medication. Patients are awake throughout the treatment, with no anesthesia or sedation needed.
At Deep Centered, we use BrainsWay Deep TMS technology. Individual appointments are typically around 20 minutes, and most patients drive themselves and return to their normal activities afterward.
A standard course of TMS is usually given five days a week over several weeks. The repeated schedule is part of the treatment, with stimulation delivered across a series of sessions rather than all at once.
TMS is often considered after antidepressants haven’t helped enough. It can also be an option when medication side effects have made it difficult to stay on a particular treatment.
We currently provide TMS in Austin and Dallas.
SPRAVATO® (Esketamine) for Veterans With Treatment-Resistant Depression
SPRAVATO® (esketamine) is an FDA-approved nasal spray for adults with treatment-resistant depression. It works primarily through the brain’s glutamate system, rather than the pathways targeted by most traditional antidepressants.
The treatment experience is different from taking a medication at home. SPRAVATO is given in a certified treatment setting, and patients stay at the office for monitoring afterward. A ride home is required.
Appointments are more frequent when treatment begins and become less frequent later in the course of treatment.
At Deep Centered, therapy is also part of our SPRAVATO program. We require our SPRAVATO patients to participate in therapy during treatment, and we feel strongly about it.
SPRAVATO isn’t something we want to treat as an isolated medication visit. Therapy gives patients time to work through what is coming up in their lives while the depression itself is being treated. Veterans who already have a therapist can continue with that therapist. If they don’t have one, we can connect them with someone at Deep Centered.
SPRAVATO is currently available at our Austin and Dallas locations.
TMS or SPRAVATO?
TMS doesn’t involve medication, and the appointments themselves are relatively short. Most patients can drive home afterward. A standard treatment course does require coming into the office five days a week for several weeks.
SPRAVATO appointments take longer because of the required monitoring period. Patients also need someone to drive them home. The treatment schedule starts out more frequently and changes as treatment progresses.
Treatment history is an important part of deciding between them. We look at medications that have already been tried, how well they worked, whether side effects were a problem, and the rest of the person’s medical and mental health history.
A preference to avoid another medication can make TMS especially appealing. Previous antidepressant treatment and the nature of someone’s depression can point the conversation toward SPRAVATO. These aren’t decisions we expect patients to make before coming in. Our clinical team reviews the history and helps determine which treatment is appropriate.
Does the VA Cover TMS and SPRAVATO?
Eligible veterans may be able to receive TMS or SPRAVATO through VA Community Care when the treatment is clinically appropriate and authorized by the VA.
Deep Centered Mental Health accepts VA Community Care Network (VA CCN) coverage, including TriWest. We work directly with the VA and have experience helping veterans get connected with care through their VA benefits.
Authorization is an important part of the process. VA Community Care coverage doesn’t automatically mean that treatment can begin without prior approval. The requirements depend on the veteran’s situation and the treatment being requested.
If you’re not sure what authorization you need, call us at (512) 956-6463. Our team can look at where you are in the process and explain what needs to happen next.
You can also schedule an appointment online and select VA CCN or TriWest as your insurance.
TMS and SPRAVATO for Veterans in Austin and Dallas
Our TMS and SPRAVATO programs are currently available in Austin and Dallas, Texas.
Deep Centered also provides therapy, psychiatry, and other outpatient mental health services. This matters because veterans dealing with depression are often also working through trauma, anxiety, PTSD, or other mental health concerns.
Care can be coordinated within Deep Centered when it makes sense clinically. Someone receiving TMS might also be working with a therapist. Therapy is already required as part of our SPRAVATO program, and psychiatric care can continue alongside either treatment when needed.
We have additional locations around Texas for other mental health services. View our Deep Centered locations to learn more.
Getting Started Through VA Community Care
If you’ve already been treated for depression and it hasn’t improved enough, it may be time to ask about other options. TMS and SPRAVATO give us two ways of treating depression that don’t simply involve switching from one traditional antidepressant to another.
For veterans in Austin and Dallas, our team can also help with the VA Community Care process.
Call Deep Centered Mental Health at (512) 956-6463 or schedule an appointment online to talk with us about treatment.
