Mental Health Awareness Month is a reminder that millions of Americans live with depression, anxiety, post-traumatic stress disorder (PTSD), and other mental health conditions, often for months or years before they recognize the symptoms for what they are. At Serenity Mental Health Centers, our psychiatrists see this pattern every day. Patients arrive describing trouble sleeping, difficulty concentrating, or persistent irritability, then discover that those symptoms are connected to something larger.
This guide covers the signs that are most commonly overlooked, the evidence-based outpatient treatments available including Transcranial Magnetic Stimulation (TMS) therapy and ketamine infusion therapy, and how to know when it may be time to speak with a psychiatrist.
Search Serenity locations offering psychiatry, TMS therapy, and ketamine treatment.
Mental health conditions don’t always announce themselves the way most people expect. The clearest cues, such as persistent sadness, panic attacks, or intrusive thoughts, are also the ones patients are most likely to recognize. The earlier, quieter signs are the ones that go unaddressed, sometimes for years.
According to Dr. TeeJay Tripp, DO, Chief Medical Officer at Serenity Mental Health Centers, the symptoms most frequently dismissed or attributed to other causes include:
These symptoms often appear before more recognizable warning signs. Many of them overlap with the early indicators of more familiar conditions.
Patients researching what they’re experiencing often start by looking up the signs of depression in adults, the signs of an anxiety disorder, the symptoms of PTSD, or an adult ADHD symptoms list.
Sleep deserves attention as a signal rather than a standalone problem. Persistent sleep disruption is rarely the underlying condition. It is typically a co-occurring symptom of depression, anxiety, or PTSD that improves when the underlying condition is addressed.
Across more than 35 outpatient mental health clinics, Serenity Mental Health Centers providers most frequently treated:
These numbers reflect what Serenity’s psychiatrists see clinically. The most common conditions are also the most likely to occur together. A patient diagnosed with depression often presents with anxiety symptoms. A patient with PTSD often experiences sleep disruption. Treatment planning at Serenity considers a patient’s full symptom picture, not just the one that brought them in.
Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive, FDA-cleared outpatient treatment that uses magnetic pulses to stimulate areas of the brain associated with mood regulation. Unlike medication, which affects brain chemistry throughout the entire body, TMS therapy targets specific neural pathways involved in conditions such as major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and anxiety.
In Serenity’s 2024 patient outcomes:
Serenity uses BrainsWay® Deep TMS™ technology, which is FDA-cleared for MDD and OCD. Deep TMS reaches deeper neural regions than standard TMS, allowing precise stimulation of the brain areas involved in mood, attention, and impulse regulation. TMS therapy is administered in an outpatient mental health clinic setting, requires no anesthesia or sedation, and allows patients to resume normal daily activities the same day.
Patients evaluating TMS therapy generally have a few questions early in the process. Many want to know what to expect during a TMS session, whether their plan offers TMS therapy insurance coverage, and how outcomes compare for TMS for treatment-resistant depression versus continued medication management. Serenity’s care coordinators help patients work through each of these as part of the consultation process.
Ketamine infusion therapy is administered intravenously by a registered nurse in a controlled outpatient setting. It is increasingly recognized for its rapid impact on treatment-resistant depression, post-traumatic stress disorder (PTSD), OCD, and severe anxiety. Many patients experience meaningful symptom relief within hours of their first treatment session.
A typical course at Serenity is approximately six sessions. Each session lasts about two hours, and patients are encouraged to bring a book, music, or another comfortable activity. Ketamine infusion therapy is administered under continuous medical supervision and is considered following an evaluation by a Serenity psychiatrist.
Patients often want to understand what a ketamine therapy session looks like before scheduling a consultation, along with how ketamine therapy for treatment-resistant depression compares with other treatment paths. Both are covered in greater detail elsewhere on the Serenity site.
Serenity Mental Health Centers takes an integrated approach to outpatient mental health care, combining evidence-based treatments rather than relying on any single therapy in isolation. Two of Serenity’s distinguishing approaches are the integration of structured gratitude practice into TMS therapy sessions and, when clinically appropriate, the coordination of TMS therapy with ketamine infusion therapy in a single treatment plan.
TMS Therapy Combined with Gratitude Practice
During TMS therapy sessions at Serenity, providers incorporate structured gratitude practices designed to support patients in developing a more resilient mindset alongside the neurological effects of the treatment itself. The approach is grounded in published research, including a foundational 2003 study by Emmons and McCullough, which found that participants who maintained a regular gratitude practice reported reduced physical symptoms and higher engagement with their care. At Serenity, gratitude practice is positioned as a complement to TMS therapy, not a replacement, and is integrated into the patient’s session experience rather than offered as a separate program.
The Serenity team has written more about this approach in TMS therapy and gratitude practice as a dual approach.
Combination Treatment with TMS Therapy and Ketamine Infusion Therapy
Serenity is one of the few outpatient mental health providers in the United States offering coordinated combination treatment that pairs TMS therapy with ketamine infusion therapy in a single patient care plan. For patients with severe or treatment-resistant conditions, Serenity psychiatrists may recommend integrating the two treatments based on the patient’s diagnosis, treatment history, and clinical evaluation. Combination treatment is not the right approach for every patient. For those who qualify, it allows Serenity providers to address both the rapid-onset relief that ketamine infusion therapy can offer and the longer-term neuromodulation benefits of TMS therapy.
Candidates for TMS therapy generally include adults with a diagnosed mood disorder who have not responded fully to medication management, or who are seeking a treatment path that doesn’t rely on daily medication. Conditions that may benefit from TMS therapy include depression, anxiety, PTSD, and OCD.
Candidates for ketamine infusion therapy generally include adults with treatment-resistant depression, bipolar depression, PTSD, severe anxiety, or who have not experienced full relief from traditional medication management.
Both treatments are administered on an outpatient basis. A consultation with a Serenity psychiatrist determines candidacy and treatment plan. Serenity Mental Health Centers does not provide traditional talk therapy and encourages patients to continue with their existing therapists during and after treatment.
Search Serenity locations offering psychiatry, TMS therapy, and ketamine treatment.
Approximately 30% of people diagnosed with major depressive disorder develop treatment-resistant depression, where two or more antidepressants fail to relieve symptoms (Cleveland Clinic). For these patients, Harvard Health reports that 50 to 60% experience meaningful improvement with TMS therapy.
“Patients deserve access to the full spectrum of evidence-based options,” Dr. Tripp says. “Medication is the right answer for many people, but it shouldn’t be the only answer. TMS therapy and ketamine therapy give us a way to reach patients who have been cycling through medications without relief.”
This shift reflects a broader change in psychiatry. Medication remains an important part of mental health care, but it is increasingly understood as one option within a larger toolkit. For patients who have not responded to medication, alternatives to antidepressants include neuromodulation therapies such as TMS, evidence-based protocols like ketamine therapy, and personalized treatment planning that considers each patient’s full symptom picture.
Mental Health Awareness Month, observed every May since 1949, is a national effort to raise awareness about mental health conditions, reduce stigma, and connect people with care. Organizations such as the National Alliance on Mental Illness (NAMI), the Substance Abuse and Mental Health Services Administration (SAMHSA), and Mental Health America lead awareness initiatives throughout the month.
Many insurance plans, including major commercial insurers, Medicare, and Tricare, cover TMS therapy insurance coverage for major depressive disorder when specific clinical criteria are met. Serenity’s care coordinators work with patients to verify benefits and navigate insurance approval.
Serenity Mental Health Centers incorporates structured gratitude practice into the patient’s TMS therapy session experience. The approach is grounded in published research, including the Emmons and McCullough 2003 study on gratitude and well-being, which linked regular gratitude practice with improved engagement in care and reduced symptoms. Gratitude practice is positioned as a complement to TMS therapy, not as a standalone treatment, and is described in greater detail in TMS therapy and gratitude practice as a dual approach.
Serenity Mental Health Centers operates more than 35 outpatient mental health clinics across eight states: Arizona, Colorado, Florida, Georgia, Nevada, Texas, Utah, and Virginia. Visit the clinic locator on this site to find a Serenity location and verify the services offered at that clinic.
Serenity Mental Health Centers operates outpatient mental health clinics in:
To find the Serenity clinic closest to you, or to discuss whether TMS therapy or ketamine infusion therapy might be right for you, enter your state or ZIP code in the clinic locator. You can also reach the Serenity care team by phone.
Search Serenity locations offering psychiatry, TMS therapy, and ketamine treatment.
