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See Med Center Health’s response to COVID-19 on our Coronavirus Update page.

Hope for people with treatment-resistant depression

Many people experience sadness, grief or anxiety at some time in their lives. The loss of a loved one, being laid off, going through divorce or any other life change – all these can be overwhelming and lead to feeling “depressed.” But there is a difference between sadness and depression. When feelings of inadequacy, fatigue or sadness continue for two weeks or more, and physical causes such as a thyroid disorder have been ruled out, that could be depression.

Usually — with the help of therapy, medication or both – people with depression are able to cope and lead fulfilling lives. For some, though, no amount of medication or therapy seems to help. This is especially true for people diagnosed with major depressive disorder (MDD). Among MDD patients with treatment-resistant depression, an alarmingly high number have thoughts of suicide. An estimated thirty percent actually attempt to take their own lives. Unfortunately, many don’t know there is hope for relief from their symptoms. Two treatments, in particular, have helped millions of people: Spravato®, a once- or twice-a-week nasal spray; and NeuroStar® Transcranial Magnetic Stimulation, a noninvasive, non-drug treatment with proven results.


Spravato is a nasal spray used in combination with an oral antidepressant to treat adults with treatment-resistant depression. It is also used to treat symptoms of depression in adults with MDD who have suicidal thoughts or actions. Spravato is only available at certified treatment centers, such as Medical Center Psychiatry in Bowling Green. Because this treatment can cause temporary side effects such as sleepiness or dizziness, it is administered in the safe environment of a doctor’s office. Patients are monitored for around two hours after receiving Spravato. In clinical studies, Spravato showed a greater reduction of depressive symptoms at four weeks than among those patients who received a placebo. Medical Center Psychiatry is the only certified Spravato treatment center in Southcentral Kentucky.

NeuroStar® Transcranial Magnetic Stimulation (TMS)

Because depression starts in the brain, TMS uses magnetic pulses, similar to an MRI, to target specific areas of the brain that regulate mood. The magnetic pulses “reignite” connections in the brain that are inactive and causing symptoms of depression. TMS is a safe, noninvasive outpatient procedure that takes just a few minutes for the treatment itself. TMS is not the same as electroconvulsive (shock) therapy. Unlike shock therapy, patients are awake during the procedure and there are few if any long-term side effects. More than 80% of people who have undergone TMS treatment have reported improvement in their symptoms, and around 60% have recovered from depression entirely. Medical Center Psychiatry is the only certified TMS treatment center in Southcentral Kentucky.

“Depression should not be stigmatized, but TREATED,” says psychiatrist Joseph Grau, M.D., with Medical Center Psychiatry. “Fear of stigmatization can cause some people to not seek care – but the importance of being treated with the appropriate methods cannot be overstated. Each individual is unique; but they are not alone. We are here to help.”

If you are struggling with depression, the first thing to understand is that you are not alone. Depression is a medical condition that can be treated safely and effectively. If you are feeling isolated, depressed, anxious or fearful, please talk to your doctor. If you have been treated for depression and nothing seems to help, call Medical Center Psychiatry at 270-843-5103 and ask about Spravato, TMS and other treatments that might be available. If you or someone you know has had thoughts of suicide, call 9-8-8 for the National Suicide and Crisis Lifeline. The lifeline is available 24/7 across the United States. Compassion, understanding and help are all available.

To learn more about how Med Center Health can help if you or someone close to you suffers from mental health issues, contact Medical Center Psychiatry.