Dr. Jonathan Horey, cofounder and chief medical officer, Active Recovery TMS. (Submitted photo)
People with depression that isn’t easily treated soon won't have to drive for hours to access an innovative, FDA-approved therapy option.
On Aug. 3, Active Recovery TMS will open a new clinic in south Salem.
The Boulder Creek Clinic, located at 2525 12th St. S.E., will treat up to 40 patients per day when running at full capacity.
Active Recovery TMS currently has locations in Hillsboro, Portland and Tigard. Dr. Jonathan Horey, cofounder and chief medical officer, said Salem has long needed such a treatment facility. He noticed Salem patients driving to his Tigard location for care.
"Treatment is five days per week, and while each session lasts only 20 minutes, you have to drive there no matter how long the treatment sessions last," he said. "Our main motivation is to offer the treatment to those that don't have access yet."
TMS, or transcranial magnetic stimulation, was FDA approved for treatment-resistant depression in 2008. Medicare, Medicaid, and almost all commercial insurance plans cover TMS for major depressive disorder.
Even so, it's difficult for people with depression to find help in Oregon, Horey said.
Horey started Active Recovery with his brother in 2017, when he couldn't find a provider for a patient struggling with longstanding depression. His patient had tried 12 different medications, and he worked with Horey in weekly therapy sessions for three years with no improvement.
Horey wanted to help, and a business was born.
"He was my motivation to start this business," Horey said. "I didn't expect it to turn into this, but I'm really glad it has. It's been really nice to see what a great option it's been for people."
TMS uses electromagnetic pulses to stimulate the dorsolateral prefrontal cortex, located on the left side of the head, right beneath the skull.
"That area of the brain has been shown to be less active in people with depression. So the idea with TMS is that we're trying to wake that area up and get it functioning the way it should. And once it's functioning, you don't need stimulation to keep it going," Horey said.
Treatment starts with an hour-long mapping session. Detailed notes guide future sessions, so technicians know just where to place the equipment, how much power to use, and how long each session should last. Weekly touchup sessions with doctors ensure that the therapy stays on track.
Therapy sessions don't hurt, Horey said, but they can be uncomfortable.
"What I always tell people is that I've tried it myself, because I wanted to see what it felt like. The best way I can describe it is 'strange.' It's a strange feeling but it's not painful. If it's painful, we can adjust it so it's not," he said.
Electromagnetic pulses can cause scalp muscles to twitch. Patients sometimes feel like they're being tapped on the head by an invisible hand, and some start to panic at the sensation. But most get used to it.
"I can count on one hand the number of patients that just couldn't tolerate it, and we've treated close to 300 now," he said.
TMS sessions complement, but don't replace, conventional depression treatments such as therapy and medication.
Conventional treatments, including counseling, won't be available at the Salem clinic for now.
"The reason we've done that is that we want to offer this therapy as a way of helping providers and patients. We pride ourselves on working closely with providers. We're in regular communication with them, and we're just supplementing their meds and the therapy they're using," he said.
Horey said his patients often benefit from his treatment sessions. Most feel better in about three to five weeks. And most complete their TMS therapy in about nine weeks.
"The great thing about TMS is that we're treating people that have not had any success with those therapies. They've gone years feeling badly," he said. "To help them feel better in the course of six to eight weeks is, I hate to say miraculous, as it seems dramatic, but to them it certainly seems that way."
He said determining the success of his treatments is easier during the pandemic. When his patients report improvement, he's more likely to believe them.
"If you can feel really good during this time, with everything going on in the world, I'm pretty confident that you're getting better," he said.
Horey said he understands that some patients are leery of starting a new treatment during the current Covid outbreak.
"It's very hard for people right now, during a pandemic, to make decisions about what's most important. 'Do I stay inside and not expose myself to Covid, or do I get treated for mental health?' I would say those are not mutually exclusive," he said. "I would encourage people not to neglect their mental health."
The Salem staff will wear masks and gloves for appointments. All equipment will be sterilized between patients. And temperature checks will be performed before entry. Social distancing guidelines will be followed, too.
To make an appointment, call (503) 683-8438. No referrals are required.
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