Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation (TMS) is a noninvasive procedure used to help reduce symptoms of depression. Taking advantage of magnetic fields that stimulate nerve cells in the brain to diminish depression-derived symptoms; Transcranial Magnetic Stimulation is an ideal treatment approach when other forms of treatment for depression are ineffective. If you’re struggling with depression and want to learn how TMS works, and, how it can help you to relieve yourself of the condition; read on as we delve in to the details and benefits of this possibly life-changing procedure.
How does Transcranial Magnetic Stimulation work? What’s involved?
During TMS sessions, the doctor or guiding medical professional will use what’s called an “electromagnetic coil” which will be positioned against the scalp of the patient; towards the forehead.
This electromagnet will output a magnetic pulse (painlessly) that will effectively stimulate nerve cells in the area of the brain that’s responsible for mood control and depression. Furthermore, TMS helps recipients by reactivating areas of the brain that may not have been active due depression.
Although scientific research has been conducted on TMS, exactly “how it works” and “why it’s effective”are questions we’re still learning the answers to. Although, the stimulation to the nerve cells caused from the magnetic pulses seem to have a noticeable and positive effect on how the brain functions.The results seem to relieve symptoms of depression while improving the mood of the treated patient.
To achieve a reduction of symptoms of depression, multiple magnetic pulses are expelled, repetitively. Because of the process, this treatment is also referred to as RTMS, or, Repetitive Transcranial Magnetic Stimulation.
Why’s Transcranial Magnetic Stimulation used?
Depression, according to the National Institute of Mental Health (NIMH), is a condition that 16 million adults in the United States suffered from in 2012 alone. To put that in to perspective, that’s 6.9 percent of the total US population. According to a study conducted by the World Health Organization (WHO), depression is a condition that 350 million people suffer from worldwide and is one of the leading causes of disabilities.
Sadness, grief, anger – these are all natural human emotions that we all encounter at some point in our lives. From time to time, such emotions can quickly emerge although typically fade away in a matter of a few days (if not sooner). However, major depression is much more than the average case of depression that we experience.
Individuals experiencing sadness or grief for extended periods of time are usually the ones with severe depression; especially when such symptoms cause the victim to lose total interest in once enjoyed hobbies or activities. Untreated, severe cases of depression can cause serious health complications with possibly life-threatening consequences.Thankfully, most of those struggling with depression are treatable and one of the routes for getting depression under control is Transcranial Magnetic Stimulation.
Learn About Depression – When’s Transcranial Magnetic Stimulation Suitable?
Major depression may occur in an instant but subside in the short-term; for some. For others, severe and persistent depression may be on-going. When struggling with depression for a period of two years or greater, more than likely, persistent depressive disorder is present. A less common but still problematic form of depression is known as bipolar disorder, or, manic-depressive illness. When it comes to bipolar disorder, victims of this condition will experience sporadic cycles of depression with varying degrees of intensity.
Many of those suffering from depression have utilized an array of recovery strategies for managing depression.Treatment routes such as therapy, counseling, and prescription medications are the most commonly pursued options by those wanting to lead a depression-free life. Overcoming depression can be difficult and managing it alone can be all that more challenging. Thankfully, due to advancements in medical technology and research – Transcranial Magnetic Stimulation was discovered and is now a depression-management technique that’s beginning to change the lives of so many that continually struggle with depression.
Causes of depression vary from person to person. Some aren’t aware of this but present circumstances, such as strenuous living conditions, can actually trigger the development of other forms of depression that Transcranial Magnetic Stimulation can help to treat. For example, some individuals struggle with a seasonal affective disorder (SAD). An example of this is people whose mood is affected and impacted by sunlight. In such a scenario, you’d find yourself feeling more depressed during the winter time compared to that of summer. When it comes to treating unique forms of depression, such as SAD, Transcranial Magnetic Stimulation may help in relieving symptoms of depression for this disorder (if others treatment forms have shown to be ineffective).
Signs of Depression – Symptoms Treatable by TMS
Individuals encountering the feelings of emptiness or sadness for periods of time lasting over 3 weeks may be experiencing severe depression.
Symptoms that signify depression is present include:
- A loss of interest in once enjoyed activities
- Heavy dwelling on the past (especially on situations or occurrences that have not gone right)
- Thoughts of committing suicide
- Problems with managing anger and mood
- Abnormal levels of anxiety
- Irritability and loss of patience
There are some physical symptoms as well that can be a sign of depression. Physical signs of depression include:
- Too much sleep
- Insomnia and restlessness when trying to sleep
- Unusual weight gains
- Abnormal loss of weight
- Unable to concentrate on tasks or activities
- Unusual pains and aches
Repetitive Transcranial Magnetic Stimulation is an effective and fast-acting treatment providing depression symptom-relief for patients rather quickly. Because of the way RTMS stimulates the brain, patients are able to experience short- and long-term relief of depression and the symptoms of it.
Unlike deep brain stimulation or vagus nerve stimulation – RTMS helps to treat depression for patients without the need of surgery or electrode implants. Furthermore, unlike other forms of therapy such as electroconvulsive therapy (ECT), repetitive Transcranial Magnetic Stimulation doesn’t require patients to be sedated. It’s a non-evasive treatment approach with very mild side effects (which we’ll cover below).
Are there side effects when undergoing Transcranial Magnetic Stimulation?
Side effects from RTMS are not too noticeable. Effects range from mild to moderate and will begin to subside within a very short period of time after commencement of treatment.
Side effects of Transcranial Magnetic Stimulation can include:
- Tingling sensations
- Spasms (or a twitching of the muscles in the face)
- Discomfort or numbness sensation along the scalp
Uncommon side effects of Transcranial Magnetic Stimulation
- Loss of hearing (if improper hearing protection isn’t used while undergoing treatment)
- Mania (more common in patients diagnosed with bipolar disorder)
Studies and further research is still being conducted on RTMS to determine what long-term side effects, if any, exist.
What are the Preparations for a Transcranial Magnetic Stimulation Treatment?
Just as with most other medical related treatments, when planning on undergoing Repetitive Transcranial Magnetic Stimulation, there are protocols and process in place (each of which we’ll cover below). Before receiving RTMS, you may be required to have a:
Physical Exam– To ensure that Repetitive Transcranial Magnetic Stimulation is a safe treatment option for you to receive, a physical exam or lab tests (or both) may be required prior to receiving treatment. During a physical exam, a doctor will check your blood pressure, heart rate, and respiration rate to ensure your vitals and health profile is stable enough to undergo RTMS. A heart exam is also conducted during the physical exam to ensure there are no irregular heartbeats, heart murmurs, or any other heart diseases that could be impacted by RTMS.
Psychiatric Evaluation– A meeting between you and a therapist or psychologist may be required before receiving Repetitive Transcranial Magnetic Stimulation. During a psychiatric evaluation you’ll have the opportunity to discuss your depression and related symptoms with a professional that can assess and understand what you’re experiencing. A psychiatric evaluation is commonly required as it affords the examining doctor the opportunity to determine if you’re a good candidate for the treatment.
BEFORE receiving RTMS, speak to your doctor if you:
- Are pregnant or are expecting to become pregnant.
- Have any implanted medical devices or any other devices constructed from metal. While not in all cases, in some, people who do have metal implants in their body may still be able to participate in Repetitive Transcranial Magnetic Stimulation treatments.
Keep in mind that Transcranial Magnetic Stimulation utilizes the power of strong magnetic fields during treatment.
Due to this, RTMS is a procedure that’s NOT recommended to individuals that have implanted devices including:
- Implanted Stimulators
- Aneurysm coils/clips
- Implanted deep brain stimulators or vagus nerve
- Implanted devices (such as medication pumps or pacemakers)
- Cochlear implants (for hearing)
- Electrode implants used for monitoring cognitive activity
- Magnetic implants (as such devices could be easily affected by RTMS)
- Fragments from bullet puncture
Furthermore, prior to receiving RTMS, inform your doctor if you have:
- Taken any medications including off-the-shelf medications and prescription-strength medication
- Suffered from seizures in the past or come from a family that has a history of epilepsy
- Ever been diagnosed with a mental health complication or disorder (such as bipolar disorder, psychosis, or a substance misuse disorder)
- Brain damage induced by either an injury or illness (such as a stroke, trauma to the head, or a brain tumor)
- Intense sporadic or frequent headaches
- Been diagnosed with any other medical complications or conditions (be completely transparent)
Transcranial Magnetic Stimulation – Overview
Repetitive transcranial magnetic stimulation takes advantage of a built-in magnet that’s used to stimulate and activate the brain. The treatment was first founded and developed back in 1985 and has since been studied, researched, and used as a preventative effort for depressions, anxiety, psychosis, and other disorders. Unlike ECT (Electroconvulsive Therapy), where using electrical stimulation on the mind tends to be more generalized, transcranial magnetic stimulation is a precise treatment that allows doctors to hone its effects on a particular region of the brain.
Through transcranial magnetic stimulation, it’s commonly believed among doctors that side effects are reduced when treatment can be focused in on a very particular area (compared to that of not being able to focus on only one region). Scientists suggest that RTMS (compared that of ECT) is less likely to cause side effects to emerge (just for the simple fact that the entire brain isn’t being effected – only a particular part of it).
Transcranial Magnetic Stimulation – Now an FDA Approved Treatment
Back in 2008, repetitive transcranial magnetic stimulation became an approved treatment for major depression by the FDA. More specifically, it was approved for individuals struggling with addiction that have used at least one other antidepressant medication that showed to be ineffective. Transcranial Magnetic Stimulation is also utilized in other countries as well as a treatment alternative for depression in individuals that showed no signs of betterment from medications for depression.
For quite some time that was a lack of evidence and solid proof to back the effectiveness of RTMS. Reviews and opinions about RTMS were mixed and conflicting for quite some time among medical professionals but that began to change in 2010 when the first clinical trial (a very large one at that) was underway which was funded by NIMH. This clinical trial concluded that 14% of patients that received repetitive transcranial magnetic stimulation were able to achieve remission compared to that of 5% that received a sham treatment (similar to that have a Placebo; a sham treatment is when a doctor goes through the treatment process without actually fulfilling the treatment).
Once this trial has concluded, or, at least the first phase of it; participants were extended the opportunity to participate in a second phase of treatment where “all” individuals would receive repetitive transcranial magnetic stimulation (even the individuals that were given the sham treatment). Astonishingly, the rate of remission during “Phase 2” climbed to 30%. As mentioned above, sham treatments are similar to that of a placebo although instead of a patient receiving a non-acting pill, an inactive procedure that mimics the process of RTMS was used.
During the Procedure – Repetitive Transcranial Magnetic Stimulation
First, the doctor conducting the Transcranial Magnetic Stimulation treatment will begin by placing an electromagnetic coil against the patient’s forehead near the part of the brain that’s believed to be responsible for mood regulation. Once the device has been placed on the skull, short electromagnetic pulses will be administered through the coil. These magnetic pulses effortlessly pass with ease through the coil and through the skull. This causes small yet effective electrical currents that quickly stimulate the nerve cells in the region being targeted.
Because of the “type” of pulse that’s being omitted, generally, the pulse will not reach any further than 2 inches into the brain. Because of this, doctors are able to more accurately able to focus in the treatment on one particular region of the brain (leaving the rest of the brain unaffected). The magnetic field that occurs during Transcranial Magnetic Stimulation is about the same strength of one produced through magnetic resonance imaging (MRI) scans. During RTMS, patients may experience a moderate tapping or knocking on the head as pulses begin to expel.
When it comes to the most effective position of the magnet on the patients head, not all doctors and scientists are in agreement. Scientists are still unsure if RTMS is best used in conjunction with other medications or psychotherapies or if it’s best effective as a standalone treatment. More studies are being conducted and research is underway to determine the best uses and application techniques of Transcranial Magnetic Stimulation.
Future Treatment Outlook for Transcranial Magnetic Stimulation
During a study that took place to determine if transcranial magnetic stimulation is affective in provide long-term relief of depression and symptoms – Rush University Medical Center, the center that conducted the study, determined that the non-drug, non-invasive therapy can provide patients with recovery from major depression. Transcranial Magnetic Stimulation can provide recipients that haven’t benefited from other antidepressants with lifelong recovery from the condition affecting millions of lives in the US – Depression!
Back in October of 2010, results of this study were published by Brain Stimulation, a medical journal managed by Elsevier.
Transcranial Magnetic Stimulation is a non-evasive treatment approach that effectively delivers highly-focused electrical pulses to a precise region of the brain (the “Left Prefrontal Cortex” – responsible for moods and personality development) so stimulation to the areas of the brain responsible for depression can take place. These pulses, while varying slightly, are very similar in intensity to the pulses generated by the magnetic field during an MRI. The short and repeated bursts of electromagnetic energy which is introduced through the patient’s scalp will excite the neurons in the connected areas of the targeted region of the brain.
Transcranial Magnetic Stimulation is a treatment that’s still be learned about and research efforts are still underway. Depression is a chronic condition for many and unfortunately many struggling with depression have had no success with antidepressant medication. Thankfully, for those who have found themselves stranded of working recovery options, transcranial magnetic stimulation may be of help as it’s an alternative to commonly-used antidepressant medication that has shown to be effective in thousands of patient-monitored cases.
If you’re struggling with depression and have attempted to use antidepressants to bring an end to depression, speak with your primary physician to explore the option of undergoing RTMS treatment at Rehab South Florida. With minimal risks and zero-to-none side effects, it’s certainly a treatment option that should not be overlooked.
Depression is many times a life-long condition and RTMS can help you to finally overcome this undesirable emotion and mental state of being. Are antidepressants not working? Than give RTMS some thought and consider it as an antidepressant, treatment alternative.