What is TMS Therapy?
When medication and therapy do not effectively treat a patient’s depression, professionals often turn to Transcranial Magnetic Stimulation (TMS) therapy. During these procedures, doctors painlessly stimulate patients’ brains with safe electromagnets.
At first glance, some patients may feel nervous about trying this treatment. However, people with depression must know that TMS is non-invasive. Furthermore, mental health professionals only recommend TMS when the benefits significantly outweigh any potential risks.
It’s also important to understand that TMS is not the same thing as electroconvulsive therapy or ECT. TMS is significantly safer than ECT with fewer side effects and risks. However, patients who do not respond to TMS may need ECT or other therapies down the road.
How Long Has TMS Been Around?
Research regarding the potential effects of TMS on the brain first started in 1985. As researchers began to understand which parts of the brain control which functions, they realized that stimulating certain parts of the brain could treat mood disorders.
Like many scientific breakthroughs, it was not readily available immediately. Instead, scientists continued to study the possibilities of TMS and risks that it may have. The United States Food & Drug Administration (FDA) first approved TMS as a treatment for depression in 2008. Since then, it has become a standard and effective procedure that has given hope to patients across the country.
Can TMS Treat Other Disorders?
TMS is primarily a treatment for depression that does not respond to conventional therapies. However, some researchers are working on ways to use TMS to treat schizophrenia, anxiety, OCD, and more. Migraines, chronic pain, ADHD
Types of TMS
As the technology and research behind TMS continue to evolve, several types of TMS have come along. Traditional TMS sends one continuous signal to the brain. Repetitive TMS (rTMS) several rapidly repeating signals. Deep TMS (dTMS) send electromagnetic waves deeper than other types of the therapy–about 4 centimeters into the brain.
How TMS Therapy Works
The exact reason for the success of TMS is unknown. As more researchers study the brain and mental illness, they can better understand the treatment works and make it even more effective. However, doctors do understand many of the broad reasons that TMS puts so many people with depression into remission.
Each area of the human brain controls different functions. For example, several parts of the brain help us with memory while others control our impulses. Imaging technology has allowed researchers to understand which specific parts of the brain activate less when patients have depression.
TMS targets these parts of the brain and stimulates the nerves in it. This causes more activity. Over the course of treatment, the brain remakes these neuropathways and patients experience relief.
What Happens During TMS?
TMS creates a magnetic field around a patient’s brain and stimulates nerve cells. The doctor places an electromagnetic coil against the patient’s scalp, near the forehead. The device then delivers electromagnetic waves that stimulate specific areas of the brain. The patient does not need to go under anesthesia, and TMS does not hurt. It could even be done during your lunch hour! The electromagnetic pulses are similar to those in an MRI.
How Long does TMS Last?
A single treatment of TMS lasts about 30 to 60 minutes, but this can vary based on the type of device and the patient’s symptoms. Clients typically come in about five times per week for four to six weeks.
When TMS works, patients can see long-lasting results. Sometimes, the depression never returns. For best results, clients should also go to therapy to learn healthy coping mechanisms that can keep depression at bay after treatment.
Is TMS Safe?
Only trained medical doctors or nurse practitioner/PA who has been specially trained in TMS can administer the treatment. Many patients tolerate TMS treatments without any unwanted side effects. About half of patients experience mild headaches after their first few rounds of treatment. Most of these people find relief with over-the-counter remedies and have fewer problems throughout the treatment.
Only about 10% of patients experience painful or tingling sensations in the scalp during TMS treatments. Like the headaches, these diminish over the course of treatment. Patients should wear earplugs during their TMS treatments. The machine gives off a pulsing sound, similar to an MRI woodpecker or metronome, which can be loud. Overall, the risks and side effects of TMS are significantly less than many antidepressant medications.
Benefits of Transcranial Magnetic Stimulation Therapy
TMS is a viable and effective alternative to other depression therapies. When patients seek this treatment, they have typically tried individual counselling and antidepressant medication. Sometimes, the drugs help but cause too many adverse side effects.
Sometimes therapy helps, but it is just not enough to fight the physical processes behind depression. Other times, both therapy and medicine do not do enough to help them. One of the most significant benefits of TMS is that it offers these clients hope after what can be exhausting trials.
Most importantly, TMS can be a long-lasting solution to a horrific illness. It’s important to remember that depression can be fatal without treatment. Because TMS offers treatment for those who do not receive relief after other therapies, it is a life saver. Patients go on to live happy, healthy, and fulfilling lives without the burden of depression.
TMS also has fewer side effects than other magnetic treatments, like ECT. Whereas ECT patients must undergo anesthesia, TMS clients stay awake. After ECT, patients must remain in the hospital. However, clients are free to go home directly after each TMS treatment.
The continuing research behind TMS may also open doors to treatments for other mental illnesses, including schizophrenia, bipolar disorder, anxiety disorders, OCD, and substance abuse. The more doctors understand about electromagnetism and the brain, the more opportunities arise.
What to Expect During Your First TMS Treatment
The first TMS treatment can feel intimidating, but your medical care team will do everything they can to help you feel at ease. It can help to know what to expect before you come to your first appointment. Below are some of the common questions that LifeStance Health gets regarding TMS.
How Do I Prepare for TMS?
You do not need to fast or do anything special before coming to your TMS appointment. However, the staff will ask you to remove any magnetic accessories before the treatment begins. You may also want to keep credit cards away from the machine as the electromagnetic pulses can wipe the strips.
The staff will give you earplugs to protect you from the thumping sounds that the machines make. Finally, you may wish to bring some over-the-counter headache medication with you, just in case.
Does It Hurt?
Some patients experience mild discomfort on the scalp during treatment and headaches afterward. However, the procedure is not invasive. The doctor will not cut your skin, and many patients feel nothing at all. As such, you can be fully awake during the procedure.
What Happens After Treatment?
Once the TMS course is complete, you are free to leave. Most patients drive themselves home. However, if you’re worried about headaches, you may wish to arrange someone to drive you back the first few times. Severe side effects are rare. However, if you have a seizure or another reaction, you should seek medical attention immediately. Otherwise, you will continue to receive treatments as scheduled.