Can TMS Worsen Depression?

Can TMS Worsen Depression?

Published: September 27, 2022

Transcranial magnetic stimulation or TMS is an FDA-approved treatment for acute depressive symptoms. It is typically offered to those who do not see improvement from first-line treatment like antidepressant medications. While there are various studies to suggest the efficacy of TMS treatment for treating depression, there is no guarantee it will work for everyone. There are some people who feel it has made their symptoms worse; this will be covered in the following blog.

What is Transcranial Magnetic Stimulation?

Transcranial magnetic stimulation is a non-invasive treatment that is used to relieve depression symptoms, also more recently it is suggested that it could aid anxiety disorders. When individuals have treatment-resistant depression, meaning other depression treatments like medication fail to work, TMS can be used as another resort.

A magnetic coil placed over the patient's head is used to increase brain activity in areas like the dorsolateral prefrontal cortex (DLPFC), a specific brain region that is associated with depression. When this coil delivers magnetic pulses, it initiates neurons to stimulate brain activity, allowing new neural connections to form and communicate with other brain regions. These new communication pathways disrupt the brain patterns that contribute to mental health disorders like depression, obsessive-compulsive disorder, and anxiety.

Delivering multiple magnetic pulses to the brain, it is also called repetitive transcranial magnetic stimulation (rTMS).

TMS treatment is used as an alternative to invasive methods like electroconvulsive therapy.

How Does TMS Treatment Work?

In a typical TMS session, a patient begins by having an electromagnetic coil placed over their head. This coil will send magnetic impulses to the brain, stimulating activity in nerve cells in specific regions that are associated with symptoms of depression. Those receiving TMS treatment will be fully awake and conscious the whole time; they are even capable of performing activities like reading or watching TV.

Many patients report a tapping sensation on their skull and some may even feel a tingling sensation on the stimulation site; however, this can be relieved by moving the device to a different angle. TMS treatment sessions typically last around 40 minutes, with the course of treatment usually lasting around six to eight weeks.

The effects of TMS usually begin to work around the first or second week. Nevertheless, it can affect patients at different times; some people feel a difference in mood toward the end of treatment.

What Are the Side Effects and Risks of TMS Treatments?

There are a few side effects of TMS treatment that can happen to patients. Fortunately, these are fairly mild and go away either after a few weeks of treatment or straight after the session. Some reported effects are:

  • Mild headaches
  • Skin tingling
  • Scalp discomfort during the session
  • In very rare cases, the sporadic trigger of seizures or mania

Although there are side effects of this treatment, antidepressants can leave individuals with effects like sexual dysfunction, fatigue, and insomnia that may worsen and last throughout the whole course of treatment. Most patients usually report little to no side effects, making TMS therapy a safe treatment for mental health conditions like depression.

Some people experience a TMS dip which usually is what makes individuals feel it caused them to feel worse; however, this usually passes after a while of receiving this noninvasive treatment.

Can TMS Make Depression Symptoms Worse?

Some people receiving TMS therapy for depression symptoms notice that TMS can worsen symptoms at first. Many patients experience a TMS dip, which is a temporary worsening of depression and anxiety symptoms. This occurs because of the adjustment that brain cells need to do once they have started TMS therapy. It is not just TMS sessions that can worsen symptoms but also the use of antidepressants, also causing a dip due to the need for our bodies to adjust.

Someone may also suggest that TMS therapy made their depression worse due to a misdiagnosis. Major depression could be diagnosed by a doctor wrongly when they may actually have a condition like bipolar disorder. Clinical studies in bipolar disorder have found some efficacy in the treatment, but more research needs to be conducted. Therefore it may not be the most effective treatment. Disorders like bipolar disorder may be more complex to treat which is why TMS treatment may not work on its own.

TMS Therapy Success Rate in Depression Treatment

TMS treatment has been shown to provide symptom relief for over 50% of those suffering from treatment-resistant depression. Furthermore, TMS therapy has provided 1/3 of those individuals a full remission, meaning their negative symptoms disappear entirely.

More research from the American Journal of Psychiatry found that 9 out of 10 patients who received TMS treatment, reported TMS to relieve symptoms like suicidal thoughts. This study also found that after treatment, 60% were still in remission after a month.

Other Conditions TMS Can Be Used to Treat

TMS therapy has not just been found effective for those suffering from depression but for many other mental health disorders. Some conditions have had more research than others but overall, TMS treatments are a cost-effective and safe way of relieving symptoms of many mental health disorders if correctly diagnosed.

Substance abuse

While there is not a massive amount of research on the use of TMS for substance abuse, there has been research to suggest efficacy. Studies have reported that the use of this can help with certain neural networks that contribute to addictive behaviors like reactivity to drug-associative cues. Positive research findings have been found for cannabis use disorder and cocaine use disorder but there is not enough evidence yet to determine how well it may work.

Anxiety disorders

There have been plenty of clinical trials to evaluate the improvement of anxiety symptoms when treated with TMS therapy. It is possible that TMS has more efficacy with certain anxiety conditions than others.

People with generalized anxiety disorder have been reported to show improved symptoms in clinical trials, along with comorbid anxiety with depression or anxious depression. However, a 2011 study examined patients with panic disorder receiving TMS treatment and these patients felt it made their anxiety worse.

These results suggest that TMS can be used to aid anxiety symptoms but it may not be effective for every disorder.

Can TMS Damage Your Brain?

Many people have concerns that prolonged exposure to brain stimulation can give you brain tumors or memory loss, however, there is no evidence to suggest that this is true.

Can Anyone Be a Candidate for TMS

TMS therapy is a safe and effective tool for treating depression and anxiety along with other mental health disorders although this does not mean anyone feeling the symptoms of these should receive it. It is also recommended to be fully open with mental health professionals to avoid a misdiagnosis.

If you have a medical implant containing metal like cochlear implants, aneurysm clips, metal stents, or shrapnel or bullet fragments in the body it may make you ineligible. It is crucial to let any professional know about anything like this. The same goes for epilepsy as TMS can trigger seizures.

Think You Want to Try TMS Therapy?

If you think you could be a candidate for this therapy, then contact GIA Chicago today to work toward recovery together. We offer Transcranial Magnetic Stimulation for depression as well as other conditions. Let us help you start living a better life with our compassionate professionals and exceptional treatment programs.

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