SZN. 3 Ep. 5/ TMS Therapy
Understanding Transcranial Magnetic Stimulation (TMS): A Comprehensive Guide
By Don Mitckess, LCPC, CRADC, Director of Clinical Strategy, Relief Mental Health
Transcranial magnetic stimulation (TMS) is a non-invasive treatment that has gained prominence for its effectiveness in treating various mental health diagnoses, particularly depression. If you’ve heard about TMS and are curious about what it involves, how it works, and what to expect from the treatment, this guide is for you.
What is Transcranial Magnetic Stimulation (TMS)?
TMS is a medication-free procedure that uses magnetic fields to stimulate nerve cells in the brain. This technique is primarily used to treat depression, especially in individuals who haven’t found relief from traditional treatments like medication and psychotherapy. During a TMS session, a device with an electromagnetic coil is placed on your head. The coil generates a magnetic pulse that stimulates nerve cells in the brain’s prefrontal cortex, which plays a significant role in mood regulation.
What is TMS Used For?
TMS is most commonly used to treat major depressive disorder (MDD), particularly in cases where other treatments have failed. BrainsWay Deep TMS™ also is FDA approved for use in treating the following:
● Obsessive-compulsive disorder (OCD)
● Anxious depression, when anxiety cooccurs with depression
● Smoking addiction
TMS is also being explored for several off-label uses, including post-stroke rehabilitation, attention deficit hyperactivity disorder (ADHD), Alzheimer’s disease, and eating disorders. In post-stroke rehabilitation, TMS is used to stimulate specific areas of the brain to improve motor function and facilitate recovery. For ADHD, TMS may help regulate attention and impulse control by targeting brain regions associated with executive functioning. In Alzheimer’s disease, researchers are investigating whether TMS can enhance cognitive function and slow down the progression of symptoms by stimulating brain areas involved in memory and learning. TMS is also being explored as a treatment for eating disorders, where it aims to reduce symptoms by targeting brain regions associated with appetite, self-regulation, and reward processing. This approach may help individuals gain better control over disordered eating behaviors and improve their overall mental health. Results suggest that TMS could offer new therapeutic options for these challenging conditions.
Deep TMS vs. Standard TMS
There are different types of TMS, with the most common being standard TMS (rTMS) and Deep TMS (dTMS). While both are effective, they differ in how they target the brain.
● Standard TMS: This form of TMS uses a figure-8-shaped coil that primarily targets the outer layers of the brain, known as the cerebral cortex. It typically focuses on the prefrontal cortex, which is closely linked to mood regulation.
● Deep TMS: At Relief Mental Health, we utilize BrainsWay Deep TMS technology, which uses a different coil design (H-coil) that sits within a helmet placed on a patient’s head, allowing magnetic pulses to be delivered to a broader area and penetrate deeper into the brain. This enables the treatment to reach brain regions that are not easily accessible with standard TMS. Because it targets deeper brain structures through a broader area, Deep TMS is usually more effective.
TMS vs. Electroconvulsive Therapy (ECT)
TMS is often mistaken for and/or compared to electroconvulsive therapy (ECT), another treatment for depression. While both are used to treat similar conditions, they differ significantly in their approach and effects.
● ECT: ECT involves sending an electric current through the brain to induce a brief seizure. This procedure is done under general anesthesia and is often reserved for severe cases of depression that have not responded to other treatments. ECT is highly effective but can have side effects such as memory loss and confusion.
● TMS: Unlike ECT, TMS does not require anesthesia, does not induce seizures, and generally has fewer side effects. The most common side effects of TMS are mild headaches which typically go away after the first few days of treatment.
What Does TMS Feel Like?
A TMS session is generally well-tolerated by most patients. During the procedure, you will sit comfortably in a chair while a helmet is placed on your head. When the magnetic pulses are delivered, you may feel a tapping sensation on your head and hear a clicking sound. Some patients report a mild headache during or after the session, but these symptoms usually subside quickly.
How Many TMS Treatments Are Needed?
The number of TMS sessions required varies depending on the diagnoses being treated and the individual’s response to therapy. At Relief, a typical course of TMS for depression involves daily sessions (five times per week) for the first six weeks. Treatment is then tapered down to 3 sessions during the seventh week, 2 sessions during the eighth week, and 1 session during the ninth week. Some patients may require additional maintenance sessions to sustain the benefits of the treatment, and many patients choose to come back for another round of treatment after some time has passed and their insurance will cover it again.
A Promising Alternative
Transcranial magnetic stimulation (TMS) offers a promising alternative for individuals struggling with treatment-resistant depression and other mental health conditions. Its non-invasive nature, coupled with its relatively mild side effects, makes it an attractive option for many. Whether you’re considering standard TMS or Deep TMS, it’s essential to consult with a healthcare provider to determine the most appropriate treatment plan for your specific needs. As with any medical treatment, understanding the procedure, what to expect, and the differences between TMS and other therapies like ECT can help you make an informed decision about your mental health care.
Relief Mental Health provides Deep TMS at all 10 of its clinics. In Illinois, clinics are located in Chicago (Lakeview and West Loop), Northbrook, Oak Brook, Orland Park, Rockford, and St. Charles. For more information, call 855.205.4764, email info@reliefmh.com or visit reliefmh.com. We’re here when you need relief.
