TMS has emerged and grown rapidly in popularity as an alternative mental health treatment with surprisingly positive results. Most major cities now have several mental health clinics that offer TMS. But what exactly is it, and is it safe? 

According to the Anxiety and Depression Association of America, Major Depressive Disorder, or MDD, affects more than 16.1 million adults (ages 18 and older) in the United States alone. That is approximately 6.7% of the population living with MDD, which accounts for the leading cause of disability in people ages 15 to 44.3. Additionally, it is not uncommon for those suffering from MDD to also be diagnosed with an anxiety disorder, and vice versa.

Both MDD and anxiety can be managed and treated, but for many, standard treatments like psychotherapy and medications are not always effective or may bring about unwanted side effects. 

TMS, or Transcranial Magnetic Stimulation, is an FDA-approved and non-invasive procedure that uses magnetic pulses to stimulate nerve activity in areas of the brain associated with mood regulation and has been used to treat depression since 2008. 

TMS treatment can benefit those suffering from:

• Major Depressive Disorder, including Treatment-Resistant Depression
• Bipolar Depression
• Post Traumatic Stress Disorder (PTSD)
• Obsessive-Compulsive Disorder (OCD)
• Chronic Pain
• Adult Attention Deficit Hyperactivity Disorder (ADHD)
• Smoking Cessation

In particular, for cases of Treatment-Resistant Depression, TMS is proving to be a realistic possibility for relief. TRD patients have often suffered for years, trying different traditional SSRIs, medications, and treatments with limited success. TMS has proven to be an effective alternative in many of these cases where nothing else seems to work. 

How does TMS work?

Studies have shown that people with depression show reduced activity in the left dorsolateral prefrontal cortex (DLPFC) in comparison to those who do not suffer from depression. The DLPFC is directly associated with cognitive tasks such as decision-making, conflict management, and mood regulation. 

A typical treatment runs five sessions a week over the course of four to six weeks with each session lasting around 40 minutes. In a session, electromagnetic coils are strategically placed against the patient’s scalp, delivering magnetic pulses which stimulate neurotransmitters and receptors reawakening the region of the dorsolateral prefrontal cortex successfully decreasing the symptoms of depression. The brain activity is stimulated with each magnetic pulse that passes through the skull and into the brain.

Each treatment is tailored to the patient as TMS is not a “one size fits all” solution. Each treatment is personalized to the specific state of your unique functioning brain. Factors such as treatment duration, frequency of stimulation, sessions, and placement may be adjusted depending on your brain’s response and activity.

Additional Types of TMS

Theta Burst Stimulation (TBS)

The most recent form of TMS, Theta Bursts, offers a higher frequency of stimulation in shorter bursts applied five times per second which imitates the brain’s natural cadence of activity. 

Within TBS, there are two subtypes: 

• Continuous (cTBS) 
• Intermittent (iTBS). 

Each has similar results and side effects in line with the standard TMS treatments, but different effects on brain function.

Deep Transcranial Magnetic Stimulation (dTMS)

As the name would imply, dTMS reaches deeper brain regions and wider areas than traditional TMS with the use of a cushioned helmet utilizing H coil technology. This method of TMS reaches about 4 centimeters beneath the surface of the skull. This is also considered an outpatient procedure with each daily session lasting about 20 minutes over the course of four to six weeks.  dTMS has been FDA cleared to treat depression since 2013 and has recently been approved for the treatment of OCD. 

What to expect in your TMS Treatment

Given that each patient and circumstance differs from the next, expect an initial session to be a series of measurements and tests to locate your left dorsolateral prefrontal cortex and then establish the natural level at which the neurons release the neurotransmitters so that the TMS settings can be fine-tuned to you and your needs specifically. 

Once the measurements are established, you are ready for the first treatment. No anesthesia or sedation is required since TMS is non-surgical, non-invasive, and virtually pain-free and most patients report a subtle tapping sensation during the procedure with little to no side effects. The most common side effects are minor facial twitches, scalp discomfort and mild headaches which oftentimes arise during treatment and subside after or shortly thereafter the treatment has concluded. 

This is an outpatient procedure, so patients are not required to take any time off from school or work following the procedure, and are not required to have assistance in driving to and from the appointments. 

The time it takes to notice an improvement in mood varies from patient to patient, but according to Bespoke Treatment, TMS therapy has shown to have a high success rate in treating mood disorders with approximately 10-20% of patients noticing significant improvements after the first week of treatment. TMS Brain Health has also experienced a 92.5% success rate through its highly personalized and properly tailored treatment plans. 

When weighing out the options of mental health treatment, it should always be done in consultation with a licensed healthcare professional to ensure optimal treatment customized to your specific circumstance and overall history of health.