Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique that is used to treat a variety of mental health conditions. TMS utilizes magnetic fields to stimulate nerve cells and change how they function.
As the brain is a complicated organ, the biology behind TMS treatment is not fully understood. However, scientists do know that magnetic energy stimulates nerve cells in the region of the brain involved in mood control. When someone suffers from depression, these areas display decreased activity as nerve cells are not communicating with each other as regularly as in a healthy brain. In turn, this decreases the amount of mood-altering neurotransmitters that are released.
Stimulation delivered from an electromagnetic coil is thought to activate these regions and higher the levels of communication between the nerve cells and other areas of the brain. This results in changes to the mood and behavior of the individual that has undergone TMS to reduce symptoms of depression.
TMS is most commonly used to treat major depressive disorder typically when other treatments haven't been effective. Major depression is a treatable condition, however for some people talk therapy (psychotherapy) and medication do not ease symptoms. In these cases, the mental illness is known as treatment-resistant depression. TMS therapy has been successful against treatment-resistant depression by providing symptom relief and improving overall mood.
Anxiety disorder, bipolar disorder, and obsessive-compulsive disorder (OCD) are other mental health conditions that TMS is being used to treat. However, further research still needs to be conducted on how successful these methods really are.
Although the TMS is not successful in treating every person's depression, for many it completely changes their life. It can take a few weeks after TMS therapy to notice a difference, with some reporting symptom improvements or going away altogether.
As the intricate workings of the technique are largely unknown, its success and methodology are slowly improving over time. Researchers are constantly learning more about the best sites on the brain to stimulate and the number of stimulations required.
It is still unknown if top-up sessions are required to maintain mental health long-term. However, medication and psychotherapy are recommended as ongoing treatment during and after the cycle of TMS therapy has been completed. If symptoms are relieved due to the treatment and then return, the person can undergo further rounds of TMS, this is called re-induction.
A huge bonus of TMS therapy is that there is minimal risk and side effects involved. Treating depression with medication comes with a number of challenges. For some antidepressant medications, the response curve for positive results is slow, plus there are a number of adverse side effects from prolonged use. These can include dry mouth, sexual dysfunction, weight gain, gastrointestinal upset, and sedation.
Other brain stimulation techniques used to tackle depression - such as vagus nerve stimulation or deep brain stimulation - are extremely invasive, requiring surgery or electrode implantation. Also, unlike electroconvulsive therapy (ECT), TMS is anesthesia free and does not cause seizures.
The practice overall is safe, though there are a few mild to moderate side effects. These usually ease shortly after an individual session and decrease in intensity with additional sessions. Some symptoms include:
If these side effects are unmanageable, the medical professional responsible for the procedure may adjust the intensity of the magnetic energy coming from the electromagnetic coil or suggest taking over-the-counter pain medication before future sessions.
In rare cases, more serious side effects can take shape. These can include:
TMS therapy is most effective in people who experience treatment-resistant depression and some other mental illnesses. However, there are a few circumstances where it is not recommended. Health professionals need to be as careful as possible when allowing people to undergo TMS otherwise treatment could result in severe injury or death.
Therefore, people with the following may not be able to receive treatment:
TMS is typically carried out in a clinical setting, however, it is possible to undergo treatment at home. Over the past seven years, companies in the USA have sold at-home brain stimulation devices. These devices generate smaller and safer currents to increase the production of serotonin in the brain.
The Fisher-Wallace Stimulator uses transcranial direct current stimulation (tDCS) as a way to stimulate electrical activity in the brain. It is placed on the head with an elastic band where it holds electrodes against each temple. It is advised the device is used for a month before assessing how effective the treatment turned out.
A smaller, more accessible device created by NPX is also available for at-home brain stimulation which has won awards. This uses repetitive transcranial magnetic stimulation (rTMS), which sends repeating pulses to the brain. To make treatment more comfortable and safe, the repetitive transcranial magnetic stimulation device uses surface pain reduction technology and directs energy toward appropriate regions in the brain. However, this is yet to be FDA-approved and further artificial intelligence advancements are being added to the technology.
At-home devices usually cost between $100-200, making TMS treatment a lot more affordable than clinical therapy which can cost around $10,000.
Depression can be all-consuming, with years of standard treatment resulting in no give to their condition. The biggest pro to this device is that many people have reported relief from their depression symptoms after undergoing at-home brain stimulation, allowing them to move past the hold their mental health condition had over their lives.
Despite millions of people dealing with major depressive disorder in the US, many do not have access to TMS therapy as they live in areas where it is not available. At-home brain stimulation devices offer the wider population a more accessible and cost-effective way to treat depression by removing barriers to treatment entry requirements.
At-home TMS sessions also mean no travel is needed to receive treatment, leaving a person's day uninterrupted. Plus, the device can be used wherever and whenever relief is needed!
The downside to carrying out TMS therapy at home is the lack of long-term clinical trials and studies into its effectiveness. Clinical TMS treatment for therapy-resistant depression underwent twenty years of clinical trials before gaining respect from the medical community and FDA clearance.
The lack of individualism is another issue, with a one-size fits all treatment approach not accounting for the differences between each person's brain. The low levels of electrical energy in at-home devices are also not as powerful as TMS sessions in a doctor's office. Therefore, a study labeled these devices as potentially less effective.
Before being able to carry out transcranial magnetic stimulation therapy, a physical and psychiatric evaluation needs to be carried out to ensure the procedure is right for you. Your doctor or mental health provider needs to know if you:
The only physical preparation needed before the session is to remove any jewelry or piercings from your body.
In clinical TMS treatments, an expert will first undergo a mapping session with their client. This is to ensure the correct location is pinpointed and the appropriate intensity of stimulation is selected. This first session normally takes around sixty minutes, with the following being around forty minutes.
Clicking sounds, tapping sounds, and slight muscle spasms may occur during the procedure, with some individuals experiencing scalp discomfort.
The scalp discomfort felt in treatment is sometimes experienced after also. However, there should be no serious side effects after the session and daily activities can be continued as normal - including working and driving.
TMS therapy has helped so many people to overcome treatment-resistant mental health disorders and turn a corner towards health. If you are considering clinical TMS therapy or at-home treatment, please do not hesitate to contact GIA Chicago today.
As each individual's wellness journey is unique, we utilize cutting-edge practices and technology to create a personalized program, specific to your needs and goals. Our expert staff can talk through if TMS may be right for you and shape a treatment plan accordingly.