Depression is one of the leading causes of disability among young people in the United States. Fortunately, this condition is treatable. Depending on the individual patient’s response to treatment, there are several effective treatment options for depression. These options include antidepressants, psychotherapy, Electroconvulsive Therapy (ECT), and Transcranial Magnetic Stimulation (TMS).
Treatment options for depression
The use of antidepressants and psychotherapy are usually the first approaches to tackling depression. However, not all patients respond well to these approaches. In fact, only about 35 percent of depression patients are adequately relieved by the first medication they try. Furthermore, if one antidepressant fails to manage the symptoms of depression, it’s less likely that another one will be effective.
When antidepressants aren’t working, ECT or TMS are applied. ECT is one of the most effective depression treatments. It involves the introduction of small electric currents to the brain triggering short-term seizures. ECT is done under general anesthesia. Despite its effectiveness, some patients find it hard to tolerate as it has side effects on memory and cognition. This brings us to TMS.
What is TMS and how does it work?
TMS is a noninvasive method of treating depression. During this procedure, powerful magnetic fields are applied to the areas of the brain associated with the depression. The magnetic field stimulates the brain cells thus reversing certain symptoms of depression.
Is anesthesia required?
Many people considering TMS are uneasy about going in for a medical procedure. They often wonder does TMS require anesthesia and an overnight stay. The answer to these is no; TMS doesn’t require anesthesia or long-term hospital stays. This is because TMS is non-invasive. During this process, an electromagnetic coil is placed against the patient’s scalp in such a way that the magnetic pulses it emits are concentrated on the areas of the brain causing depression. This process is painless. TMS involves the application of multiple magnetic pulses. For this reason, it’s also referred to as repetitive Transcranial Magnetic Stimulation (rTMS).
How effective is TMS?
About 50-60 percent of depression patients who undergo TMS register a positive response. About a third of them go to full remission. Full remission means that the symptoms of depression disappear completely.
It’s worth noting that depression relief is not always permanent. This is not a TMS problem; almost all treatments for mood disorders exhibit a recurrence of symptoms. Most patients who have undergone TMS stay for about one year before the symptoms reappear. ECT is normally recommended for depression patients who don’t show a significant improvement after TMS.
Side effects of TMS
Unlike other forms of brain stimulation such as ECT and deep brain stimulation, TMS is noninvasive. Furthermore, it does not require anesthesia, neither does it cause seizures. It is, therefore, safe for most patients. Nonetheless, patients may experience the following mild side effects, especially after the first TMS session.
- Tingling and twitching of facial muscles
- Lightheadedness
- Headache
- Discomfort at the point of stimulation
Severe side effects
TMS is not recommended for people with head injuries, epilepsy, bipolar disorder, or other severe neurological conditions. This is because it may cause serious side effects such as seizures and mania. Additionally, the patient may suffer hearing loss if the ears are not well protected during TMS therapy. Severe side effects from TMS are rare.
What to expect during TMS therapy?
Once you walk into a clinic for TMS treatment, the therapy won’t start immediately. Instead, the doctor will first perform various tests to determine whether TMS is right for you. This includes assessing your medical history and establishing whether you have any metal implants in your body.
The doctor will then establish the best point on your head to place the electromagnetic coil. The magnetic intensity needed to sufficiently stimulate the brain cells differs from patient to patient. The ideal magnetic intensity is usually established by increasing the magnetic intensity until the patient’s finger twitch.
Finally, don’t expect to experience significant relief from your first TMS therapy session. The treatment is likely to run for several weeks with daily sessions of between 20 and 50 minutes. Most patients register noticeable relief in their fourth, fifth, or sixth week.
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