TMS Therapy and Depression Treatment
If you are suffering from major depression, you know that every day can seem difficult and hopeless. And you are not alone. The Latest Statistics on Major Depression from the National Institute of Mental Health(NIMH) in 2016 show that:
- In the United States, an estimated 16.2 million adults in the United States had at least one major depressive episode. This number represents almost 7% of the United States population.
- The prevalence of adults with a major depressive episode was highest among individuals aged 18-25 (10.9%).
- The prevalence of major depressive episode was higher among adolescent females (19.4%) compared to males (6.4%).
Symptoms of Major Depressive Disorder
There are many different types of major depressive disorder. Each type can have a different cause, however, they all involve the same feeling of disinterest in activities you once enjoyed and feelings of hopelessness, sadness or anxiousness as well as other symptoms. See a mental health professional for a formal diagnosis, but to have a formal diagnosis of major depressive disorder you will need to experience a primarily depressed mood for two weeks or more, as well as other symptoms as outlined below.
Although the number and intensity of symptoms will vary for each individual, they are typically as follows:
- Persistent sad, anxious, or “empty” mood
- Feelings of hopelessness, or pessimism
- Feelings of guilt, worthlessness, or helplessness
- Loss of interest or pleasure in hobbies and activities
- Decreased energy or fatigue
- Moving or talking more slowly
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Difficulty sleeping, early-morning awakening, or oversleeping
- Appetite and/or weight changes
- Thoughts of death or suicide, or suicide attempts
- Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Major Depression Can Cause Severe Impairment
In 2016, an estimated 10.3 million U.S. adults aged 18 or older had at least one major depressive episode with severe impairment. Severe impairment was indicated if their depression caused severe problems with their ability to manage at home, manage well at work, have relationships with others, or have a social life. Those adults who had major depression with severe impairment represented 4.3% of all U.S. adults.
For adolescents aged 12 to 17, approximately 9.0 percent had a Major Depressive Episode with severe impairment. Adolescents were defined as having a Major Depressive Episode with severe impairment if their depression caused severe problems with their ability to do chores at home, do well at work or school, get along with their family, or have a social life.
Depression Treatment Options
Common treatments for a major depressive episode may include antidepressants, psychotherapy, exercise, TMS and electroconvulsive treatment (ECT). A prescribing psychiatrist can provide both psychotherapy services and prescribe antidepressants, which may differ for each person based on their individual considerations. However, ECT is generally avoided, except in extreme circumstances, in favor of both psychotherapy and antidepressants. ECT is generally avoided because the patient typically needs to be in the hospital and receive anesthesia. ECT may also cause some side effects, including confusion, disorientation, and memory loss. Unlike the TMS treatment that is noninvasive and done with the patient being awake, without any need for anesthesia.
Depression Treatment With TMS Therapy
What Is TMS Therapy?
Transcranial magnetic stimulation (TMS) is a non-invasive method for using a magnetic field to cause an electric current to flow in a small region of the brain via electromagnetic induction, which causes the excitation of neurons in the brain. During a TMS procedure, a magnetic field generator, or “coil”, is placed near the head of the person receiving the treatment. The neuron excitation is caused by the electric currents induced in the tissue by the rapidly alternating magnetic fields, a process called electromagnetic induction. The TMS machine triggers activity in the brain without applying electrodes on the brain and without surgery.
Who Is A Good Candidate For TMS?
A doctor can help decide if NeuroStar TMS Therapy is right for you. TMS Therapy has been approved for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode.
NeuroStar TMS Therapy is only available by prescription.
What Happens In A Typical TMS Procedure?
A typical TMS session lasts approximately 30-50 minutes and does not require anesthesia. Patients come to the office five times per week. The treatment goes on for six to eight weeks, for an average of 20-30 total treatments. The TMS treatment is time-intensive, but research shows it can provide long-lasting improvements.
What Happens During The TMS Procedure:
An electromagnetic coil is held against the forehead near an area of the brain that is thought to be involved in mood regulation.
Short electromagnetic pulses are administered through the coil. The magnetic pulses easily pass through the skull, and causes small electrical currents that stimulate nerve cells in the targeted brain region.
Generally, the person feels and hears a slight knocking or tapping on the head as the pulses are administered.
Side Effects of TMS
For those who experience side effects, the most common side effect they have reported is a headache and/or pain or discomfort (tenderness) on the scalp, at or near the treatment site. However, this is usually transient; it occurs typically during the TMS treatment course and does not occur for most patients after the first week of treatment. There is a rare risk of seizure associated with the use of NeuroStar TMS (less than 0.1% per patient).
Who Is Not A Candidate For TMS
NeuroStar TMS Therapy should not be used with patients who have non-removable conductive metal in or near the head. NeuroStar TMS Therapy has not been studied in patients who have not received prior antidepressant treatment.
How To Pay For TMS Therapy Treatment
Insurance Coverage For TMS Therapy
Insurance coverage for TMS is expanding due to the increasing recognition by the insurance companies of the effectiveness of TMS. In Texas, TMS treatment is covered by Blue Cross Blue Shield, Cigna, and Optum (formerly United Behavioral Health).
If you don’t have these carriers, TMS Therapy® may be covered by your health insurance provider on a case-by-case basis. Currently, insurance coverage for the TMS procedure varies and individual carriers and plans may determine coverage on a case-by-case basis.
Most insurers will only cover members after they have tried 3 or 4 medications without success, although this may change in the future, as was seen with Medicare when they changed this approval to 1 failure of medication. Although anyone can pay for the treatment out of pocket. Research shows that taking fewer medications before TMS can reduce the number of side effects of these medications, and increase the success rate of the TMS treatment.
Success Rate Using TMS With Major Depression
Repetitive transcranial magnetic stimulation, known as rTMS, may produce long-lasting changes in electro-cortical function. According to researchers, the pulses are thought to increase blood flow and encourage the growth of connections between brain cells. TMS can also cause the release of the neurotransmitters dopamine, serotonin and norepinephrine, which are chemicals that help send signals between cells. The magnetic field is about the same strength as that of a magnetic resonance imaging (MRI) scan.
Midtown Psychiatry Experience With TMS
At Midtown Psychiatry and TMS Center, Dr White has been using TMS to help people with Major Depression since 2014. She has seen a success rate of 54% percent for patients who’ve tried TMS at her office that have seen improvements in their depression symptoms.
“For the people who do see an improvement, it can be life-changing, as many of those patients have suffered from Major Depression for years,” Dr. White says. The success stories of those helped using TMS can be seen in the note cards that Dr. White has posted on a bulletin board in her office.
The results Dr. White has seen in her office are similar to studies announced at the American Psychiatric Association meetings, which report that 53 percent of patients with medication-resistant depression who were treated with TMS reported no or mild depression following six weeks of treatment, according to results.
The TMS patients achieved better results than depressed patients who tried a different medication after failing to improve from past medication. Among patients trying a new medication, 38 percent saw improvements, according to study results.
However impressive the studies are, the studies and Dr. White caution that TMS does not work for everyone. In more serious cases of major depression, intensive outpatient treatment or hospitalization may be required.
TMS For Other Conditions
Research is ongoing into whether transcranial magnetic stimulation, or TMS, can help people with autism, schizophrenia, tinnitus, and a host of other conditions involving the brain. Although the FDA has approved TMS only for medication-resistant depression, the treatment has been approved in Europe for bipolar disorder, post-traumatic stress disorder, chronic pain, obsessive-compulsive disorder and adult ADHD, according to transcranialmagneticstimulation.com.
Integrative Treatment And Major Depression
Dr. White uses what she calls Integrative treatment, which, after a comprehensive evaluation, may include a combination of various therapeutic modalities such as relaxation, psychotherapy, yoga, medication, meditation, exercise, TMS therapy, nutritional supplementation, herbal medicine, vitamins, dietary changes, light therapy, and others. If you find yourself experiencing any of the symptoms of a major depressive disorder, you should seek assistance from a medical professional. Thankfully, in recent years, there is much less of a stigma for a major depressive disorder, and there is plenty of in-depth information available about depression online that you can discuss with your doctor.
What Our Patients Are Saying About TMS Treatment At Midtown Psychiatry
We have a bulletin board in our office which has note cards posted from people who have experienced TMS treatment in our Houston TMS Psychiatrist Office. Here are a few:
“As someone who has struggled with depression on and off my whole life and struggling with another long term episode I was excited to find a new treatment. After completing the TMS treatment I’ve been able to climb out of that depressive state and start doing the things I need to do to continue to enjoy my life. I would recommend the treatment.”
“My experience with TMS was very helpful. I went from being tired all day and not finding much pleasure in life to seeing hope for the future.”
“TMS help with my depression symptoms better than any medication ever has with no side effects. I would definitely recommend TMS to those suffering from depression and/or anxiety.”
WANT TO HEAR FROM PEOPLE WHO’VE TRIED IT?
You can hear from some of our patients as they discuss the real impact of TMS on their lives by watching Dr. White in a television video interview about TMS.
About Midtown Psychiatry & TMS Center
Midtown Psychiatry and TMS Center was created to provide the best possible mental health care available. With each patient, we strive to identify and treat the underlying causes of distress and symptoms of anxiety, depression, and other mental health issues. We work closely with patients and their families to create a treatment plan that addresses any imbalances we find. This may include addressing nutritional, lifestyle, and other core imbalances. Our treatment team, directed by Dr. Daniela White, MD, is dedicated to providing the best in diagnosis and treatment possible for a wide range of psychiatric issues, using an integrative treatment approach that improves the quality of life for our patients.
To that end, Midtown TMS and Psychiatry Center works in partnership with our patients and their families, advising them on options for treatment, such as psychotherapy, medication, TMS therapy, nutritional supplementation, vitamins, dietary changes, light therapy, yoga, meditation, exercise, herbal medicine, and others.
To learn more about TMS and our integrative treatment approach–make an appointment using the button or form on this page or call us directly at 713.426.3100.