There is no one-size-fits-all treatment for mental health disorders. While some treatment modalities are more effective than others, there still exists a category of individuals who are nonresponsive to traditional therapeutic interventions.
Depression, for example, is a common yet debilitating mental health disorder that many people seek treatment for. Yet, nearly 10-30% of those who seek treatment do not respond to traditional mental health therapy, such as antidepressant medication. This group of individuals has what is referred to as treatment-resistant depression.
Within the last several years, several new treatment alternatives have been tested for individuals that are known to have treatment-resistant depression. One of these treatments is known as transcranial magnetic stimulation (TMS), which has proven to be effective in providing long-lasting relief of depressive symptoms. Though its effects speak for themselves, many people wonder if there are any side effects to this new treatment option. With that said, it may be helpful to understand what the TMS procedure is and how it works.
Is my depression treatment-resistant?
How can an individual know if their depression is treatment-resistant? For a diagnosis to be made, patients usually experience little to no relief from depressive symptoms after attempting at least two antidepressant medications. In addition, it may also be diagnosed in patients who do not respond to alternative medical treatments, such as electroconvulsive therapy (ECT).
What is transcranial magnetic stimulation (TMS)?
Transcranial magnetic stimulation (TMS) is a type of brain stimulation therapy. It is a non-medication-based practice used as one treatment alternative for depression. The FDA has approved this modality as a way to treat major depression for those whose depression is considered treatment resistant.
Depression impairs several regions of the brain. However, the prefrontal cortex seems to be the brain area most deeply affected by this condition. The prefrontal cortex is responsible for mood regulation. When an individual has depression, they experience abnormally low activity in this brain region and the areas surrounding it. As a result, people with depression often experience periods of extreme and persistent feelings of sadness, loss of pleasure, and lack of motivation, among other distressing mood-related symptoms.
To treat these effects, TMS stimulates the prefrontal cortex and surrounding brain areas that play a role in facilitating depressive symptoms. During a TMS session, patients remain awake and alert. A physician holds an electromagnetic coil against the forehead, close to the prefrontal cortex. The procedure itself consists of this device sending short electromagnetic pulses through the coil, past the skull, and into nerve cells in the targeted brain region. In other words, TMS stimulates low-activity nerve cells in mood-regulating areas of the brain.
Additional considerations for TMS
Because of how simple this procedure seems, many people may be skeptical about it. Still, there are several considerations to keep in mind for those who may be interested in TMS.
First, it is important to understand that TMS is only offered as an in-office treatment. That being said, it does not take long. One TMS session only takes between 19-37 minutes. Treatment consists of one session a day, administered five days a week for up to four or six weeks. This totals between 20 and 30 treatments with an average of 28 minutes per session.
Second, patients can remain confident in their ability to drive themselves to and from their treatment sessions as there are no direct effects on alertness or understanding.
Third, it may be helpful to acknowledge that TMS is both safe and easily tolerable. Patients who have experienced TMS can attest that there are little to no side effects of the procedure, especially when compared to the side effects of many antidepressant medications. The only reported side effect of TMS was scalp discomfort from the electromagnetic coil. Still, this side effect was generally mild to moderate and occurred less frequently as treatment continued.
In addition, patients report no systematic side effects from TMS, including:
- No weight gain
- No sexual dysfunction
- No sedation
- No nausea
- No dry mouth
- No adverse effects on concentration or memory
- No drug interactions
Finally, it is essential to understand that TMS should not be used on patients who have implanted metallic devices or non-removable metallic objects in or around their heads. Similarly, it should not be used in patients with implants controlled by physiological signals. This includes, but is not limited to, pacemakers, implantable cardioverter defibrillators (ICDs), and vagus nerve stimulators (VNS).
Will insurance cover my TMS treatment?
In general, TMS will likely be covered by most insurance companies. This is because it is an effective and FDA-approved option for the treatment of depression. Still, it is important to talk with your insurance provider because they may require you to pay a deductible, copay, or coinsurance.
DiscoveryMD is a comprehensive mental health and addiction treatment facility that offers TMS therapy along with numerous valuable therapeutic modalities as a part of our treatment programs. We believe in the efficacy and safety of this treatment. If you believe you could benefit from TMS therapy, do not hesitate to contact us today.