How Does TMS Treat Depression?
Having Major Depression can disrupt your life and interfere with your daily functioning. What makes depression even more difficult is finding out that antidepressants and psychotherapy are not effective treatments for you. If that’s your case, you’re not alone. Up to 50% of people are diagnosed with TRD – Treatment Resistant Depression – which means that even though they’re following traditional treatment, they don’t notice an improvement in their depressive symptoms. This often creates additional feelings of hopelessness, frustration, and helplessness. However, a highly effective alternative can provide significant relief: Transcranial Magnetic Stimulation, or TMS. TMS is a specific kind of brain stimulation therapy, which involves a series of repetitive, brief, and highly focused magnetic pulses to specific regions of the brain. This non-invasive technique aims to improve symptoms of a variety of neurological or mental health issues, such as:
Major Depressive Disorder
TMS is commonly prescribed to those individuals who have not achieved relief from depression by using antidepressant medications and psychotherapy or who have not well tolerated antidepressant medication side effects. TMS was approved by the FDA in 2008, and research also shows a substantial success rate, with 40-64% of patients achieving remission and significant improvement.
Treatment Resistant Depression and TMS
Treatment Resistant Depression (TRD) is characterized by severe depressive symptoms that interfere with the quality of one’s life; this includes significantly disturbing day-to-day functioning. Most commonly, people with TRD experience:
- persistent feelings of sadness, guilt, or worthlessness,
- significant changes in appetite and sleep,
- fatigue and low energy,
- poor focus and decision-making.
You might be struggling with TRD if:
- Your symptoms have been present for over 2 weeks,
- You tried psychotherapy and medication, but they failed to improve your functioning.
- you are in one of those high-risk groups:
- women and older adults,
- people with an underlying medical condition,
- history of substance abuse or eating disorders,
- experiencing recurrent bouts of depression.
TMS is a beacon of hope for those with TRD, who couldn’t find relief with traditional treatment for their depression. This procedure produces a long-lasting, positive change in the functioning of patients through the use of magnetic stimulation to activate the dorsolateral prefrontal cortex. This area of the brain has reduced activity in those with depression, which explains issues like:
- low energy,
- appetite changes,
- cognitive control,
- and regulation of emotions.
TMS fixes that by increasing neuronal excitability of the prefrontal cortex. To put it simply: TMS boosts activity in that part of the brain, providing long-term relief.
What Happens in TMS Sessions?
1: Initial Evaluation
Before you can undergo the TMS treatment, you need to be evaluated in order to determine whether you are a good candidate or not. Here are the criteria:
|You’re a good fit||You should avoid TMS|
|You’ve been going to psychotherapy and/or taking antidepressants, but they don’t introduce a positive change in your functioning.||You have metal in your head, i.e. cochlear implants, electrodes, and neck/brain stents.
(Braces or dental fillings are OK)
|You struggle with severe side effects of the medication.||You have a history of seizures/epilepsy or a medical condition that heightens your risk of a seizure.|
2: The Preparation
- Because the treatment involves magnets, you can expect to be first asked to remove any metallic items, i.e., jewelry, piercing, etc.
- Afterward, you’ll be provided with earplugs since the TMS machine produces loud clicking sounds when delivering pulses.
- Then, you’ll sit comfortably in a chair while the TMS technician determines the intensity of stimulation needed by delivering brief pulses and monitoring your motor reaction.
3: The Mapping Session
Your first session, aka the mapping session, is the process of locating your “hot spot” – the target treatment area in the dorsolateral prefrontal cortex. Each patient undergoing TMS has a precise location of their “hot spot, ” targeted throughout all the subsequent 36 treatment sessions.
The mapping session can take up to 1 hour to complete, and it’s recommended to undergo your first TMS session right after the mapping session is completed so that the physician can confirm the correct location of your “hot spot”.
4: TMS Sessions
Each TMS session boils down to:
- the stimulation coil being placed next to your target area (“hot spot”) in the prefrontal cortex, which is the front part of the brain,
- The device delivers pulses that cause brief activity in the brain cells of the target area.
You can expect to hear a clicking sound and feel gentle tapping from the stimulation coil. The length of each session can vary depending on different factors, but shouldn’t last more than 1 hour. On average, it takes around 20 minutes. TMS is a non-invasive, outpatient procedure, which means that it’s painless, doesn’t require anesthesia, and you can resume your normal activities, such as driving after each session.
The TMS treatment consists of 36 sessions, starting with daily treatments 5 days a week (from Monday to Friday) for 6 weeks, followed by a taper of 3x/week, 2x/week, and 1x/week.
Use TMS To Treat Your Depression With Harbor Psychiatry
The benefits of TMS include:
Minimal Side Effects
- TMS has fewer side effects than antidepressants, which can cause issues like sexual problems, weight gain, significant fatigue, nausea, etc.
- TMS’s most common side effects are short-term mild headaches and/or scalp discomfort.
Safety, Comfort, and Effectiveness:
- NIMH research shows how TMS helps three times as many people as sham treatment does to experience remission of depressive symptoms.
- TMS has been a golden standard in treating TRD for years since it was approved by the FDA in 2008.
- Each TMS session takes less than 1 hour – usually around 20 minutes – and right afterward, you can resume your normal daily activities.
If you’ve been battling depression and traditional treatment has failed to improve your mental and physical health, click here to contact us to start your TMS treatment.