When it comes to depression, getting help and feeling better should be a top priority. Over 18 million adults in the US are affected by this mental health disorder, a disorder that is also the leading cause of disability around the world. Although depression can be an extremely debilitating disorder both mentally and physically, there are fortunately many treatment methods available for those seeking help. Some of these are quite popular, while others are still on the rise. What matters most is finding a treatment that works for you and that can ultimately deliver quality results with greatest success and least discomfort. That’s where TMS therapy comes in as an alternative treatment option that is FDA-cleared, well-tolerated, and covered by most insurance companies in the US. In this thorough guide to TMS therapy, we’ve gathered all the information you need to know about TMS and whether it’s the right option for you or your patients.

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What is TMS Therapy?

TMS (Transcranial Magnetic Stimulation) therapy is a non-invasive, FDA-cleared treatment for depression that is painless and has minimal side effects. Using a chair equipped with special magnetic coils which are placed over a patient’s scalp, soft magnetic pulses are sent to the prefrontal cortex. These pulses stimulate the nerve cells within the left prefrontal cortex, which are responsible for controlling our mood and emotions. Nearly a decade of research, as well as a great number of clinical trials, have proven that this magnetic stimulation greatly impacts the neurotransmitters of the brain in a highly beneficial way, decreasing the symptoms of depression for extended periods of time. TMS therapy is an excellent treatment option for depression that doesn’t require medication, and is highly encouraged for those patients who have not been able to feel better after trying antidepressant medications and/or psychotherapy.

What is TMS Therapy Used For?

Since 2008, TMS therapy has been FDA cleared to treat depression and Obsessive Compulsive Disorder (OCD). There’s also been evidence that’s shown TMS helps reduce symptoms of anxiety and PTSD, although insurance companies don’t normally cover the costs for patients who want to get TMS treatment for these two conditions. However, when a patient has anxiety or PTSD, it is quite common the patient also suffers from depression. Most insurance companies, including Medicare and TRICARE, will cover the cost of TMS when a patient has depression. Hence, if a patient suffers from depression-induced anxiety or depression-induced PTSD, it is quite likely they will get coverage for treatment from their insurance provider.

How Does TMS Therapy Work?

TMS therapy works by using an electromagnetic coil that’s placed atop the patient’s scalp, near the forehead. Once the session begins, the electromagnetic coil starts sending soft magnetic pulses to an area of the brain called the prefrontal cortex. This area of the brain is where our emotions and mood are controlled. This stimulation activates the region of the brain that shuts down when a patient is depressed, therefore improving the patient’s mood and decreasing the symptoms of depression.

What Does TMS Therapy Feel Like?

Here’s some great news: the majority of patients who undergo TMS therapy have a very positive and pleasant experience during treatment. The chair used during the 19-minute session contains magnets that are placed on the scalp- near the forehead- which are responsible for sending the electromagnetic pulses to the brain. These pulses are so soft that many patients nearly don’t feel them. Some may feel a very light tapping sensation during their first time receiving treatment, however it’s nothing to worry about. 

Given that TMS has very minor side effects, patients can often directly return to their usual activities (such as driving to work, walking to the grocery store, etc.) immediately after treatment. There’s no recovery time needed after each session, which is great for those patients who may have tight agendas. 

https://youtu.be/0C5Blr0h4zQ

TMS Therapy Side Effects

One of the biggest advantages of TMS therapy is the minimal, virtually side effect-free element of treatment. Some minor side effects that could potentially arise from TMS therapy are headaches associated with the headband used during the session and skin irritation on the application site, both of which are rare occurrences. The most serious potential side effects of TMS therapy are seizures, however the risk associated with seizures caused by TMS therapy is extremely rare and the precaution is often directed towards those with a known history of seizures. Regardless, when administered correctly, there shouldn’t be any side effects to TMS therapy at all. It’s important to keep in mind that TMS treatment is always carried out by either a licensed physician or a trained technician who is supervised by a physician. You can rest assured you are in great hands!

Compared to the common side effects of many antidepressant medications, TMS therapy is highly tolerated by patients in the sense that it doesn’t generate pain or uncomfortable sensations. Some of the most common side effects of antidepressants include headaches, shivers, nausea, weight gain, weight loss, fatigue, insomnia, loss of libido, loss of appetite and blurred vision, to name a few. 

In essence, the minor side effects associated with TMS therapy vastly outweigh both the side effects of antidepressant medications and the debilitating symptoms of depression. Furthermore, TMS does not affect cognitive function, and thus patients may receive treatment at any time of day without having to compromise their daily activities. In summary, TMS therapy is a seamless treatment boasting rare side effects, making it a compatible treatment alternative for those looking to maximize their day to day lives while getting the help they need.

Is TMS The Same as ECT?

Electroconvulsive Therapy (ECT) is a procedure that greatly differs from TMS therapy. For starters, ECT consists of an electric current that is applied to the brain, which then causes an intentional generalized seizure in the patient. Compared to TMS therapy, it is a far more invasive treatment that must be performed at a hospital and requires the use of general anesthesia. The side effects of ECT are also much stronger, and it’s quite usual that it leaves some degree of cognitive impairment. 

In contrast, there’s no anesthesia used in TMS therapy, nor does it require a hospital or momentary hospitalization. There are very minor side effects associated with TMS, and treatment leaves no cognitive impairment in its wake. More importantly, TMS is designed to send targeted magnetic pulses to stimulate a very particular part of the brain to improve a patient’s mood, and does not commonly cause seizures. Patients who undergo a session of TMS therapy can continue on with their daily activities without the need to recover.

https://youtu.be/wIiyG4YApUY

TMS Therapy for Depression

Depression can be a terribly debilitating disease. With depression, even the simplest tasks can feel nearly impossible. Although it’s commonly assumed that depression affects people on an emotional level, the reality is that depression can be physically exhausting. Depressed patients have feelings of anxiety, seem irritable, or feel extremely fatigued on a day-to-day basis. 

The most important thing for any person who feels they may be depressed is to talk to a medical professional. With a proper diagnosis, the best course of action forward can be determined. It’s imperative to keep in mind that depression is a very common disorder, and that you’re never alone! About one in six people experience depression at some point in their life. 

When it comes to treating depression with TMS therapy, patients usually have already tried an antidepressant medication without seeing any improvement. Alternatively, patients who have taken antidepressants and have grown tired of the negative side effects may choose to get treated with TMS instead. In some cases, it may be advised by a professional to receive TMS while still taking medication. The specific course of action best for you can and should be determined by a medical professional.

Verify If You Qualify

TMS Therapy for PTSD

Here’s a fact that might surprise you: about 70 percent of US adults have experienced one traumatic event in their lifetimes, and of those, 20 percent will develop PTSD. One in three people will develop PTSD at some point in their lives. Although many people associate PTSD with war veterans, it’s actually a highly common disorder that affects many individuals, even those who may have never been part of the military. In fact, any type of traumatic experience – no matter how big or small it may seem to you – can lead to PTSD. 

The most common symptoms of PTSD are difficulty avoiding thinking about the traumatic experience, sudden irritability, social isolation, insomnia, intrusive thoughts, and heightened reactivity to stimuli, among many other symptoms. If you’re experiencing any of the above symptoms mentioned, you can speak to a professional who will give you a proper diagnosis and a treatment plan. Although TMS for PTSD is not covered by insurance, it is quite common that PTSD patients also have depression. There’s ample research that shows how TMS therapy can be an effective treatment for depression-induced PTSD, so it’s crucial that you first talk to a mental health expert that can provide you with a precise diagnosis of your condition. 

TMS Therapy for Anxiety

In the US, more than 40 million people suffer from anxiety disorder. This disorder is characterized by extreme feelings of stress, worry, or fear that are felt so intensely that it interferes with a person’s day to day activities and life. Some of the common symptoms of anxiety are having a hard time falling asleep, having intrusive thoughts you can’t control, hypervigilance, sweating, lack of concentration, and palpitations, to name a few. If you think you may be dealing with an anxiety disorder, talk to your primary care physician or a mental health expert to get an accurate evaluation of your condition. 

Although TMS therapy is FDA cleared for depression, there’s been much evidence to suggest that it can also help decrease the symptoms of anxiety. Anxiety itself is actually a common symptom of depression and PTSD. When a patient has anxiety that is caused by depression, they can greatly benefit from TMS therapy. While insurance does not cover TMS therapy for anxiety, there are other options. Get in touch with the clinic nearest you to learn more about the options you have available.

TMS Therapy Cost

There are many defining factors that will determine whether insurance will cover TMS therapy for a patient. Fortunately, since TMS therapy is FDA-cleared, the majority of insurance providers will cover treatment for those patients suffering from depression and who have tried both psychotherapy and/or antidepressant medications without any success or improvement. Depending on each patient’s medical history and personal situation, coverage may or may not be granted. That’s why it’s so important to get in touch with your nearest TMS clinic to verify whether you’re qualified for coverage.

Verify If You Qualify

Works Cited

Cirillo, P., Gold, A. K., Nardi, A. E., Ornelas, A. C., Nierenberg, A. A., Camprodon, J., & Kinrys, G. (2019, June). Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6576151/

Depression. (n.d.). Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression

Facts & Statistics. (n.d.). Retrieved from https://adaa.org/about-adaa/press-room/facts-statistics

Mennitto, D. (2019, February 05). Frequently Asked Questions About TMS at The Johns Hopkins Hospital in Baltimore, Maryland. Retrieved from https://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tms/faq_tms.html

What is Depression? (n.d.). Retrieved from https://www.psychiatry.org/patients-families/depression/what-is-depression

There has truly never been a better time to talk about mental health. From global stressors, all the way down to smaller issues in our lives, taking care of our mental health has never been more important. Now is the time to be communicating with our friends and family about our mental health if we don’t already. Although these conversations can be difficult to initiate, it is crucial that we learn how to start a conversation about mental health with others. Together we’ll explore some healthy conversation tips to keep in mind.

https://www.youtube.com/watch?v=qbo9Fe896QM

Removing the Taboo

Talking about our physical health may seem easier and more natural, especially since it’s a more common conversation topic in our culture and society. It can feel far more acceptable to check in with our friends and family about a physical diagnosis, how they are recovering from surgery, or any other illnesses. However, we may not be as comfortable checking in with our loved ones about their mental health or sharing about our own mental health. Begin by realizing mental health is just as important as physical health, and that we all struggle with emotional issues throughout our lives. This means we all go through similar struggles, and it’s perfectly normal to feel mentally unhealthy. Reaching out for help is also normal and important. 

Opening Up to Vulnerability

Starting a conversation around mental health may feel wrong or intrusive. It’s possible that if we didn’t have these conversations growing up, we will likely avoid them in our adult lives. Dr. Brené Brown describes that any unstable feelings we may get when we step out of our comfort zone, is actually, vulnerability. Vulnerability is “uncertainty, risk, and emotional exposure”. Vulnerability, while uncomfortable in the moment, can lead to progress and opportunity for our emotional self and our relationships. When it comes to talking about a topic as personal and intimate as mental health, we may feel a greater sense of vulnerability. This is a great skill to practice and learn at any point in our lives, and it is a key piece in starting a conversation about mental health.

Evaluating Our Own Mental Health

Asking about mental health requires some vulnerability, but how exactly do we go about starting this conversation? It may depend on your level of self-awareness. In addition to practicing and learning about vulnerability, taking the time to explore your own mental health and wellness can be helpful when wanting to talk with others about their mental health. If we can take some time to learn our own triggers, or areas where we become activated to feel more worried, anxious, or scared, this can help us to understand others when they do share about their mental health.

An important thing to keep in mind is to not compare our mental health to others mental health. Our triggers may not be others’ triggers, and our struggles may not be others’ struggles. This is normal and okay. When we spend a lot of time comparing and assessing our emotions through the lens of others, we may inadvertently be worsening our own mental health.

Getting Down To It

If you want to discuss with someone your own mental health (outside of a trained mental health therapist), first start by identifying people you trust and would like to support you. That way, if you want to continue this conversation, it can happen at any point in your relationship with it feeling less like you are using them solely as an outlet. Plus, you’ll feel comfortable enough to open up about your feelings.

If you want to discuss with someone your concern about their mental health, there are a few ways to approach this genuinely and compassionately. First, identify what it is that you are worried about. What are you noticing in their behaviors? Appearances can be deceiving, so note actions and behaviors that you have witnessed, versus what they physically look like. A healthy conversation tip can be sharing what you are witnessing, along with a simple ask of “how are you doing recently?”. If this is conveyed as being rooted in a place of genuine concern, it may signal that you are paying attention to them, and may create an opportunity to open a conversation. This may also help them to understand what their own behaviors are, as oftentimes we are not fully aware of our actions, particularly if we are experiencing mental distress. If there is someone more appropriate than yourself to address someone else’s mental health (someone closer to them, not in a position of power, etc.), this may be a more helpful person to include in or initiate the conversation.

The act of starting a conversation about mental health will not inherently make anything worse. This is a common misconception, particularly when talking about suicide and suicidal ideation. What can make someone’s mental health worse is ignoring warning signs or pretending that everything is okay when it is obviously not. Sure, unhelpful conversations may happen, but sometimes the attempt to connect can be enough.

Recognize and Applaud Your Courage

Mental health conversations require some courage, especially if this is not something that we are used to talking about. Vulnerability is a practice. We will mess up, say the wrong thing, or not reach out to others when maybe we should have. The best thing we can do is continue to reach out to others when we think they may need it, and hope our loved ones do the same for us when we need it. Mental health is essential, so taking the necessary steps to improve it should be a priority. 

Works Cited

University of Minnesota Center for Spirituality and Healing. (n.d.). Daring to be Vulnerable with Brené Brown. Retrieved October 14, 2020, from https://www.takingcharge.csh.umn.edu/daring-be-vulnerable-brene-brown