CBT Not Working? Here Are A Few Reasons Why

Innovative treatments like Spravato (esketamine) and ketamine therapy are changing the way we treat depression and anxiety—giving hope to those who need it most.

For people in Apex, NC, and beyond who have struggled with depression that seems unyielding, there’s exciting news: the FDA has approved Spravato (esketamine) as the first-ever stand-alone therapy for treatment-resistant depression. This groundbreaking treatment offers new hope to those who haven’t found relief through traditional medications.

The thing about depression is that it often doesn’t look the way we think it should. It doesn’t always look like someone crying or feeling hopeless. For many, it can show up as:

At the 2024 Behavioral Health Tech (BHT) Conference in Phoenix, Arizona, the atmosphere was filled with anticipation as the spotlight turned to one of the most powerful advocates for mental health: Paris Hilton. Dr. Vinay Saranga had the opportunity to attend the conference, where he met with other passionate professionals working to revolutionize mental health care. But it was Hilton’s keynote address that truly made an impact. Known for her glamorous public persona, Hilton stepped onto the stage not as a celebrity, but as a survivor—a voice for those who, like her, have experienced trauma and struggled with mental health in silence. The Power of a Celebrity Voice in Mental Health When a public figure like Paris Hilton shares their mental health journey, it creates ripples far beyond the room. For years, Hilton has been known for her glamour and entrepreneurial success, but her recent advocacy work has revealed a deeply vulnerable side that resonates with millions. During her keynote, Hilton spoke candidly about her experiences as a survivor of institutional child abuse and the lasting impact it had on her mental health. She spoke not just of survival, but of hope—hope that sharing her story would help others break the chains of shame and seek the help they deserve. Her platform allows her to bring these issues to the spotlight, encouraging others to seek help and shattering the stigmas that often prevent people from reaching out. It’s a reminder that mental health struggles don’t discriminate—they touch every community, every age group, and every socioeconomic background. Hearing Paris Hilton’s words was a reminder of the deep need for empathy in mental health care. It highlighted how trauma from childhood can last throughout a lifetime, affecting relationships, self-worth, and overall well-being. After hearing her speech, it was clear that everyone in the room was connected in this fight for a world where healing is possible, no matter the past. How Childhood Trauma Affects Adults Hilton’s story shines a light on an important truth: the trauma we experience as children doesn’t just stay in the past. For many survivors, the emotional pain from those early years can stick with us, affecting both our mental and physical health as we grow older. It’s like carrying a heavy backpack that never goes away. Even if you try to move forward, those old wounds can still weigh you down, making life harder than it needs to be. This is why it’s so important to recognize the long-lasting effects of trauma and to find the right help to heal. Healing isn’t easy, but with the right support, it is possible to lighten that load and begin to truly move forward. Emotional Impact: Survivors often experience chronic anxiety, depression, or PTSD. Feelings of worthlessness or guilt can stem from unresolved childhood experiences. Relationship Challenges: Trust issues, fear of vulnerability, and difficulty forming healthy connections are common struggles for those who’ve endured trauma. Physical Health: Research shows that early trauma can lead to long-term health issues, including heart disease, chronic pain, and autoimmune disorders. Understanding the connection between early experiences and adult mental health is essential. It’s why compassionate, specialized care—like the kind Dr. Saranga and his team provide—is so important. Breaking Through Trauma with Innovative Treatments For individuals living with the weight of unresolved trauma or treatment-resistant depression, traditional therapies alone may not be enough. Advances in mental health care, however, are providing new hope for those seeking a breakthrough. Transcranial Magnetic Stimulation (TMS) TMS is a non-invasive treatment that uses magnetic fields to stimulate specific areas of the brain associated with mood regulation. It’s FDA-approved and particularly effective for those who haven’t found relief through medication or talk therapy. Many patients describe it as life-changing, helping them regain clarity, energy, and a sense of control over their emotions. Ketamine Therapy Once primarily known as an anesthetic, ketamine is now being used in controlled, therapeutic settings to treat severe depression and PTSD. By helping to “rewire” neural pathways, it can offer rapid relief from depressive symptoms, allowing individuals to engage more fully in other forms of therapy and healing. A Customized Approach Dr. Saranga and our team at The North Carolina Institute of Advanced NeuroHealth understand that mental health is not one-size-fits-all. Our approach focuses on getting to the root of each patient’s struggles, creating individualized treatment plans that may include therapy, medication, innovative treatments like TMS or ketamine, and lifestyle support. Moving Forward Together Dr. Saranga’s experience at BHT2024 reinforced the importance of community and innovation in mental health care. Events like this bring together thought leaders, advocates, and providers, all working toward a shared goal: helping people find their light in the darkest moments. If you or someone you love is struggling with unresolved trauma or treatment-resistant depression , know that you’re not alone. Help is available, and breakthroughs are possible. Contact our compassionate team today to learn more about innovative treatments and personalized care. Together, we can help you move forward toward healing and hope.

At the North Carolina Institute of Advanced NeuroHealth, we are excited about the possibilities AI brings to behavioral health. We are also mindful of the balance needed to ensure AI works alongside our human-centered approach, rather than replacing the interactions that build trust and foster healing.

You may know someone like Alex. Out of nowhere, it’s as if a dark cloud settles over his life, lingering for weeks or even months. In this darkness, he faces a battle each day—to get up, to respond to messages, to focus on work. Some days, just making it through feels nearly impossible. Alex has tried countless therapies and has been through more medications than he can count, yet nothing seems to fully lift the weight of his depression. And with every treatment that falls short, he feels hope slipping just a little further away. When Therapy and Medication Aren’t Enough Unfortunately, Alex’s story is very relatable. Even though therapy and medications are effective for many, up to one-third of people aren’t helped by depression medications and need something more. One of the biggest challenges is that depression is complex and there’s no one-size-fits-all treatment. For those experiencing treatment-resistant depression, the frustration and hopelessness of feeling “stuck” can be overwhelming. At The North Carolina Institute of Advanced NeuroHealth, we’re here for those who feel like they’ve tried it all, yet still can’t find the relief they need. We know how exhausting it can be to search for answers that feel just out of reach. That’s why we offer compassionate, personalized care focused on exploring new, innovative treatments designed to open doors where others have closed. If you’re ready for a fresh approach that truly considers what you need, we’re here to help you find the breakthrough you’ve been waiting for. Let’s explore a few of your options. Spravato®: A New Option for Treatment-Resistant Depression One promising advancement in depression treatment is Spravato ®, an FDA-approved nasal spray developed specifically for those with treatment-resistant depression. Unlike traditional antidepressants, which can take weeks or even months to have an effect, Spravato® can work within hours, offering relief from severe symptoms more quickly. How Does Spravato® Work? Spravato® is derived from esketamine, a form of ketamine that affects a different neurotransmitter system than standard antidepressants. This alternative pathway can help “wake up” parts of the brain that have become less active due to depression. The results are often transformative for individuals who have tried multiple treatments without success. Benefits of Spravato®: Fast-acting relief: Many patients report symptom improvement within hours or days, a dramatic difference from traditional medications. Effective for severe cases: Spravato® can be particularly effective for individuals with suicidal ideation, offering a sense of hope and relief when they need it most. FDA-approved for treatment-resistant depression: With careful administration and monitoring in a medical setting, it’s designed to be both safe and effective. What to Expect with Spravato® Treatment Spravato® treatment involves in-clinic sessions where our clinical team monitors your response, ensuring your safety and comfort. Most patients undergo twice-weekly treatments initially, which may decrease over time based on how well their symptoms are managed. We work closely with your insurance provider to determine coverage options, making Spravato® an accessible choice for those needing relief from treatment-resistant depression. Transcranial Magnetic Stimulation (TMS): A Non-Invasive, Effective Option Another powerful tool in our treatment toolkit is Transcranial Magnetic Stimulation (TMS) . This non-invasive procedure uses magnetic fields to stimulate nerve cells in regions of the brain associated with mood control and depression. Like Spravato®, TMS is an FDA-approved treatment specifically for those who haven’t responded to standard therapies. How Does TMS Work? TMS targets the prefrontal cortex, an area of the brain that tends to show reduced activity in people with depression. By stimulating this area with targeted magnetic pulses, TMS helps “reset” neural pathways, gradually improving mood and reducing depressive symptoms over time. Sessions are quick and don’t require any sedation, so you can resume normal activities immediately afterward. Benefits of TMS: Non-invasive: No surgery, no anesthesia—TMS is done in-office, and you’re able to continue your day without interruption. Minimal side effects: Unlike medications, TMS doesn’t cause fatigue, weight gain, or other common side effects. Sustained results: Many patients experience lasting symptom relief after a full course of treatment, which typically spans four to six weeks. What to Expect with TMS Treatment During each session, you’ll sit comfortably while a device gently delivers magnetic pulses to your brain. Sessions typically last 20 to 40 minutes, and for most patients, TMS is covered by insurance with a qualifying diagnosis of treatment-resistant depression. Our team is here to guide you through the process, answer questions, and coordinate with your insurance to make the treatment as accessible as possible. Why We Believe in a Holistic Approach At our center, we know that true healing involves addressing every aspect of a person’s life that contributes to their well-being. Our compassionate and personalized approach to mental health care focuses on both immediate relief from symptoms and long-term recovery. We’re here to support you as you explore these advanced treatment options and help you find the path that best fits your individual needs and life goals. A Few Reasons to Consider Our Team for Your Mental Health Needs: Comprehensive support: We work closely with you to understand the root of your symptoms and recommend a treatment plan designed just for you. Insurance guidance: Both TMS and Spravato® are often covered by insurance for qualifying individuals with treatment-resistant depression, and our team can help navigate the insurance process with you. Commitment to innovative care: We stay at the forefront of mental health advancements, offering access to the latest, most effective treatments available. Ready to Explore a New Way Forward? If you’ve been battling depression and traditional treatments just haven’t brought the relief you need, it might be time to explore something different. Spravato® and TMS offer new hope for those who’ve tried so much and still feel stuck. You deserve a life where each day isn’t weighed down by hopelessness or exhaustion, and these treatments might just be the change you’ve been looking for. Take the First Step—No Wait List, Just Support We know how hard it can be to reach out—especially when you’re hoping for a new answer—but we’re here to make the process simple and supportive. There’s no waiting list; we’re ready to help you take that first step as soon as you are. Together, we’ll explore options that could make a real difference and work toward a life that feels lighter and brighter. Reach out today , and let’s start this journey to renewed well-being, with compassionate care every step of the way.

Treatment for Seasonal Depression. Whether it’s medication management, light therapy, or exploring advanced treatments like TMS and Spravato, support is available to help you.

Spravato: Finding Relief with Depression Nasal Spray in Apex, North Carolina and surrounding communities. We're thrilled to offer this FDA approved alternative to antidepressants.

Understanding the Connection Between Depression and Fatigue. This is where alternative treatments like Transcranial Magnetic Stimulation (TMS) Therapy offer new hope.