Neuromodulation Therapy

For many people with conditions such as depression or bipolar disorder, neuromodulation is a safe, effective treatment option. 

Neuromodulation Therapy

For many people with conditions such as depression or bipolar disorder, neuromodulation is a safe, effective treatment option. 

Neuromodulation services near you

Neuromodulation refers to several nonsurgical procedures that improve how certain areas of your brain work. These procedures include transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). They can provide significant relief— even when symptoms are severe or life-threatening or standard treatments haven’t helped.

Fortunately, UW Medicine experts now provide neuromodulation therapy right here in Seattle at the Garvey Institute Center for Neuromodulation, located on the first floor of the Center for Behavioral Health and Learning.

Learn more about the Center for Behavioral Health and Learning »

What is neuromodulation?

Within the brain, healthy neurons (nerve cells) use electricity to send messages throughout your body.

If you have a condition like severe depression or obsessive-compulsive disorder, some of your neurons may not work properly. For example, they might not produce enough of the brain chemicals that control your mood and emotions.

Although many people can manage their condition with medication or therapy, these treatments do not work for everyone. That’s where neuromodulation can make a difference.

TMS and ECT send mild magnetic or electrical impulses into your brain. These impulses stimulate your neurons so they work better and communicate more effectively.

Over time, these treatments may “rewire” your brain — helping you feel better.

Neuromodulation treatments tailored to you 

Even though TMS and ECT offer similar benefits, the treatment processes are quite different. They also treat different conditions.  

If your psychiatrist or care provider has referred you to the Garvey Institute Center for Neuromodulation for therapy, one of our experts will help you understand which procedure is right for you.

Transcranial magnetic stimulation (TMS)

TMS is a noninvasive procedure that uses magnetic energy to alter your brain’s electrical system. It’s approved by the U.S. Food and Drug Administration (FDA) to treat specific conditions. 

  • Major depressive disorder (also known as clinical depression or major depression) 
  • Obsessive-compulsive disorder (OCD) 

How TMS works

During a typical TMS procedure, you sit or recline in a comfortable chair. We’ll place a small but strong magnet on your head (with a special helmet) or against your face (using a movable arm).

When we turn on the device, its magnetic field interacts with (and changes) the electrical activity in your brain. Turning the magnet on and off sends “pulses” of magnetic energy to targeted parts of your brain.

Each treatment session can take anywhere from a few minutes to a half hour. Most patients need three to five sessions per week for approximately six weeks.

Benefits of TMS

TMS is an ideal treatment option for certain people.

  • You can go home afterward. Because TMS is noninvasive, you won’t need any anesthesia. You’ll be awake and alert during the procedure. After your session, you can immediately return to your normal activities. 
  • It’s safe and effective. TMS has a low risk of side effects, and complications are rare. Studies have shown that it improves symptoms in people with depression and OCD. Many people with severe depression no longer have suicidal thoughts after TMS treatment. 
  • It can be combined with other treatments. TMS can be used safely with other behavioral health treatments, including medication and therapy.

Electroconvulsive therapy (ECT)

With ECT, we send electrical currents into your brain to provoke a small seizure. The seizure creates a burst of electrical activity in a specific part of your brain, stimulating those neurons and helping them work better.

ECT has been used for decades to treat several types of severe conditions. It’s approved by the U.S. Food and Drug Administration (FDA) with a Class II designation, which means in can be used to treat specific conditions with general and special controls. Conditions treated include:

  • Bipolar disorder  
  • Catatonia (when someone is awake but unresponsive) 
  • Major depressive disorder 
  • Schizophrenia 
  • And other conditions 

What to expect with ECT 

Several professionals will work together to prepare you for (and administer) ECT.

  • Before your procedure, you will receive general anesthesia. This means you’ll be completely asleep during the session. You won’t feel any discomfort or anxiety.
  • Because seizures can cause some of your muscles to move uncontrollably, we’ll give you a muscle relaxant. This medicine helps your body stay still during the procedure. We’ll also put a bite guard into your mouth to protect your teeth if your jaw clenches. 
  • Next, we’ll place electrodes (small, sticky discs) around your temples or forehead. We’ll deliver a brief electric current into your brain through these electrodes. This current will cause a seizure that may last anywhere from 30 to 90 seconds. 
  • Once the seizure has occurred, we’ll withdraw you from the anesthesia. Most patients are awake after 15 minutes but some patients can be confused for more than an hour after the procedure. You will not be able to drive yourself home after ECT.

The number of ECT treatments you’ll need depends on several factors. Your provider will let you know how many treatment sessions you can expect.

Benefits of ECT 

ECT is an effective treatment option for certain people.  

  • It helps when other treatments can’t. ECT is especially effective at treating depression that hasn’t responded to medication. It’s also an option for people who cannot take medication. 
  • It offers quick results. It can take weeks for someone with a severe condition to recover with medication alone. On the other hand, ECT can improve symptoms in three to five treatments.  
  • It can be used with other treatments. For patients who respond well to medication, using medicine in combination with ECT can further relieve symptoms.

Learn more about neuromodulation

If you’re interested in having TMS or ECT at UW Medicine, you can request an appointment or ask your healthcare professional to provide a referral.

To start this process, either call us at 206.668.5470 or request an appointment online.

Meet our neuromodulation specialists

Randall Espinoza, MD

Stephen Thielke, MD, MS, MA

Brandon Thomas, MD