Treatment Comparison: TMS, Counseling, Spravato, and Genetic Testing

Understanding Your Mental Health Care Options
If you’re exploring treatment for depression, anxiety, or ongoing mental health symptoms, you may feel overwhelmed by the number of options available.
Many people ask:
“Should I try therapy, medication, TMS, Spravato, or genetic testing - and how do I know what’s right for me?”
The truth is, there’s no one-size-fits-all answer. Each approach works differently, and the best plan often depends on your history, symptoms, and how you’ve responded to treatment in the past.
Below is a clear comparison of four commonly used approaches: Counseling (therapy), TMS therapy, Spravato (esketamine), and genetic testing.
Counseling (Talk Therapy)
What it is:
Counseling or psychotherapy focuses on understanding thoughts, emotions, behaviors, and coping patterns. Common types include CBT, DBT, and trauma-informed therapy.
Best for:
- Mild to moderate depression or anxiety
- Life transitions, stress, or trauma
- Developing coping skills and emotional insight
Pros:
- Non-medical, non-invasive
- Helps with long-term emotional growth
- Can be combined with any other treatment
Limitations:
- May not fully relieve biological or treatment-resistant depression
- Progress can be gradual
- Some people feel “stuck” despite long-term therapy
Counseling is often a foundational part of care, even when other treatments are added.
TMS Therapy (Transcranial Magnetic Stimulation)
What it is:
TMS is an FDA-approved, non-invasive brain-based treatment that uses magnetic pulses to stimulate underactive areas of the brain involved in mood regulation.
Best for:
- Treatment-resistant depression
- People who haven’t responded well to medications
- Those who want a non-medication option
Pros:
- No systemic medication side effects
- Short daily sessions with no downtime
- Can produce long-lasting improvement
Limitations:
- Requires a multi-week commitment
- Results build gradually
- Not typically first-line treatment
TMS addresses brain circuit function, which is why it can help even when medications haven’t.

Interested in learning more?
Schedule a consultation to see if TMS could be right for you.
Visit our contact page or call 253-900-1605 to speak with our team.
Spravato (Esketamine)
What it is:
Spravato is an FDA-approved nasal spray derived from ketamine, used under medical supervision for treatment-resistant depression.
Best for:
- Severe or persistent depression
- People needing faster symptom relief
- Those who haven’t responded to other treatments
Pros:
- Can work more quickly for some patients
- Targets glutamate pathways (different from standard meds)
- Often helpful when other options haven’t been
Limitations:
- Requires in-clinic monitoring after each session
- Ongoing maintenance may be needed
- Medication-based with temporary side effects for some
Spravato is often considered when faster improvement is important or when other approaches haven’t provided enough relief.
Genetic Testing (Pharmacogenomic Testing)
What it is:
Genetic testing analyzes how your body may metabolize certain psychiatric medications, helping guide medication selection.
Best for:
- People with multiple medication failures
- Those who experience strong medication side effects
- Patients starting or adjusting medications
Pros:
- Provides personalized medication insights
- Can reduce trial-and-error prescribing
- Non-invasive (usually a cheek swab)\
Limitations:
- Does not treat symptoms directly
- Doesn’t guarantee medication success
- Often used as a support tool, not a solution
Genetic testing can be a helpful guide — but it works best when combined with clinical judgment and other treatments.
Comparing the Options at a Glance
| Treatment | Primary Focus | Best For | Key Consideration |
|---|---|---|---|
| Counseling | Emotional & behavioral support | Mild–moderate symptoms | May not address biological factors alone |
| TMS Therapy | Brain circuit stimulation | Treatment-resistant depression | Requires daily sessions |
| Spravato | Rapid neurochemical effects | Severe or persistent depression | Requires monitoring & maintenance |
| Genetic Testing | Medication guidance | Medication trial history | Informational, not therapeutic |
Can These Treatments Be Combined?
Yes - and often they are.
Many people benefit from combinations such as:
- Counseling + TMS
- Counseling + Spravato
- Genetic testing to guide medication alongside therapy
- TMS followed by maintenance strategies
Mental health care is most effective when it’s personalized and flexible.
Choosing the Right Path Forward
The right treatment depends on:
- Symptom severity and duration
- Prior treatment response
- Medication tolerance
- Personal preferences and lifestyle
- Insurance and access considerations
That’s why a thorough evaluation matters.
Personalized Care at Creative Wellness
At Creative Wellness, we help patients understand their options — not just choose the fastest or most common one.
We offer:
- Counseling support
- TMS therapy
- Spravato (esketamine)
- Guidance around medication and genetic testing
- Thoughtful treatment planning focused on long-term wellness
Schedule a consultation to explore which approach - or combination - may be right for you.


















