Many people suffer from varying degrees of depression. For most, successful treatment can be found using medication. However, some sufferers cannot tolerate medication well, or find that the medication does not fully relieve their symptoms. Now, there is a treatment available that can possibly bring relief to those who previously could not find help. The treatment is called Transcranial Magnetic Stimulation (TMS) and it appears very promising.
What is Transcranial Magnetic Stimulation?
Transcranial magnetic stimulation uses magnetic fields to stimulate nerve cells in the brain in order to treat depression. During the procedure, a large magnetic coil is placed on the patient’s scalp near the forehead. The electromagnet within the coil creates electric currents which are believed to stimulate the areas of the brain involved in mood control and depression.
When is TMS used?
Doctors may recommend TMS when other traditional methods of treatment for depression, such as medication and psychotherapy, have not worked, or if patients have experienced significant side effects from multiple medication trials.
How does it work?
How TMS relieves depression is not completely understood at this point. TMS is relatively new — only approved by the Food & Drug Administration in 2008, so more studies are still being done and data is still being evaluated. As research continues, doctors will have a better understanding as to why this procedure may be helpful. It is believed that the magnetic impulses affect the brain cells involved in mood control, causing improvement. Electric stimulation of areas of the brain to treat mental illness is not new, such as Electroconvulsive Therapy (ECT). Though highly effective in treating severe depression, ECT can be associated with substantial side effects, such as memory loss.
Does TMS work right away?
TMS usually requires a series of treatment sessions to be effective. These are usually scheduled on a daily basis, five times per week for four to six weeks.
How do I know if I am a candidate for TMS?
Your mental health provider will conduct an interview with you to determine if you meet the criteria for possible treatment. If you are going to ask your insurance carrier to help with payment for TMS, they generally require proof of failed treatment on multiple anti-depressants along with “adjunctive” medication trials for treatment-resistant depression. They will also require patients to have had past efforts with psychotherapy. If you have already been approved for ECT treatment by your insurance carrier, TMS may be approved as an alternative.
What can I expect at a TMS treatment?
- Treatment can be done in a doctor’s office, although doctors performing TMS must be certified and have the right equipment.TMS does not require anesthesia and is not invasive. You do not need to have electrodes implanted in your body or any type of incision.
- You will be taken to a treatment setting and sit in a comfortable chair. You can use earplugs during the treatment because the machine does make noise during the procedure. You can listen to your music player with earbuds if you prefer.
- During the procedure, you will also feel a tapping sensation on your forehead. You may also feel your hands or fingers twitch during the testing phase as the doctor determines the right electromagnetic dose for you.
- The procedure lasts about 40 minutes, and the entire appointment may take up to one hour, including preparation time and post-procedure evaluation.
- After treatment, you can return to your normal activities. You do not require a driver to get you to and from your appointment, as is always the case with ECT.
Are there side effects?
The most common side effects are short term and are headache, scalp discomfort where the magnetic coil was placed, tingling, spasms or twitching of facial muscles, and lightheadedness.
Summary
It is not yet known whether TMS can be used to treat depression for the long term or whether periodic “maintenance” treatments may be required. According to research to date, many people see relief quickly–either in terms of lessening of symptoms or even symptoms disappearing completely. However, not enough data is in to determine whether or not this improvement is lifelong. Still, for those who have previously not been able to find any relief of their depression symptoms, TMS offers a promising option to consider. 
