Blog | Seattle NTC

Update to COVID-19 precautions and operations (May 2020)

By | Uncategorized

Valued patients –

We continue to work diligently to ensure that SeattleNTC remains a safe place to receive essential healthcare. As public health recommendations continue to evolve, particularly for medical settings, please note the following additional policies: All staff and patients must wear a mask while in the clinic, in order to reduce the likelihood of spread of the novel coronavirus.

If you do not have a mask of your own, we can provide one for you to reuse during your visits to our clinic.
In order to continue to minimize the number of people who need to be on-site at any given time, we are operating with reduced staff. As such, there may be changes to our typical hours, scheduling flexibility, the availability of staff by telephone, and the speed with which we can return voicemails. We sincerely appreciate your patience with these inconveniences.
We continue to screen patient and staff temperatures prior to entry to the clinic. We will need to send home anyone whose temperature registers 100F or higher.

As new coronavirus symptoms continue to be recognized, please remember that patients and staff must be free of ANY symptoms for 72 hours prior to coming to SNTC, including, but not limited to:

1. Fever
2. Chills
3. Cough
4. Sore throat
5. Shortness of breath
6. Muscle aches
7. New loss of taste or smell

Updated COVID-19 Precautions (March 2020)

By | Uncategorized

As recommendations regarding the novel coronavirus have updated, we have made the following changes to our policies:

1) The novel coronavirus can produce GI symptoms, such as diarrhea, and at times this may be the only symptom patients experience. As such, if you have ANY symptoms, staff and patients are being asked to please stay home.

2) We ask that patients wash their hands for 20 seconds with soap and water before entering the clinic.

3) Based upon updated guidance, all staff and patients should be asymptomatic for 72 hours prior to returning to work/treatment. Please continue to ask for clarification if you are not sure which timeline applies to your situation.

4) Consistent with recommendations from the Department of Health and Gov. Inslee’s office, we are continuing to work to minimize the number of people who need to be on-site at any given time, including urging that all office visits, to the extent possible, be completed by telehealth unless you are already in the office for a treatment..

Thank you, and please stay safe and healthy!

Information about SeattleNTC clinic operations and COVID-19 (Coronavirus)

By | Uncategorized


In order to ensure that we continue to be a safe place to receive care, we are taking the following precautions to protect you against COVID-19/coronavirus, as recommended by the CDC, and continue to monitor updates from the University of Washington, Swedish Medical Centers, the CDC, and Department of Health:

–       Any patients or staff with cough or fever or any other symptoms, are being asked to stay home until they are symptom-free for at least 72 hours. We are NOT enforcing late cancellation fees for illness-related cancellations. Patients with symptoms may still have telehealth visits (see below). Please ask our staff for details.

–       Although we are happy to see you, we are avoiding handshakes or any other unnecessary direct physical contact at this time.

–       We wash our hands with soap and water for 20 seconds between every patient contact and use additional hand sanitizer as needed.

–       Our medical equipment, including our TMS machines and treatment rooms, are sanitized between every treatment

–       Surfaces, including door handles, counters, and pens, are sanitized frequently. We are not using clipboards and have removed magazines from the waiting rooms.

–   We are taking additional steps to reduce the amount of direct physical contact required to visit NTC.

–   In order to keep you updated on any further developments, we are asking that you consider leaving an email address on file. We will not share this email with anybody.

We sincerely appreciate the opportunity to continue to care for you during this time. If you have any other questions or concerns, please let us know. All questions related to telehealth or coronavirus can be sent to [email protected]. As policies change, we will continue to send additional updates.


The SeattleNTC team



SeattleNTC is dedicated to the health and safety of its staff and patients. We understand that your medical care is essential, and that you need to be able to see your doctors during this time.

As such, SeattleNTC is now offering remote office visits and consultations via telehealth. In place of visiting in person, you may now visit your doctor remotely using your home computer, tablet, or phone. If you are interested in this option:

  1. Please contact your insurance provider to see if telehealth visits with SeattleNTC are a covered benefit under your plan. Please note that last week’s bipartisan bill to fight coronavirus enabled telehealth visits for all Medicare patients. In addition, most Tricare patients and all Kaiser patients should be covered. Most large employers also cover telehealth visits, but it is necessary to check each specific plan.
  2. If you need any help determining whether your plan covers telehealth with our physicians, please ask our billing staff for assistance, at 206-467-6300, extension 8. If your company has a human resources (HR) department, they may be able to assist as well.
  3. If your insurance plan does not cover telehealth, you may still visit your physician remotely, by either telephone or video conferencing, for an out-of-pocket fee. Please contact our billing department at 206-467-6300, extension 8, for details.

SeattleNTC’s telehealth platform is, and it works well through either Google Chrome or Safari. No app download is required. If you need help with, please let our front desk staff know.

Thank you!






Introducing: Dr. Jesse Adams and New Saturday Clinics

By | SNTC Announcement

“I chose University of Washington  and Seattle Children’s Hospital not just due to their sterling clinical reputation, but because this is my home and my community, and I wanted to practice here.”

A Seattle-area native, Dr. Jesse Adams grew up in University Place and Port Orchard, attending the University of Washington for undergraduate and medical school. He completed his adult psychiatry training at San Mateo County in California and his Neuropsychiatry & Behavioral Neurology fellowship at Stanford University. After spending five years in the San Francisco Bay Area, Dr. Adams found his way back home to the Pacific Northwest for his fellowship.

Currently a senior child and adolescent psychiatry fellow at Seattle Children’s Hospital, we’re excited to have Dr. Adams provide adult consultations in our Seattle office on Saturdays.

We know how stellar of a practitioner Dr. Adams is and so should you. We spoke to him about his background, his path to neuropsychiatry, and what excites him about the work we do at SeattleNTC.

Torn between neurology and psychiatry, Dr. Adams found a way to blend his passions in neuropsychiatry

“Many of us develop an attachment to or fascination with a particular part of medicine, and for me, it was the brain,” reveals Dr. Adams. Appreciating the complexity of the brain, he wanted to devote his career to its study.

“The brain is infinitely complex, and is the only organ that literally physically changes and develops in direct response to outside, non-physical influences – how you are raised, positive and negative experiences you’ve had, how people talk to you and relate to you.”

He ultimately leaned towards psychiatry due to his interests in how mental health conditions affect the development of the brain.

“TMS and ECT excite me for a pretty simple reason – they work, and work well, for many patients where medications and therapy have not.”

As we’re well aware, depression is a crushing illness for many. Like the rest of the team here at SeattleNTC, Dr. Adams is cognizant of the number of patients who suffer from depression, and see no results with therapy and antidepressants.

“For some, TMS and ECT can be life-changing, and sometimes life-saving, treatments, that can produce dramatic, lasting change for someone who has never responded to any other therapy. TMS, in particular, is incredibly adaptable, and as our understanding of the brain grows, there is the potential that this technology could help patients with a large variety of neuropsychiatric conditions.”

During our Saturday Clinics, you can expect Dr. Adams to focus on you and your needs.

The adult consultations typically take between 60 and 90 minutes and concentrate on determining whether either treatment makes sense for each patient. Dr. Adams will not only review the patient’s symptoms, their severity, their history with medication and therapy treatments, but also logistical hurdles and medical comorbidities which may influence the decision for each patient and family.

“I view my role as helping each to weigh the risks and benefits of both procedures against other conventional treatments available, and to help them make the best decision possible for them. If ECT or TMS is a fit, then we may review next steps so that treatment may occur as soon as possible. If not, then I also attempt to help provide thoughts for other treatment.”

We truly appreciate Dr. Adams taking time out of his busy schedule to help our patients. Feeling nervous and need an icebreaker? We hear Dr. Adams loves skiing and scuba diving!

Ready to book a consultation or have more questions for Dr. Adams and our team? Reach out to us today. We look forward to hearing from you!

Myths and Mental Illness: Week 4

By | Guest Posts, Mental Illness Myths

The following guest article from Swedish Health Services/Providence Health & Services is the fourth in a series debunking myths about mental illness that will be featured here on the SeattleNTC blog.

Myth #4: Children are too young to develop mental illness

From inconsolable preschoolers to moody teenagers, how do you know if it’s just a phase or a symptom of mental illness?

“The difficult thing for parents is identifying what is a normal part of growing up, and what needs intervention,” said Dr. Joyce Gilbert, medical director of the Sexual Assault Clinic and Child Maltreatment Center at Providence St. Peter Hospital in Olympia, Wash.

A phase is something that is developmental or temporary, and comes and goes. On the other hand, mental illness is something that does not dissipate. If a child is not overcoming a “phase” then parents, teachers, physicians and others should ask why and engage with resources early to ensure the child gets the help needed.

Mental illness can happen to anyone at any age, and in fact, one in five children suffers with mental health conditions such as anxiety, difficulty focusing and social challenges. Half of all lifetime mental illnesses begin by age 14; brushing off issues as a phase kids and teens will eventually grow out of can lead to other problems later in life.

Early intervention is key
“Most of the time, the first signs of mental health issues occur in preschool or kindergarten, when children are surrounded by other children,” said Felisha White, RN, Psychiatric Center for Children and Adolescents at Providence Sacred Heart Medical Center in Spokane, Wash. “At that point, it becomes clear to their teachers and their parents that they aren’t behaving like their peers.”

For older children, White suggests watching for sudden behavioral changes, such as angry outbursts, declining grades, isolation from friends, or disruptions in normal sleeping, eating and hygiene habits.



Sources: National Alliance for Mental Illness; National Institute for Mental Health

Myths and Mental Illness: Week 3

By | Guest Posts, Mental Illness Myths

The following guest article from Swedish Health Services/Providence Health & Services is the third in a series debunking myths about mental illness that will be featured here on the SeattleNTC blog.

Myth #3: Mental illness often leads to violent and dangerous behavior

When news of a shocking incident such as a mass shooting first reaches us on TV, it’s likely that we’ll hear the words “mental illness” as the media speculates why it happened. But less than five percent of violence in the United States is caused by people with mental illnesses. The truth is, a mentally ill person is more likely to be a victim of violence — at four times the rate of the general public.

“The majority of individuals living with mental illness have productive relationships and are described by others as loving and caring people,” said Tamara Sheehan, director of psychiatry, Providence Sacred Heart Medical Center & Children’s Hospital, in Spokane, Wash.

About one in five adults in America experiences a mental illness. When people in this group are involved with violence, severe conditions such as untreated psychosis or co-occurring drug or alcohol abuse are typically contributing factors.


Sources: Mental Health Myths and Facts; National Alliance on Mental Illness.

Myths and Mental Illness: Week 2

By | Guest Posts, Mental Illness Myths

The following guest article from Swedish Health Services/Providence Health & Services is the second in a series debunking myths about mental illness that will be featured here on the SeattleNTC blog.

Myth #2: You can just “snap out of it”

We wouldn’t expect a person with a broken leg or diabetes to just” snap out of it,” and in the same way we shouldn’t expect a person to think their way out of a mental illness.

“This misunderstanding is harmful because it creates unreasonable expectations and unnecessary suffering for people who have mental illness,” said Robin Henderson, PsyD, chief executive of behavioral health for Providence Medical Group in Oregon.

Many complex factors can contribute to mental illness, including genetics, hormonal changes during pregnancy, chronic physical illness and even traumatic experiences.

“We need to realize that as humans, our mind and body are connected by more than our neck,” Dr. Henderson said.

When to get help

Everyone experiences difficult times in life, and sadness can be a normal reaction, but it usually lessens with a little time or is manageable.

“When the feelings persist to the point that your quality of life and daily functioning are affected, you should reach out for help from a professional,” Dr. Henderson said. “Depression is a real illness, and we know that many people who get treatment, get better.”

About 16 million Americans have depression. If you have been experiencing any of the following symptoms for more than two weeks, you may be suffering from depression and should contact your primary care provider:

·       Changes in sleep or appetite
·       Difficulty concentrating
·       Loss of interest in hobbies and activities
·       Decreased energy
·       Low self-esteem
·       Feelings of hopelessness
·       Physical aches and pains

Sources: National Institute for Mental Health; National Alliance for Mental Illness.

Myths and Mental Illness: Week 1

By | Guest Posts, Mental Illness Myths

The following guest article from Swedish Health Services/Providence Health & Services is the first in a series debunking myths about mental illness that will be featured here on the SeattleNTC blog. 

Myth #1: Mental illness only affects certain types of people

Each year, almost 1 in 5 Americans experience mental illness, according to the National Alliance on Mental Illness. More than half won’t be treated due to stigma, lack of access to services or lack of knowledge about help that is available.

As part of our commitment to improving the lives of people with mental illness, we’re launching a series of articles to debunk the myths surrounding these life-threatening conditions. We hope you find them helpful to someone you care about. —Amy Compton-Phillips, M.D., executive vice president and chief clinical officer

Mental illness is a reality for millions of Americans of all ages, races and cultural backgrounds. Like physical illness, mental illness is a medical condition.

“It doesn’t matter what you look like or where you are from, mental illness can affect anyone,” said Arpan Waghray, M.D., medical director of behavioral health at Swedish Health Services. In fact, 50 percent of Americans will have a mental illness at some point in their lives—ranging from a short-term bout of the blues, to depression or anxiety.

As common as mental illness is, it can be easily swept under the rug due to many persistent myths that make it hard to reach out for help.

“Research shows us that negative perceptions can hold people back from seeking treatment and sometimes even prevent them from revealing issues to their doctors,” Dr. Waghray said. “These findings stress the importance of educating the public on how to support people who have a mental illness, and also the need to remove barriers to treatment.”

Sources: National Alliance for Mental Illness; Centers for Disease Control; American Psychological Association

When Symptoms Return

By | Uncategorized

By Joshua Bess, M.D.

Patients who have been treated for depression with Transcranial Magnetic Stimulation (TMS) or Electroconvulsive Therapy (ECT) can sometimes go the rest of their lives without needing to undergo additional TMS or ECT treatment. But these patients are the exception, not the rule.

Most patients who have undergone acute treatment with TMS or ECT will experience a return of symptoms at some point. It may be a year after treatment, or it may be longer. Each person is different. But relapse at some point is more likely than not.

Therefore, it’s important for all patients who undergo TMS or ECT to realize going into it that although the treatment is likely to help them significantly, it is probably not a lifelong cure, and they and their care team need to be prepared for the possibility of relapse.

At SeattleNTC, we want to have frank conversations with our patients about the potential for symptoms to return. If we can talk openly about this possibility, we will be better prepared to address symptoms if and when they return. We may even be able to prevent relapse.

Following acute treatment, we have two options. One is to take a “watch and wait” approach, which is not the same as doing nothing. Rather, we continue to communicate with patients about how they are doing and to consult with their general psychiatrist or therapist. If symptoms come back or get worse again, we encourage patients to come and talk to us so that we can decide, together, whether to reinitiate treatment.

A second option is to continue treatment, even before symptoms start to return, as a means of preventing relapse. This is similar to staying on medication even after symptoms subside. In the case of “maintenance” TMS and ECT, treatments are less frequent than during the acute course, but the protocol for each treatment is the same one that helped the patient get better.

We stress with our patients that even if they are feeling better it’s essential to continue seeing members of their care team so that if there are any signs that symptoms may return we can intervene immediately – and, hopefully, well before symptoms become so bad the patient is in crisis.

Remember that depression is somewhat like cancer in that people who have recovered from cancer can be “in remission” for years, but you can never say with 100 percent that the cancer is gone. It’s the same with treating depression. There are people who are in remission for years but usually that is because they continue to undergo active monitoring or treatment.

So to our patients, we say: please don’t ignore any signs of distress that indicate you may be relapsing. The earlier we can intervene with treatment, the sooner you’ll be feeling better again.


TMS for Depression during Pregnancy and Postpartum

By | Deep TMS

By Suzanne Kerns, M.D.

Women who suffer from depression during pregnancy or in the postpartum period might not seek treatment if they assume medication is the only treatment option available to them. Although concerns about taking medication while pregnant or breastfeeding are understandable, untreated depression can also be very dangerous.

Women who want to avoid or limit the use of antidepressants may consider Transcranial Magnetic Stimulation (TMS) as a safe and effective treatment option. Approved by the FDA in 2008 for treating depression, TMS works by delivering electromagnetic pulses to specific areas of the brain that regulate mood.

A standard treatment course is five sessions a week for four-to-six weeks. Each session lasts about one hour. Patients remain awake and alert during the treatment, and there are minimal side effects.

Several research findings have shown that TMS is a safe and viable treatment for women who are pregnant or postpartum.

  • A University of Pennsylvania study of TMS and pregnancy found that among 10 pregnant women treated with TMS, 70 percent responded well within just 20 sessions, with no adverse effects on pregnancy or fetal outcomes. The only side effect was a mild headache in four of the patients.[1]
  • Another study that focused on TMS during postpartum found that eight of the nine women who were treated with TMS experienced complete remission of their depression.[2]

In addition to being safe and effective for patients, TMS has not been shown to have adverse effects on a fetus or nursing child. A recently published study looking at 26 children ages one to five years old, whose mothers had received TMS treatment during pregnancy, found there were no differences between the children born to women who had TMS during pregnancy and children born to women who did not undergo TMS.[3]

TMS’s safety and effectiveness make it an ideal option for women with a history of non-response to standard antidepressant medications that are deemed safe in pregnancy or for women who don’t want to take medication during pregnancy or while breastfeeding. Unlike antidepressant medication, TMS does not enter the bloodstream, and therefore does not have any known or foreseeable effects on a fetus or nursing child.

[1] Kim, DR, Epperson, N, Paré, E, Gonzalez, JM, Parry, S, Thase, ME, Cristancho, P, Sammel, MD, O’Reardon, JP. (2011) An open label pilot study of transcranial magnetic stimulation for pregnant women with major depressive disorder. Journal of Women’s Health 20(2): 255-261.

[2] Garcia, KS, Flynn, P, Pierce, KJ, Candle, M. (2010) Repetitive transcranial magnetic stimulation treats postpartum depression. Journal of Brain Stimulation 3(1): 36-41.

[3] Eryılmaz, G, Sayar, GH, Özten, E, Gül, IG, Yorbik, O, Işiten, N, Bağci, E. (2015) Follow-Up Study of Children Whose Mothers Were Treated With Transcranial Magnetic Stimulation During Pregnancy: Preliminary Results. Journal of Neuromodulation 18(4): 255-60.