Category: Blog

Understanding Stress, Anxiety, and Depression: Similarities and Differences

Understanding Stress

Life comes at us fast. Deadlines stack up, relationships shift, finances fluctuate, and sometimes it can all feel like too much. You’ve probably heard people talk about feeling “stressed,” “anxious,” or “depressed” in everyday conversation. But these words, while often used interchangeably, actually describe very different mental and emotional experiences. Knowing the distinctions between them […]

Smoke Signals: How Children of Smokers Are Affected Without Lighting Up

Smoke

When we talk about smoking and its dangers, our minds often go to lung cancer, heart disease, or secondhand smoke. But what’s often overlooked is how deeply smoking affects children—not just physically, but emotionally and psychologically, too. Even if they never light a cigarette themselves, kids growing up in homes with smokers often carry invisible […]

Can TMS Therapy Help Break Addictive Thought Patterns? A Look at Depression and Habit Loops

inner-2

Addiction and depression often go hand in hand, reinforcing each other in a cycle that feels impossible to escape. Negative thought patterns, emotional distress, and compulsive behaviors create habit loops that trap individuals in destructive cycles. Traditional treatments like therapy and medication can help, but for those struggling with treatment-resistant depression or addiction-related thought patterns, Transcranial […]

Is TMS Right for You? Understanding the Eligibility and Benefits

Transcranial Magnetic Stimulation (TMS) is gaining traction as a groundbreaking treatment for mental health conditions, particularly for those who have not responded well to traditional therapies. But how do you know if TMS is right for you? Understanding the eligibility criteria and the benefits of this innovative approach can help you make an informed decision […]

How Is Spravato Nasal Spray Different Than Ketamine Infusion?

For individuals struggling with treatment-resistant depression (TRD), both Spravato nasal spray and ketamine infusion therapy have emerged as groundbreaking treatments offering hope. While both are derived from ketamine and show remarkable effectiveness, they differ in their delivery method, composition, and administration process. Understanding the distinctions between Spravato and ketamine infusions can help individuals make informed […]

Inpatient vs. Outpatient Mental Health Services: What’s the Difference?

Inpatient vs. Outpatient

Mental health care is essential for individuals navigating mental health challenges, offering varied services to meet unique needs. Among these services, inpatient and outpatient mental health care are two primary options. Understanding their differences can help individuals and families make informed decisions about care.   What Are Inpatient Mental Health Services? Inpatient mental health services provide intensive, […]

Hagan Health and “24 Reasons”: Breaking the Stigma around Mental Health

Hagan Health is dedicated to advancing mental health awareness and advocacy, especially for youth. We proudly partner with “24 Reasons,” a 501(c)(3) non-profit founded by Trey Moses, who created this organization in memory of his friend and teammate, Zach. After Zach’s tragic death by suicide, Trey continued his career wearing Zach’s number, 24, as a […]

Fighting the Hidden Battle: Self-Stigma and Its Impact on Young People

Self-stigma occurs when individuals internalize negative beliefs about themselves, often due to societal stigma around mental health or personal struggles. For young people, these beliefs can feel like a quiet, relentless voice whispering, “You’re not good enough,” or “Your struggles define you.” During their formative years, when they’re still figuring out who they are, self-stigma […]

Autism Spectrum Disorder

What It Means and Next Steps What are the symptoms of autism in adults? As children with autism mature into adults, some symptoms may get better, and others may get worse. The stresses associated with paying bills, starting a family, and holding a job can impact ASD symptoms in adulthood. Common Adult Autism Symptoms Include: […]

Neuro Emotional Technique: Healing From Within

Neuro Emotional Technique

Have you ever felt a sudden surge of energy in a grocery store, surrounded only by canned goods? Or found yourself on the verge of tears while looking at a particular piece of clothing? These are moments of what we call “mixed emotions”! (cue Joy from Inside Out). But are they truly mixed emotions? It […]

smoking

Smoking Addiction

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results to help patients to quit smoking.  Known as the addiction coil, the H4 coil was specifically designed for targeting the deep areas of the brain involved in addictions.

A large study in 14 centers examined adults who had been long-term heavy smokers, all having failed prior quit attempts using medication, therapy, or other methods. Of those that completed Deep TMS treatment, 28% achieved four consecutive weeks without smoking, most of them not smoking for at least three months after treatment.  Among all participants in the study, the average number of cigarettes smoked per week over the course of treatment was reduced by 75%.  

TMS has none of the side effects commonly found in medication to treat smoking cessation. TMS is well-tolerated with years of safety data supporting Deep TMS. Patients may initially experience minor headaches or pain at the site of treatment which typically subside after the first few sessions. There is no preparation, no anesthesia, and patients are able to resume daily activities immediately after each treatment session. Treatments are done in our office. Each treatment session lasts 25-30 minutes. They are done daily on weekdays for 3 weeks followed by a weekly session for another 3 weeks.

BrainsWay Deep TMS offers a fresh approach that may help to quit smoking using cutting-edge neuroscience. Clinically proven and well-tolerated, Deep TMS is the first non-invasive technology that is FDA-cleared to treat smoking addiction.

addiction

OCD

Deep TMS has recently be approved by the FDA for treatment of obsessive-compulsive disorder (OCD).  OCD traditionally has been treated primarily with exposure psychotherapy, and while it is also treated with medication such as fluvoxamine, OCD does not respond well to medication management.  Medication improves symtpoms greater than 30% in only 50% of patients, and half of OCD patients stop taking their medication due to side effects.  And while exposure therapy might improve OCD, as many as 80% of patients continue to have symptoms after psychotherapy, according to some studies.

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results for improving the symptoms of OCD.  The technology stimulates the brain using its patented H-coil, known as the H7 coil, resulting in a deep and broad penetration of the magnetic field into areas of the brain that are affected in OCD. Deep TMS is safe and well-tolerated, has a very low rate of side effects, and does not require anesthesia.  

Research has proven a higher level of improvement using Deep TMS.  Almost 68% of OCD patients were able to reduce symptoms by more than 30%, and 87% of those who responded saw sustained improvement for at least a year.

depression

Depression

Major depression was the diagnosis first approved for treatment with TMS, and it is still the most commonly treated condition. Most patients are treated with TMS after failures of medications and psychotherapy, as insurance companies will pay for TMS treatment only after medication failures.  However, TMS treats depression much better than medication, and some would argue that TMS should be the first treatment instead of the last.  

When patients have not improved with medication, they are considered to be “treatment-resistant”. And in treatment-resistant depression, TMS treatment results in significant improvement, defined as more than a 50% reduction in symptoms, in more than 80% of patients.  And more than 60% of patients achieve remission.  That is a very high and a very impressive number of people who are happy for the first time in many years after TMS treatment.

TMS treatments for depression are done in a series of 36 treatments.  Patients have a 20-minute treatment 5 days a week for six weeks followed by 6 more treatments in a tapering schedule over three more weeks. No preparation is needed, and there is no recovery time.  After each treatment, patients are able to leave and go about their day.  Except for a rare seizure, which occurs in 1 of 1000 patients, TMS has only minor side effects of mild headache or scalp soreness in the first few days. 

It is said that after successful TMS treatment, that there is a 50% chance of relapse of depression within the first year.  However, at Hagan Health we consider that statistic to be too high, and our relapse rate is lower.  While treatments are done by certified and experienced treaters, Dr. Hagan is closely involved in determining the location and strengths of settings to provide the most accurate treatment.  In addition, Dr. Hagan meets with patients every week or two before and during treatment, and periodically after treatment, in order to insure the best possible results.  Depression varies from patient to patient, and it is important to get the know the patient and the thoughts, feelings, and circumstances that might lead to relapse.  Using cognitive therapy techniques, patients are taught to be aware of triggers and to be prepared with the cognitive tools used to reduce the chances of relapsing. 

TMS for Anxious Depression

Recently TMS has been cleared by the FDA for treatment of Anxious Depression.  This condition is one in which anxious distress is a major part of the clinical picture while depression remains the predominant diagnosis.  Anxiety which is treated along with depression is also significantly improved, while TMS is not currently considered appropriate for the treatment of anxiety without depression.

Dr. Hagan Bio

So the lesson Al taught me was about my lack of happiness related to feelings of inadequacy. Even though I had become a brain surgeon, I did not have a healthy self-regard. Al explained to me that my father, in his drive to succeed and to push me to succeed, would never let me savor a victory, that whenever I achieved something important, he would ask, . “How could you have done it better?” Or “what is next?”. He was setting the bar at perfection, such that nothing less than perfection was going to be good enough. Al said, “Nobody is perfect”, and that I would be much happier deciding what degree of imperfection I was going to settle for. When one sets the bar at perfection, then every effort falls short of perfection and is therefore a relative failure, it becomes yet more evidence of one’s belief that he is fundamentally flawed and inadequate. He said that we are all always doing our best, and that is not fair for my father or for me myself to tell myself that I am not good enough. It was the single most important piece of wisdom that I would learn for the next several decades, and I have told this story many times to those who, like me, grew up to have similar issues.

After seeing Al for a year, another year or two went by. One day at church I was listening to a talk from a psychotherapist who had grown up in a family in which his mother was an alcoholic and his father was a workaholic. His story sounded so much like mine that I decided to see him professionally to “learn more about this garbage in my head”. I saw Paul for two years.

A few years later, life had become quite stressful. I was married with three small children, practicing neurosurgery full time and doing some farming on the side. It was at this time that I started seeing my third therapist, the one that I would see for most of the next 10 years. Keith was a psychiatrist, an MD like me, who did only psychotherapy. A few months after starting my therapy with Keith, I realized that I liked what he did better than what I did. The process of therapy is that of developing an increasing awareness of how one got to be the way he or she is, starting with childhood issues. Specifically, this type of therapy is called “psychodynamic psychotherapy”.

Dr_Hagan
Terry

Three years into my experience with Keith, I made the final decision that I would rather be a psychiatrist, because I came to love the process of developing insight into one’s own psychology. As I closed my neurosurgery practice and completed a residency in psychiatry, I was so grateful the entire time for the opportunity to turn myself into a psychiatrist. “Who gets to do that?!” Years later a patient was looking at the books on my bookshelf and asked, “So you were a neurosurgeon; did you like it?” I had been asked many times why I decided to give up neurosurgery to become a psychiatrist, but no one had ever asked if I liked neurosurgery. The answer had to be that no, I did not. I did not like who I was. But I have loved psychiatry from the very beginning, and I really appreciate the contribution it has had in my own personal development.

But because of my heavy early experience in psychotherapy, I also became proficient and experienced in both psychodynamic psychotherapy and in cognitive behavioral therapy (CBT). And I attended the Cincinnati Psychoanalytic Institute for a year to take my psychotherapy skills to a higher level.

During the 17 years that I have been practicing psychiatry, I have continued to grow. The most gratifying experiences I have had have been when I have settled into a psychotherapy relationship with a patient, while there have been many, others with whom I have combined psychiatry with psychodynamic therapy, practicing psychodynamic psychiatry.

Terry
Dr. Hagan Bio

During these same years, I have also been on several mission trips, which have given me perspectives that I would never have learned otherwise. The concepts of loving your neighbor, giving of your time and resources, being kind and gentle and gracious, have come to define me.

I have always been at the head of my own practice, managing my own business. I have experience with other businesses as well, such as being a successful alpaca breeder for 10 years. “They do not teach business in medical school.” In a growing psychiatry practice, running the business is something you learn from necessity.