Frequently Asked Questions

Harbors North is located in the Northview Plaza at 3890 Charlevoix Rd, Suite 210, Petoskey, MI 49770. Our convenient Petoskey location serves patients throughout Northern Michigan.

Harbors North specializes in advanced treatments for depression and anxiety. We offer two FDA-approved therapies:

Spravato (esketamine) — A nasal spray therapy for treatment-resistant depression that works differently than traditional antidepressants.

TMS (Transcranial Magnetic Stimulation) — A non-invasive treatment using magnetic pulses to stimulate brain areas involved in mood regulation.

We are not a general psychiatry practice. Our specialty focus means deeper expertise and better outcomes in advanced depression treatment.

Yes, treatment at Harbors North requires a referral from a prescriber — your primary care physician, psychiatrist, or psychiatric nurse practitioner. Patients are welcome to call us with questions at (231) 829-7126, but to start treatment, we'll need a formal referral from a provider. We screen referrals and contact patients directly to begin the process.

Harbors North stands out in several ways:

Unique Offering: We're the only clinic in Northern Michigan offering both Spravato and TMS therapy under one roof.

Specialty Focus: We focus exclusively on advanced treatment for treatment-resistant depression and anxiety — this deep specialization means greater expertise.

Experienced Team: Our team is led by a board-certified psychiatrist with over 20 years of clinical experience, with all providers specializing in these treatments.

Accessible Care: We bring life-changing treatments to Northern Michigan, so patients don't have to travel hours to major cities for advanced care.

Harbors North accepts most major insurance plans, including:

BCBSM, BCN, Priority Health, Medicare, Medicaid, Aetna, UHC/Optum, McLaren, and others.

We recommend calling us at (231) 829-7126 to verify your specific coverage, and we handle all pre-authorization paperwork on your behalf.

Spravato is an FDA-approved nasal spray containing esketamine (a form of ketamine) designed to treat treatment-resistant depression. Unlike traditional antidepressants that work on serotonin, Spravato works on NMDA receptors in the brain and can provide meaningful symptom relief, often within weeks rather than months. It's administered in a controlled clinical setting where patients are monitored throughout treatment.

Spravato may be appropriate if you meet these general criteria:

Major Depressive Disorder (MDD) — You have a diagnosis of depression.

Treatment-Resistant: You haven't responded adequately to at least two different antidepressant medications at therapeutic doses.

Age: You are 18 years or older.

Not suitable for bipolar depression — Spravato is not approved for bipolar disorder.

The best way to determine if Spravato is right for you is to discuss it with your healthcare provider or call us at (231) 829-7126. We'll do a thorough evaluation.

To prepare for that conversation, you can build a discussion guide to bring to your provider →

Here's what a typical Spravato session involves:

Self-Administration: You'll self-administer the nasal spray dose in our office under supervision.

Monitoring Period: You'll be monitored by our clinical team for approximately 2 hours after administration.

Potential Effects: You may experience dissociation, sedation, dizziness, or other side effects, which typically resolve within a few hours.

Ride Home Required: Due to potential impairment, you'll need to arrange a ride home. You cannot drive yourself.

Recovery: Most patients feel back to normal by evening and can return to their regular activities the next day.

Spravato treatment frequency varies depending on your response:

Induction Phase: Twice weekly for the first 4 weeks (this is the standard starting schedule).

Maintenance Phase: After 4 weeks, if you're responding well, treatment may be reduced to once weekly or every other week, depending on your individual progress and clinical judgment.

Your treatment schedule will be personalized based on how you respond and your clinical needs.

Timeline varies by individual, but typically:

Weeks 3-4: Many patients notice initial improvement in mood, energy, or sleep within 3-4 weeks of starting treatment.

Variable Response: Some patients respond faster, others take longer. This is normal and expected.

Full Benefits: The most significant improvements often emerge over the first 8-12 weeks of treatment as the full course progresses.

If you have concerns about your progress, contact us so we can adjust your treatment plan if needed.

No. Spravato can only be administered in a certified medical office under direct supervision by a healthcare provider. This is a requirement of the FDA's REMS (Risk Evaluation and Mitigation Strategy) program. Harbors North is a certified Spravato clinic, and every treatment session is conducted safely in our office with full medical supervision.

Common side effects of Spravato typically occur during and shortly after treatment and include:

Dissociation — A feeling of detachment from reality (temporary, usually mild).

Sedation — Drowsiness or sleepiness.

Increased Blood Pressure — Blood pressure may temporarily rise; we monitor this closely.

Dizziness or Lightheadedness — Common during the monitoring period.

Nausea — Some patients experience mild nausea.

Most side effects resolve within a few hours and are well-tolerated. Our team monitors you throughout your session and can manage any discomfort. Serious side effects are rare in a supervised clinical setting.

TMS (Transcranial Magnetic Stimulation) is an FDA-approved, non-invasive treatment for depression. Here's how it works:

A magnetic coil is placed against your scalp, and it delivers painless magnetic pulses that stimulate brain cells in areas involved in mood regulation. Unlike medications, it doesn't enter your bloodstream. It's drug-free, has no systemic side effects, and most patients find it well-tolerated. You remain awake and alert throughout treatment.

No — TMS and ECT (electroconvulsive therapy) are completely different treatments:

TMS: No seizures, no anesthesia, no memory loss, no downtime. You drive yourself home and return to normal activities immediately.

ECT: Uses electrical currents to intentionally induce a seizure. Requires general anesthesia, can cause memory effects, and requires downtime. You cannot drive the same day.

TMS is a gentle, outpatient procedure. ECT is a more intensive inpatient procedure. Both have their place in treating severe depression, but they're quite different experiences.

You may be a candidate for TMS if:

Diagnosis: You have a diagnosis of Major Depressive Disorder (MDD).

Treatment-Resistant: You've tried antidepressant medications without adequate improvement.

No Metallic Implants: You don't have metallic implants near your head (like pacemakers near the treatment area).

No Seizure History: You don't have a personal history of seizures or seizure disorder.

Age: You are generally 18 or older.

Call us at (231) 829-7126 to discuss whether TMS is right for you. We'll review your medical history and determine candidacy.

To prepare for that conversation, you can build a discussion guide to bring to your provider →

Most patients find TMS sessions straightforward and comfortable:

The Sensation: You'll feel a tapping or clicking sensation on your scalp during treatment — this is the magnetic pulse. It's not painful.

Comfort Level: The majority of patients tolerate TMS well and find it comfortable once they understand what to expect.

Session Duration: Standard sessions are about 15 minutes. Some specialized sessions (mapping sessions) take 45 minutes to 1 hour.

Awareness: You remain fully awake and alert throughout — you can talk to staff, listen to music, or relax in your comfortable chair.

Recovery: No recovery time. You can drive yourself and return to your day immediately.

The standard TMS treatment course is:

Duration: 36 treatment sessions over approximately 6–9 weeks.

Schedule: The first 30 sessions are Monday through Friday (5 days per week). The final 6 sessions are spaced every other day as treatment tapers. No treatments on weekends.

Session Types:

• Standard sessions: About 15 minutes each (most of your treatment days)

• Mapping sessions: 3 sessions during the course that take 45 minutes to 1 hour (these establish your individual treatment parameters)

Your treatment schedule is flexible, and we work with your schedule to make treatment convenient.

TMS has a solid track record of effectiveness:

Response Rate: Approximately 50-60% of patients experience significant improvement in symptoms.

Remission Rate: About 30-40% of patients achieve full remission (significant improvement or symptom-free status).

Timing: Many patients notice improvement starting mid-way through treatment, with full benefits often emerging after completing the full course.

Best Results: Completing the entire 36-session course is important for best outcomes. Partial treatment may provide some benefit but is less likely to result in full remission.

If you're not responding as well as hoped, our team can adjust your treatment approach.

Yes, both Spravato and TMS are covered by most major insurance plans, including:

BCBSM, BCN, Priority Health, Medicare, Medicaid, Aetna, UHC/Optum, McLaren, and others.

We handle all pre-authorization paperwork on your behalf. Call us at (231) 829-7126 to verify your coverage and discuss your plan details. We can often provide cost estimates before treatment begins.

Copay amounts vary by insurance plan:

Medicaid: Typically $0 (most state Medicaid plans cover Spravato with little to no patient cost).

Commercial Plans: Once your deductible is met, copays typically range from $10–$60 per session. Before your deductible is met, costs may be higher. Exact amounts depend on your specific plan.

Savings Programs: Janssen Pharmaceuticals offers the "Spravato With Me" savings program for eligible patients, which may further reduce or eliminate copays.

Call us to verify your exact costs. We can often provide a cost estimate based on your specific insurance plan.

TMS copays also vary by plan:

Medicaid: Typically $0 (most state Medicaid plans cover TMS with little to no patient cost).

Commercial Plans: Generally $10-$70 per treatment session, depending on your specific plan and deductible status.

Since TMS typically involves 36 sessions, we recommend calling us to discuss your total expected cost. We can provide a detailed estimate based on your plan.

We offer private pay options for uninsured patients:

Spravato: $1,600 per session (typically 8 sessions in the first month, then fewer as frequency decreases).

TMS: $350 per mapping session, $300 per standard treatment session (36 sessions total).

We understand cost is a barrier to care. Call us at (231) 829-7126 to discuss payment plans or financing options that may be available. We're committed to making advanced treatment accessible.