How Effective Is TMS: Hope For Treatment-Resistant Depression

Transcranial magnetic stimulation (TMS) is a treatment option approved by the FDA (US Food and Drug Administration) to treat symptoms of depression. Recent research on TMS has shown promising results in symptom reduction and remission. 

Some people experiencing depression receive traditional treatment options, including prescribed medications and therapy. However, some of these individuals do not respond to treatment and continue to experience symptoms for months or years. TMS may provide relief for people with treatment-resistant depression.

What Is Transcranial Magnetic Stimulation (TMS)? 

Transcranial magnetic stimulation uses magnetic energy pulses throughout parts of the brain to encourage enhanced communication between brain cells. The pulses created by magnetic energy stimulate brain areas responsible for regulating mood. These pulses have been proven to improve mood and reduce depression and can be offered in variations, depending on the patient's needs.

TMS for depression entails using a particular device or helmet placed on the patient's head. It sends electromagnetic currents to the brain through the skull. The patient may receive impulses to the brain for several minutes in timed intervals. Some individuals may attend sessions several days a week for four to six weeks as part of their treatment. TMS requires no sedation, surgery, or anesthesia. Side effects from treatment may include mild scalp discomfort or a headache after a session. Still, many patients reported they could take over-the-counter medications to treat the symptoms. 

A person may qualify for TMS treatment based on their history of depression, how long their symptoms have persisted, and whether past treatments have worked. Studies continue to examine how TMS affects the brain and how long the effects last. In the 21st century, no studies link TMS to brain damage or severe harm. Most patients can continue regular activities after sessions. 

How Effective Is TMS? 

A recent meta-analysis of several studies has associated TMS with symptom remission. In one study cited in the analysis, 20.7% of patients had remission, 34.5% had partial remission, and 3.4% had worsened depression. While these results show promise, some mental health experts believe several factors, including social, biological, and psychological influences, may cause depression. Therefore, a person might see more improvement by using TMS in combination with other forms of treatment to target social and environmental factors, as well. 

Is There Hope In Treating Treatment-Resistant Symptoms? 

People experiencing severe depression for an extended period may have symptoms resistant to treatment. For some, making adjustments to treatment helps temporarily or shows no results. TMS is a more modern treatment, but research shows significant impacts, and the FDA has approved the treatment as safe. 

Depression itself is complex and may occur with other mental health concerns. Research is ongoing to understand how depression and other mental health conditions affect the brain. TMS, like any other treatment option for depression, may undergo changes and improvements to help people gain and sustain favorable results.

Since early research results show evidence that TMS is helping people treat depression symptoms, TMS is being used to treat other conditions that affect the brain, including forms of anxiety, chronic pain, substance use disorders, and diseases that affect mobility and cognitive behaviors. TMS is approved for adults over 18, but some children and teenagers may be considered for treatment. Talk to your doctor if you or your child is considering TMS for depression. This procedure is medical, so it is performed in a medical setting, often by a psychiatrist, neuropsychologist, or doctor. 

Are There Any Challenges To Seeking TMS Treatment? 

TMS may not be accessible for some. To qualify for TMS treatment, individuals must work with a professional to determine whether they meet the criteria, as certain health conditions may make some ineligible. In addition, qualified technicians must administer TMS with tools and equipment authorized by the FDA. Some locations may not have this option available due to limited professionals providing the service. 

Some locations may only see so many patients at a time, with sessions lasting between 20 and 40 minutes. Researchers are looking into reducing the time needed per session while still achieving favorable results. Other TMS device options are available for use, but each may provide different results.

Cost can be another barrier to receiving TMS. The TMS therapy cost can be expensive, with some options reaching $10,000. Those interested in TMS may check if they can afford the option with or without insurance coverage, and they might require a referral to obtain this treatment. They may also need to review and compare treatment options with their doctor if experiencing symptoms of other mental or physical health issues.

What Happens If TMS Doesn't Work?

TMS may not work for everyone, and research is still being completed to determine why this difference exists. However, there are a few theories about variations in how the brain receives magnetic impulses. 

Some experts believe there could be a lack of understanding of how the currents penetrate the skull and brain, creating varied results in how the brain was stimulated if stimulation occurred. Some experts believe that one side of the brain is responsible for the development of depression and, therefore, should be targeted by TMS, but other experts say there isn't enough research to support this claim.

During TMS sessions, the licensed technician is in the room with the patient the entire time. Those who reported no changes in their depression symptoms say they still found the technician helpful because of the social interaction during the sessions. Some patients may place much focus on getting TMS for their symptoms. Still, many technicians say that people tend to overlook the importance of socially interacting with others to ease their depression symptoms.

As a result, some of those who saw little to no improvement in their symptoms still benefited from the session. Clients experiencing isolation found some comfort in talking with the technician during their sessions and thereby gained more perspective on coping with their symptoms.

If TMS doesn't work for you, there may be other treatment-resistant depression options available, like electroconvulsive therapy, which is done under anesthesia. Talk to your doctor about the best option for you.

Further Support Options 

Experiencing resistant depression symptoms can be challenging. While TMS relieves some individuals from symptoms, the procedure continues to evolve. If TMS is seen as a last resort and symptoms persist, know there are options, and more may become available in the coming years. 

Alongside TMS treatment, having a therapist to discuss your symptoms with can be helpful. If your symptoms are severe and you struggle to leave home or find a consistent face-to-face therapist, you might also try online therapy through a platform like BetterHelp.

One study conducted by the University of Zurich involving 62 people with persistent moderate depression found that online therapy was as effective as in-person therapy in the short term while therapy was being actively conducted. At three months post-treatment, the patients in the internet-based treatment remained stable, while those who received only in-person therapy experienced worsening symptoms.

Online therapy can be conducted anywhere via phone, video, or live chat. This format can make online therapy particularly useful to those living in rural areas or with busy schedules. Additionally, online therapy may be more affordable than traditional therapy without insurance. 

Continue reading below to find reviews of some of our licensed therapists from people working through depression.

Therapist Reviews

“Auslyn has been absolutely phenomenal. She has helped me with my depression, anxiety, some relationship coping, and even some parenting skills. She has made such an impact not only on myself but in my marriage as well. 10 out of 10!”

“Jarad has helped me so much with depression and anxiety, and complicated relationship issues. He helps me see my situation with far more clarity and how to move forward with strength. He understands anything we discuss immediately and with care and a sense of humour when appropriate. I look forward to our sessions and drawing upon his vast knowledge of so many topics that are pertinent to my issues. There is no judgement and I finally have a safe and productive space to make sense of things.”