Which Depression Treatment Is Right for Me?

The most common depression treatments today are antidepressant medications and talk therapy. But what if those options don’t work for you? If you’ve tried them before with no luck, you may decide to use alternative therapies to treat your depression.

Follow these simple steps to make an informed decision about your depression treatment. With several alternative and progressive therapies available today, you should be able to find one that suits your unique needs.

Step 1: Learn About Your Depression Treatment Options

The first step in choosing a treatment for your depression is to understand what’s available. The following options may be recommended for someone with treatment-resistant depression, meaning that the condition has not responded to traditional options like antidepressants, SSRIs and psychotherapy. Some patients will select one of the following options before being labeled as treatment-resistant to avoid wasting time, money, and disappointment of trialing less effective treatments first.

• Ketamine Infusion Therapy: A low dose of ketamine is delivered directly to the bloodstream via intravenous infusion. It has an especially high success rate of over 80%.
• Esketamine nasal spray: The user inhales esketamine AKA Spravato via a nasal mist. It has a success rate of around 40%.
• Transcranial Magnetic Stimulation (TMS): A magnetic coil is placed on the scalp to induce electrical activity. It has a success rate of 30% to 50%.
• Electroconvulsive Therapy (ECT): Electric currents are passed through the brain to induce a brief seizure. It has a success rate of around 50%.

Now that you’re aware of some of the most effective options for alternative depression treatments, it’s important to compare the various features of each treatment.

Step 2: Compare The Treatments To See What’s Best For You

Each of the alternative therapies for depression has their own treatment timeline, common side effects, and associated costs. Here are some important factors to consider:

• Time Commitment: Some treatments are more time-intensive than others. This includes both the treatment timeline, as well as the typical duration of relief. Are you prepared to take medication every day? Do you have availability for multiple sessions? Is your depression so severe you need immediate relief? These are questions to consider when choosing the right treatment.
• Side Effects: It's also important to consider side effects when deciding which alternative depression treatment is right for you. Be sure to look into the potential long and short-term side effects that can occur with each treatment type.
• Associated Costs: Most people will need to factor financial costs into their decision when looking into alternative therapies for their depression. Not just how much the treatment costs, but the whole picture. Just because insurance covers a portion of most antidepressant medications, doesn't mean there aren't associated costs. What is the cost of your doctor visits, refills, copays, deductibles, etc.? What is the price of negative side effects? What is the cost to you, your family, friends, and employer of ineffective treatments? Factor this in with the lifelong commitment that may be necessary to keep your depression symptoms at bay, and you may find other alternative treatment options to be worth the higher upfront expense.

Step 3: Figure Out Treatment Responsibility

Before you begin any new type of treatment, it’s smart to talk to your insurance company about what will be covered. If you find the treatment you’re interested in isn’t covered by insurance, ask why, and look into underlying reasons for its exclusion from coverage. For instance, many pharmaceutical companies do not want to see ketamine used therapeutically because it undermines the sales of their less effective antidepressant drugs. Insurance companies might not accept Ketamine Infusion Therapy because they often resist paying for new treatments for as long as possible.

Here are some other questions you’ll want to ask about each treatment option:

• What is the success rate?
• What are the side effects?
• How many sessions are there?
• How long is each session?
• What is the cost?
• Is there a copay for each session?

Step 4: Talk to Your Primary Care Physician

Once you understand your treatment coverage, the next step is to contact your primary care physician (PCP) or mental health professional (MHP). You may need a referral in order to seek an alternative treatment for your depression. In addition, your PCP or MHP can communicate directly with an alternative therapy provider to discuss your medical history and other treatments you’ve explored in the past. Open communication between your doctors can help to facilitate better treatment with your unique mental health needs and medical history in mind.

Step 5: Research and Reach Out To Treatment Facilities

Having talked to your PCP or MHP, it’s likely they can provide you with recommendations on different treatment facilities in the area. It’s also a good idea to do your own research online. How long has the treatment facility been in practice? How many patients have they treated, and what is their overall success rate? Has the treatment facility been acknowledged in the media and/or within the medical community for advancing the treatment? Different facilities have different care protocols, so it’s important to choose one that fits your comfort. Check on Yelp, Google, Healthgrades, and Facebook for recent patient reviews. If you come across negative comments, has the treatment facility tried reaching out to them to rectify their concern? Once you’ve narrowed down a few facilities, it’s important to reach out to them. You’ll likely be able to tell on that first call whether they truly care about helping you, or if they’re just interested in your business. They should be warm and responsive, and actively look to answer all of your questions. They should sound knowledgeable and demonstrate experience and not contradict themself. 

Ketamine infusions for mental health conditions are considered "off-label" and are currently not covered by insurance. Approximately 25% of all prescriptions in the US are written off-label and approximately 33% of psychiatric prescriptions are written off-label. Many of these prescriptions are indeed covered. The insurance networks are inconsistent in their application of this policy and it is not a good basis for them to deny coverage for ketamine infusions. Unfortunately, this is their current position. Hopefully, they will come to realize that ketamine infusions are more effective and less costly for them than other treatments they are currently covering. We will continue to fight for insurance coverage for all patients, as we have since 2014.

We want to help you find a treatment solution that works for you. With the right treatment provided by the right care team, you have a good chance of experiencing relief from your symptoms. Book a free phone consult with our Patient Care Specialists to talk about your options.