Oct 02 2024 17 mins
Research shows that up to 20-30% of individuals might feel well-known treatments like cognitive behavioral therapy (CBT), SSRIs, or other psychotropic medications, while helpful, haven’t really eradicated their symptoms in the way they’d like.
This is where often controversial alternatives like ketamine therapy, transcranial magnetic stimulation, electroconvulsive therapy, and other emerging therapies come in.
In my newest podcast episode, I explore some of the alternative treatments and give you a guide to the pros, cons, and the major controversies concerning each of them. Take a listen right here in Substack, on Apple, Spotify, or watch the video podcast on YouTube.
As with all things concerning your health, it’s important to be able to make informed decisions about the treatment options available to you. So, let’s dive in and be sure to talk with your mental health or medical professional before you start any new treatment.
Ketamine Treatment
Ketamine treatment has been getting a ton of media coverage lately. Originally developed as an anesthetic, ketamine has recently been repurposed for depression treatment, particularly for those who haven't responded well to other medications.
* Pros. One of the biggest advantages is its rapid onset. Unlike traditional antidepressants that can take weeks to show effects, ketamine can start to work within hours. It's been especially promising for treatment-resistant depression, offering relief when other options have failed. Ketamine infusions, given in low and controlled doses, have shown remarkable results in many cases.
* Cons. Given its history as a recreational drug, ketamine has the potential for abuse. There can be side effects, like dissociation, dizziness, or increased blood pressure. Many of the long-term effects of ketamine treatment are still not fully understood.
* Controversies. There's some debate about keatamine’s use due to its side effects, concerns about its accessibility, and the ethical considerations of its off-label use, as ketamine treatment is not FDA approved. Ultimately, there is much that we don’t know about ketamine treatment.
Transcranial Magnetic Stimulation
Transcranial magnetic stimulation (TMS) is a relatively new treatment for treatment-resistant depression. TMS uses magnetic fields to stimulate nerve cells in the brain. It should only be used when other treatment options haven’t been effective.
* Pros. TMS is a non-invasive procedure with minimal side effects that is done in an outpatient setting. TMS has proven efficacy for those with treatment-resistant depression, and is FDA approved for depression. You don't need anesthesia, and you can return to your normal activities right after a session.
* Cons. TMS requires a significant time commitment—typically daily sessions over several weeks. It can be expensive, and it is not always covered by insurance. And, like any treatment, it's not effective for everyone.
* Controversies. The controversies around TMS largely focus on accessibility and cost, as well as debates on its efficacy compared to other treatments. However, it’s generally considered a safe and effective option for many.
Electroconvulsive Therapy
Electroconvulsive Therapy (ECT) has a long and complex history, but it remains one of the most effective treatments for severe depression. It is often used as a last resort. ECT consists of brief electrical stimulation of the brain while the patient is under anesthesia. ECT's effectiveness in treating severe mental illnesses is recognized by the American Psychiatric Association, the American Medical Association, the National Institute of mental health in many, many other similar organizations in other countries.
* Pros. ECT can be highly effective,especially for severe depression, suicidal ideation, or when other treatments have failed. It often works quickly, which is crucial in emergency situations.
* Cons. The most significant is the potential for memory loss, both short-term and sometimes long-term. ECT requires general anesthesia, and there’s still a stigma attached to it, partly due to its portrayal in media. It also doesn’t prevent a return of the illness in the future.
* Controversies. There are some ethical considerations around consent, especially when it comes to severe cases where a patient might not be fully capable of consenting due to a condition such as psychosis. There is also an ongoing debate about its safety and side effects.
Other Emerging Treatments
Psychedelic-assisted therapy, using substances like psilocybin or MDMA, has shown promise in recent studies for both depression and PTSD. However, these treatments are still in the experimental stages and come with their own sets of
* Pros and Cons: They can offer deep psychological insights and rapid improvements for some, but they also raise concerns about safety, legal status, and long-term effects.
Are Alternative Treatments Right for You?
When considering alternative treatment options, it is essential that you do not take a DIY approach. It is important to make sure that you really are a candidate for one of the above treatments, and that you find a credible provider you can have an honest conversation with. Listen to my podcast episode (here in Substack, or on Apple or Spotify) or watch the video podcast on YouTube for some key factors you should consider if you’re thinking about exploring alternative treatments.
There are also less invasive approaches you can take to help improve symptoms of anxiety and depression. Here’s one that costs no money, takes just 10-20 minutes a day, and has been shown to improve mood, sleep, and emotion regulation.
Actionable Tip: Morning Light Exposure
Morning light exposure can boost your mood and energy levels throughout the day. This works because of your body’s internal clock, or circadian rhythm. Your internal clock regulates a wide range of biological processes, including your sleep-wake cycle, hormone release, and even your mood.
Morning sunlight is rich in blue light, which is especially effective at signaling to your brain that it's time to wake up and be alert. This helps regulate the production of melatonin, the sleep hormone, so you feel more awake during the day and sleepier at night.
By getting natural light exposure in the morning, you’re essentially setting your body’s clock. This makes it easier to fall asleep at night and feel more energized and positive during the day. Several studies have shown that consistent exposure to morning light can reduce symptoms of depression, especially in people with Seasonal Affective Disorder (SAD), and improve overall mood and well-being.
Here are five ways you can incorporate morning light exposure into your daily routine:
* Step Outside First Thing in the Morning. Start your day by stepping outside for 10 to 15 minutes of direct sunlight exposure within the first hour after waking up. This could be as simple as walking your dog, enjoying your morning coffee on the porch, or doing a quick stretch routine in your backyard.
* Combine Light with Movement. Try to combine this light exposure with some gentle exercise or stretching. A brisk walk around your neighborhood or some light yoga in the garden can enhance the benefits, boosting your endorphins and getting your blood flowing.
* Create a Morning Sun Ritual. Make it a ritual! You could designate a specific time each morning to sit by a window or go outside, listen to your favorite podcast, do a quick meditation, or write in a journal. Creating a consistent routine around this practice can make it a sustainable habit.
* Maximize Indoor Light Exposure. If you can’t get outside, try to spend time by a window that gets plenty of morning light. Open the blinds as soon as you wake up, and consider moving your morning activities (like reading or eating breakfast) to a bright spot in your home. Even indirect natural light can help, although direct exposure is more effective.
* Use a Light Therapy Box in Winter Months or Cloudy Days. During the darker months or if you live in a place with limited sunlight, you might want to use a light therapy box. These devices mimic natural daylight and can be particularly helpful for those with Seasonal Affective Disorder or anyone looking to boost their mood when natural light isn’t readily available.
Remember, if you are considering alternative treatment options, it is essential to be informed and to find a provider you trust.
I hope this newsletter provides a solid jumping off point for further discussions with your doctor. If you found this to be helpful, click below and share this newsletter with a friend or family member.
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About me:
Dr. Judy Ho, Ph. D., ABPP, ABPdN is a triple board certified and licensed Clinical and Forensic Neuropsychologist, a tenured Associate Professor at Pepperdine University, television and podcast host, and author of Stop Self-Sabotage. An avid researcher and a two-time recipient of the National Institute of Mental Health Services Research Award, Dr. Judy maintains a private practice where she specializes in comprehensive neuropsychological evaluations and expert witness work. She is often called on by the media as an expert psychologist and is also a sought after public speaker for universities, businesses, and organizations.
Dr. Judy received her bachelor's degrees in Psychology and Business Administration from UC Berkeley, and her masters and doctorate from SDSU/UCSD Joint Doctoral Program in Clinical Psychology. She completed a National Institute of Mental Health sponsored fellowship at UCLA's Semel Institute.
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