Depression is a severe mental health condition that impacts many people. The lifetime prevalence of depression across the general population is 10%. Many affected individuals seek alternative treatments such as TMS therapy for depression.
Depression symptoms can have a dramatic effect on the lives of impacted people and include:
- Depressed mood
- Anhedonia or loss of interest or pleasure
- Changes in appetite
- Weight gain or loss
- Sleep difficulties (insomnia or hypersomnia)
- Psychomotor agitation
- Fatigue or loss of energy
- Diminished ability to think or concentrate
- Feelings of worthlessness or excessive guilt
- Suicide ideation
And while depression is commonly treated with antidepressant medications and psychotherapy, sometimes these treatments do not work. For example, major depressive disorder, or major depression, is similar to depression but is associated with significant morbidity and mortality.
In addition, medication and psychotherapy may be insufficient, resulting in treatment-resistant depression. Cases such as this may benefit from TMS treatments.
What is TMS?
TMS stands for transcranial magnetic stimulation. This form of treatment has been highly successful for treating individuals with major depression and treatment-resistant depression. A TMS physician will place an electromagnetic coil on the scalp near one’s forehead during a TMS treatment session. This coil delivers magnetic pulses to stimulate nerve cells in the brain’s prefrontal cortex.
The prefrontal cortex regulates emotion, so this type of treatment effectively treats persistent depression. In addition, throughout a TMS therapy session, the patient is fully awake and aware. This treatment feature is part of what distinguishes it from electroconvulsive therapy or ECT.
ECT results in a brief and controlled seizure that impacts neurons and brain chemicals. ECT is also used for treatment-resistant depression. However, it uses electrical currents rather than the magnetic fields used for TMS treatment.
TMS is a less intense and invasive procedure that activates targeted brain areas. It is a form of brain stimulation, but it does not require anesthesia (such as ECT does) or implanted electrodes or surgery.
TMS is an FDA-approved treatment for use in treating depression. TMS therapy often eases depression symptoms and improves one’s mood. However, many patients with PTSD, behavioral health problems, and bipolar disorder may benefit from TMS therapy. Though at this time, TMS is only FDA-approved for depression.
What Are the Different Types of TMS Treatments?
If your physician believes that TMS therapy for depression can help you, a few different types can be explored, including:
Repetitive Transcranial Magnetic Stimulation (rTMS):
rTMS treatment sessions last for about 40 minutes per session. It is generally the type of TMS most people think of when discussing TMS therapy. TMS is delivered in the outpatient setting, and the patient can function normally preceding and directly after the appointment.
An electromagnetic coil the size of a hand is put on the front part of the scalp. Repetitive transcranial magnetic stimulation treatment is a 6-week course of treatment 5 days a week, followed by a taper-off schedule over weeks 7 through 9. It can be used as a stand-alone treatment or in combination with antidepressants.
Intermittent Theta Burst Treatment (iTBS)
Intermittent theta-burst treatment (iTBS) is a novel repetitive transcranial magnetic stimulation technique that can have antidepressant effects when applied over the prefrontal cortex. With iTBS, bursts lasting two seconds are repeated every ten seconds. Simulation occurs for approximately three minutes and may have tremendous long-term effects on cortical excitability.
Intermittent theta burst treatment is a promising new form of TMS delivery that may be more efficient than standard TMS treatment.
Does TMS Therapy For Depression Work?
The short answer is yes, TMS can be highly effective in treating depression and major depression. In fact, between 50% and 60% of people with depression who have tried and failed with medications respond positively to TMS treatments. About one-third of these individuals will experience a complete remission, which results in all symptoms going away.
The average length of positive response is slightly over one year. After the condition returns, some patients will come back for additional TMS treatment sessions, resulting in positive outcomes.
Who Can Benefit from TMS Therapy?
Patients suffering from depression, major depression, or treatment-resistant depression can explore TMS as a treatment option. Before receiving TMS treatment, the individual should undergo a psychiatric evaluation to ensure the treatment is compatible with the patient’s needs.
TMS therapy is not recommended for the following patients:
- Those who are pregnant.
- Patients with metal or implanted medical devices, such as aneurysm clips or coils, stents, implanted stimulators, implanted vagus nerve or deep brain stimulators, implanted electrical devices (pacemakers, medication pumps), electrodes for monitoring brain activity, cochlear implants, magnetic implants, bullet fragments, any other metal devices or objects in the body.
- Individuals on certain medications. Consult with your TMS therapist before proceeding.
- Those with a history of seizures or epilepsy.
- Patients who have a history of brain tumors, strokes, or brain damage.
If your depression is persistent and fails to respond to conventional treatments, TMS therapy For depression is an option to consider. However, before making any decisions, it is best to consult your mental health provider to determine whether you could benefit from TMS.
In many cases, TMS therapy For depression can dramatically ease the symptoms of depression and result in an improved mood and enhanced quality of life.