Depression treatment has come a long way in the last several years. A combination of psychotherapy and medication has helped thousands of individuals recover from debilitating symptoms. However, there is still a population of individuals who have depression that is considered “treatment-resistant” and who have not found the treatment that works for them.
Fortunately, transcranial magnetic stimulation (TMS) has proven to be an effective and long-lasting treatment alternative. It is important to become familiar with this valuable treatment option to understand that recovery is possible, even for those who have not experienced relief from depression through traditional treatment methods.
Depression and substance use are prevalent in the United States.
In 2020, an estimated 21 million adults in the United States 18 years or older had experienced at least one major depressive episode. This number represents eight percent of the adult population in the United States. A major depressive episode is characterized by a low and depressed mood that lasts at least two weeks. Depression, also referred to as major depressive disorder (MDD), is a serious mood disorder that can be diagnosed after symptoms of a major depressive episode last two weeks or more.
Some people experience depressive episodes after experiencing a loss, drastic life change or other hardship. These depressive episodes may last a few weeks, though they tend to resolve themselves over time. Others experience depressive episodes from a combination of genetic, environmental, biological and psychological factors that cause them to develop long-lasting depression. This kind of depression does not go away on its own.
Traditional treatment approaches are not always effective for depression and substance use disorder.
It is essential to understand that many people who struggle with substance use also struggle with co-occurring mental health disorders such as depression, and vice versa. This is because the same brain areas that are affected by substance use are also affected by mental illness. Similarly, depressive symptoms may result from substance use due to dysregulated dopamine production in the brain.
Additionally, there is no one-size-fits-all approach for treating these conditions. Although many evidence-based, traditional treatment approaches have proven their value in treating mental health disorders and substance use disorder (SUD), not everyone sees results from these approaches.
When it comes to depression, a few unique treatment challenges include:
- Nearly half of individuals that have experienced a major depressive episode are not correctly diagnosed
- Of those who are diagnosed and treated, only about half of them benefit from treatment due to inadequate trialing of therapy and medication as well as reduced treatment engagement
As a result, researchers have sought out alternative treatment approaches, particularly ones that neurologically stimulate different brain areas that are affected by depressive symptoms. One such approach is transcranial magnetic stimulation.
What is transcranial magnetic stimulation?
TMS is a non-medication-based alternative treatment option for depression. It is a brain stimulation therapy that physicians can use to evoke specific areas in the brain. It was first developed in 1985, though it was not approved by the FDA until 2008. It now stands as an FDA-approved treatment for major depression in individuals who experience depression that is resistant to at least one antidepressant medication trial.
How does TMS work?
While a patient sits awake and alert, an electromagnetic coil is held against their forehead near the brain area known as the prefrontal cortex. This area is responsible for mood regulation. When the procedure begins, short electromagnetic pulses are delivered through the coil. These pulses pass through the skull and stimulate nerve cells in the targeted brain area.
It is important to recognize that this procedure is non-invasive and painless. Still, some common side effects include discomfort where the coil is held against the forehead, as well as tingling of the facial muscles during the procedure.
A TMS session can take anywhere from 19-37 minutes and can be administered five times a week for four to six weeks.
Is TMS effective?
There is a plethora of evidence for the clinical efficacy of TMS in treating major depression. One study from 2015, conducted by Dr. Kimberly Cress at the TMS Center of Sugar Land, TX, pooled 123 patients with unipolar major depressive disorder that were identified as treatment-resistant. After each patient was treated up to five days a week for four to six weeks, 72% of patients achieved remission of depressive symptoms. Close to 90 of the 123 patients no longer qualified for a diagnosis of major depression. Of those that achieved remission, nearly 80% maintained remission at their four-year follow-up.
The evidence of the effectiveness of TMS does not stop there. You can read more about the successes of TMS in articles and publications listed here.
It is also important to note that TMS therapy is being used in hundreds of clinical trials for treating many other mental health disorders. There will always be individuals that fit in the category of treatment-resistant, no matter their diagnosis. TMS may become a valuable treatment option for individuals that struggle with treatment resistance for the following conditions:
- Attention deficit disorder (ADD)
- Post-traumatic stress disorder (PTSD)
- Bipolar disorder
- Chronic pain
- Smoking cessation
- Parkinson’s disease
- Alzheimer’s disease
DiscoveryMD is a comprehensive mental health and addiction treatment facility that understands common treatment challenges that arise with depression. We offer TMS treatment for individuals who struggle with persistent, treatment-resistant depression. We have seen the effectiveness of this treatment option before our very eyes. If you are hesitant to try TMS therapy or are curious to learn more, contact us today.