Transcranial Magnetic Stimulation And Depression: An Effective Treatment?
If you or someone you know experiences symptoms of depression, you may have heard of a treatment called transcranial magnetic stimulation, or TMS. TMS can sometimes help with symptoms of depression as well as other brain-related conditions. There are some risks associated with the treatment, but when conducted safely and properly, it can yield some significant benefits in some patients.
What is transcranial magnetic stimulation?
Transcranial magnetic stimulation (TMS) involves stimulating specific areas of the brain with a magnetic field. This is intended to stimulate the nerve cells that may contribute to symptoms of depression. A magnetic field is used to stimulate the brain in hopes of sparking a change.
Although TMS isn’t considered an invasive procedure and is relatively low risk, it’s typically reserved for instances where other traditional treatment options have not produced the desired results. Patients who don’t respond to psychotherapy, prescription medication, or other forms of treatment may be candidates for TMS. There are some risks associated with TMS therapy, but when conducted safely and properly, it can have some significant benefits for some patients.
How TMS works
During most sessions of transcranial magnetic stimulation, a trained professional places an electromagnetic coil against the scalp, near the front of the head. Next, a pulse is passed through the scalp and into the brain. It's placed in this area to target the part of the brain that controls mood. Researchers believe that areas like this have decreased levels of activity in individuals who experience depression. By stimulating them into action, doctors may help patients experience relief from depression symptoms.
According to Harvard Medical School, more than 50% of individuals who didn’t experience relief from depression with medication experience a “clinically meaningful response with TMS.”
For this reason, you may want to speak with your primary care doctor or a mental health professional if this method of treatment sounds interesting to you. You can ask about any potential side effects of TMS and discuss alternative treatments if TMS isn’t right for you.
Risks of TMS
Because transcranial magnetic stimulation (TMS) is noninvasive and doesn’t involve anesthesia, it is generally considered safe. Most people don't have severe side effects, and the most common risks are typically minor. Still, there are some risks to be aware of, especially if you have any preexisting conditions.
The following are some examples of side effects:
Headache
Discomfort of the scalp
Lightheadedness
Tingling or spasms in facial muscles
Treat depression in online therapy
Regardless of whether you pursue TMS, therapy will likely become a necessary part of your journey to relieve symptoms of depression. The benefits of therapy are numerous, especially with the rise in online therapy options. Being able to seek the care you need from wherever you are means that you don’t even need to get out of bed to find support. Even on your toughest days, an online therapist can be more convenient.
If you’re living with depression or symptoms related to it, you might find that online therapy is preferable to in-person options for more reasons than just flexibility. In fact, one literature review of 17 studies noted that online therapy may be more effective than in-person therapy when it comes to treating symptoms of depression. Another study found that online therapy was also effective for anxiety and bipolar disorder. TMS alone often isn’t enough to make symptoms go away and stay away in the long term, but with the support of a mental health professional, you may be able to see a more significant change in the way you feel and function.
Takeaway
What does transcranial magnetic stimulation do?
Transcranial magnetic stimulation, or TMS, is a non-invasive procedure that can stimulate nerve cells in the brain by using electromagnetic coils placed on the scalp. These coils generate magnetic fields in the form of pulses that activate specific regions of the brain associated with mood control, such as the prefrontal cortex. The reasoning behind this is that the activity in these parts of the brain is reduced in those experiencing certain mental health disorders, like obsessive-compulsive disorder and major depressive disorder. By stimulating these regions, a person may feel symptomatic relief and subsequent improvement in mental well-being.
What are the pros and cons of TMS?
There can be a variety of advantages and disadvantages to brain stimulation therapies like TMS, including the following:
Pros:
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This procedure varies from other types of electrotherapy, like deep brain stimulation (DBS). One of the main differences between deep brain stimulators and TMS is the invasiveness of the procedures, as DBS involves making holes in the skull and directly implanting electrodes into the brain.
Does TMS really work for anxiety?
Research suggests that TMS may be an effective treatment for conditions like general anxiety disorder. In many cases, healthcare providers will only use TMS once more traditional approaches have proven to be ineffective. These traditional approaches often include psychotherapy and medications. The success rate of TMS for anxiety can vary from person to person but may be as high as 75%. However, more research may need to be conducted to conclude its viability and effectiveness as an anxiety treatment.
Does TMS rewire the brain?
While the phrase “rewire your brain” may be interpreted in a variety of ways, TMS may be able to increase activity in certain regions of the brain, potentially affecting its function. This brain stimulation is done through the use of electromagnetic coils attached to the skin and scalp of the head. Once attached, each magnetic coil will send pulses of energy into the dorsolateral prefrontal cortex, areas of the superficial cerebral cortex, and a variety of other regions. In doing so, TMS may relieve the symptoms of certain mental health disorders, such as depression and obsessive-compulsive disorder.
What is the success rate of TMS therapy?
The success rate for TMS therapy will vary depending on what neurological disorders are being addressed and the nature of a patient's previous medical history. According to the media and publishing division of Harvard Medical School, Harvard Health Publishing, approximately 50% to 60% of those who have tried medication-based treatments for depression (but have not received any benefit) have experienced a meaningful response with transcranial magnetic therapy (TMS).
In addition, one-third of these individuals experienced full remission from their depression symptoms, though these effects were not always permanent. However, patients who underwent TMS procedures often felt better for months after treatments before a recurrence of symptoms occurred. It's important to note that success rates may vary, and it may be beneficial to explore other studies or methods of treatment.
What is the success rate of TMS?
While success rates may vary, one study suggests that 30% to 50% of patients undergoing transcranial magnetic stimulation therapy will respond to the treatment, but may not achieve remission of symptoms. Several factors may influence whether a person responds to TMS treatment. For example, younger individuals, who could have a higher level of brain plasticity, may respond more often to TMS therapy than older individuals.
It's important to note that this is only one study, and further research may need to be conducted to draw more finite conclusions on the efficacy of TMS. This study also doesn’t consider the success rates of other forms of TMS, like deep transcranial magnetic stimulation or intermittent theta-burst stimulation. In addition, individuals who do not benefit from TMS may still find success with more intensive forms of electric stimulation, like electroconvulsive therapy.
Who should avoid TMS?
Individuals who are using certain medical devices may not be eligible for TMS therapy. These devices include:
- Pacemakers
- Medicine Pumps
- Implanted stimulation devices
- Aneurysm coils or clips
- Implanted hearing devices (like cochlear implants)
- Certain brain activity monitoring devices
- Stents
Those who have shrapnel or other metals within their body may also not be able to undergo TMS therapy due to the magnetic fields produced by the procedure. In addition, certain medical conditions may not be able to use TMS, such as those with a history of seizures or migraines.
Who is not a good candidate for TMS?
Those who have experienced success using antidepressants or other medication may not be good candidates for TMS therapy, as TMS is typically only used once a person has been determined to have treatment-resistant depression. However, this may not be true in all cases, as more recent research may indicate that TMS could be effective for treatment-resistant depression when used alongside antidepressants.
Another group that may not be eligible for TMS is those who are under the age of 18 or are experiencing certain medical conditions. These conditions can vary but often include those that cause seizures or require the use of implanted medical devices such as nerve stimulators, pacemakers, or defibrillators.
Who should not use TMS?
It may not be beneficial for individuals with embedded metal, implanted medical devices, bullet fragments, or tattoos with metallic or magnetic ink to use transcranial magnetic stimulation (TMS) or repetitive transcranial magnetic stimulation (repetitive TMS). Because these procedures use electrically generated magnetic pulses, anything containing metal or devices that use electricity may be disrupted. This could result in objects moving around in the body or malfunctioning, which may cause injury; in some cases, these injuries can be fatal. Due to the potential risks, it's important to be open and honest with your physician before undergoing this or any procedure.
How many sessions does it take for TMS to work?
How many sessions a TMS patient has to undergo before the procedure has an effect may vary. According to the UNC School of Medicine, a typical course of TMS will last for six weeks, with five treatments taking place each week. These treatments can last anywhere from 20 to 40 minutes and do not involve any cutting of the skin, surgery, or anesthesia. While individuals may feel symptomatic relief before the end of their TMS series, it is often recommended that they finish the full course to experience the full effects of the procedure.
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