Interventional psychiatry is a mental health specialty that uses electrical or magnetic stimulation, as well as some drug treatments, to alter brain circuitry and subsequently ease the symptoms of long-term depression, bipolar disorder and anxiety disorders.
You may be a candidate for interventional psychiatry if medication and therapy have not helped you.
Currently, electroconvulsive therapy is offered at all Sutter behavioral health centers, while other interventional psychiatry procedures are offered at the Sutter Center for Psychiatry in Sacramento and Alta Bates Summit Medical Center in Oakland and Berkeley.
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy is a procedure that passes a small electric current through your brain to treat long-term depression and other serious behavioral health illnesses. In recent years, extensive research around ECT has confirmed it’s a safe and effective treatment for significantly reducing the symptoms of severe depression, mania and catatonia.
ECT takes about five to 10 minutes, with added time for preparation and recovery. For your first treatment, you will probably be admitted to the hospital. You may be able to have future treatments on an outpatient basis.
While you are under anesthesia, a small amount of electric current is delivered to your head, causing seizure activity in your brain. This process lasts for about 40 seconds. Doctors believe the seizure activity may help the brain “rewire” itself, which can relieve symptoms.
Vagal Nerve Stimulation (VNS)
Vagal nerve stimulation uses electrical impulses to stimulate areas of the brain that regulate mood, sleep, appetite and motivation. It is used to treat long-term or recurring depression and bipolar disorder.
Subtle electrical signals are delivered to the brain from a battery-operated, computer-controlled device called a pulse generator, which is surgically implanted in the upper chest like a pacemaker. Wires attach the device to the left vagus nerve, which travels from the brain down through the neck and to several of the major organs. Electric signals travel from the generator to the vagus nerve. When stimulated, the nerve sends signals up to the brain.
These electrical impulses relieve symptoms of depression or mania in some people–for reasons that doctors don’t fully understand. It usually takes several months, however, to see the results.
Transcranial Magnetic Stimulation (TMS)
Transcranial magnetic stimulation uses short pulses of magnetic fields to stimulate nerve cells in the area of the brain thought to control mood. These pulsed magnetic fields may have a positive effect on the brain's neurotransmitters levels. TMS may provide an alternative treatment option for those who have not benefited from the use of antidepressant medication.
TMS is an outpatient procedure done in your psychiatrist’s office, and does not require sedation or surgery. You remain awake and alert during treatment, which lasts about 20 to 40 minutes. TMS consists of at least five treatments a week during a four to six-week period.
Ketamine Infusion Therapy (KIT)
Ketamine infusion therapy is a newer treatment option for people with mental health conditions that have not improved with medications or other interventional procedures.
The drug acts on an entirely different neurotransmitter system than antidepressants, and often brings rapid relief to some people with severe depression or suicidal thoughts.
When you arrive for your treatment, you are placed on a bed, and an IV is inserted in your arm. You then receive a 40-minute infusion of a very low dose of ketamine. Though this drug is an anesthetic, the dose is so low that at most, you may become a little drowsy.