What Is TMS Therapy and Who Does It Help?
If you suffer from depression, you are not alone. Major depression is one of the most common mental health disorders in the United States. In 2017 about 17.3 million adults had at least one major depressive episode. While many patients find relief from depression through antidepressant medications and talk therapy, some will experience treatment resistant depression, which makes it much more difficult to break the cycle of depressive symptoms. Fortunately, there are alternative therapies available, including Transcranial Magnetic Stimulation, or TMS therapy.
A Closer Look at Transcranial Magnetic Stimulation Therapy
TMS therapy is an FDA-approved, drug-free depression treatment that involves delivering repetitive magnetic pulses to the brain—for this reason, it’s also sometimes called rTMS. This non-invasive treatment targets specific regions of the brain to stimulate nerve cells, which in turn improves depressive symptoms. Long term results from TMS therapy are not immediate, but a difference in mood may be noticed as early as the second week. TMS requires a course of about 4-6 weeks of treatment sessions delivered 5 days per week.
- How It Works – TMS therapy uses an electromagnetic coil that’s placed against the scalp near the front of the head. Once activated, the coil delivers magnetic pulses to the brain tissue, which then stimulate nerve cells. One theory of how TMS works to improve depressive symptoms is that the magnetic fields activate regions of the brain that experience decreased activity in patients suffering from depression.
- What to Expect – Transcranial magnetic stimulation is a painless, non-invasive procedure. It’s performed on an outpatient basis and takes about 20-60 minutes per session. During the treatment sessions, you may read, watch TV, or simply relax. You will need to wear ear protection during treatment to minimize noise from the clicking of the magnetic coil. After each session you can return to normal activities with no restrictions—you’ll even be able to drive yourself home after treatment. It may take up to 3 weeks to see noticeable improvements in depressive symptoms, and your full course of treatment may take up to 6 weeks.
- How to Prepare – You don’t need to take any special steps to prepare for your treatment sessions once you begin TMS therapy. However, you will need a physical exam and full psychiatric evaluation to ensure that this therapy is a safe option that will be effective for your needs.
Ideal Candidates for Treatment
Most patients who undergo TMS therapy have tried one or more antidepressants without successful improvement of their symptoms. Some patients begin TMS after experiencing negative side effects from a single antidepressant medication. Many people tolerate treatment well, but only a mental healthcare provider can help you determine if it’s the right option for you.
Adults and seniors with treatment resistant depression may be ideal candidates. Patients who have participated in electroconvulsive therapy (ECT) in the past may also find TMS to be a favorable alternative. People who should avoid TMS therapy include:
- Individuals with a history of epilepsy, seizures, or medical conditions that increase the risk of seizures (seizures are a rare side effect of treatment).
- Individuals taking stimulant medications.
- Individuals with metal implants in the head, including deep brain stimulators, electrodes, aneurysm clips or coils, metal plates, permanent piercings, and cochlear implants. Similarly, those with shrapnel or bullet pieces in the head should avoid this treatment (magnetic pulses can heat or move metal fragments in the head, leading to serious injuries).
- Individuals who are pregnant or nursing
Pros and Cons of TMS Therapy
For many patients with treatment resistant depression or adverse reactions to antidepressant medications, the benefits of TMS therapy far outweigh any potential downsides. However, there are still some pros and cons of treatment to think about.
- Advantages – For most patients, treatment is well tolerated. It’s also drug-free, requires no anesthesia, and is non-invasive. As an outpatient procedure, TMS therapy has no downtime. While TMS is a relatively new treatment option compared to other depression treatments, it has shown efficacy in patients who have previously struggled to manage depressive disorders. Patients may experience a full remission of depressive symptoms with continued results for a year or more. Treatment may be repeated if symptoms recur.
- Disadvantages – Patients report a painless treatment experience, but there may be some mild discomfort and temporary side effects, such as scalp discomfort, headaches, and facial twitching during the treatment. Minor skin irritation at the coil placement site is also possible. Side effects are generally easily managed and well tolerated. However, treatment does also require a significant time investment. Sessions may last up to one hour and take place 5 days per week over a period of one month to six weeks. Depending on how far away you are from the mental health clinic, your treatment may take a few hours out of your schedule each day.
Insurance coverage can be another challenge for patients seeking treatment. You may be required to try at least four different antidepressant medications prior to receiving coverage. However, your mental healthcare provider may offer resources for helping you attain coverage.
Integrated Behavioral Health is a trusted provider of Transcranial Magnetic Stimulation in Alabama. Through several clinic locations throughout the state, we provide comprehensive treatment for depression, anxiety, and other mood disorders. Our diverse team of providers treats patients of all ages and backgrounds. To request a consultation, fill out the contact form on our website or call 855-422-1618. Consultations may take place in person or via a telehealth visit.