Transcranial Magnetic Stimulation

By Corrina Horne |Updated March 29, 2022

Transcranial Magnetic Stimulation As Treatment For Depression

Depression is a serious health concern. The condition is something of a chameleon in that it affects everyone differently and looks dramatically different in every personality it touches.

For this reason, depression often goes undetected – or is misunderstood – which can exacerbate symptoms and endanger lives. Despite more than 300 million people living with depression worldwide, many aspects of depression are still not entirely understood, and treating depression can prove difficult.

Treatment for depression varies widely, based on a person's needs, comfort level, and economic ability. Though there are countless ways to treat depression, ranging from lifestyle alterations to talk therapy, several areas of study have emerged to focus primarily on depression treatment. One of these therapies is Transcranial Magnetic Stimulation, or TMS.

Transcranial Magnetic Stimulation

Not Sure If TMS Therapy Is Right For You?

Transcranial Magnetic Stimulation, or repetitive Transcranial Magnetic Stimulation (rTMS), is a depression treatment that uses a magnetic force to alter the patterns of your brain to decrease the symptoms of depression.

Placing a magnetic coil against the side of a patient's head, practitioners then apply a series of pulses within the magnet to stimulate the nerves in your brain responsible for mood control.

The theory behind this particular type of therapy suggests that stimulating and awakening areas of the brain that are usually less active in depressed individuals will help alleviate the symptoms of depression and improve a patient's quality of life.

Possible Side Effects Of Transcranial Magnetic Stimulation Therapy

Because this procedure is non-invasive and merely utilizes magnetic pulses, TMS is considered a safe treatment for depression, without any dramatic or alarming risks.

That being said, there are some mild possible side effects brought on by TMS sessions, which can include headaches, lightheadedness, facial tingling or numbness, and discomfort during the procedure.

Unlike many other treatment options, however, these side effects usually dissipate immediately after concluding a session or shortly thereafter. While many people use TMS as a last resort, only engaging a TMS therapist after other avenues have been exhausted, its low-risk process could be an ideal alternative for individuals who are sensitive to standard medication or seemingly inoculated against traditional talk therapy.

Qualifications Necessary To Administer TMS Therapy

Only a qualified TMS therapist should administer TMS. This particular treatment type is not taught as a regular part of earning a psychology certification and is considered a specialty. This plays into the overall cost of TMS and patients should take the time to thoroughly check all credentials before enlisting the assistance of a practitioner. The equipment involved in TMS requires delicate handling and a thorough understanding of the brain and could prove painful if not used correctly.

What's A TMS Session Like?

There is some variation within the practice of TMS, but the basic mechanism is the same: a magnet is placed against the scalp—traditionally, near the forehead—and magnetic pulses are delivered. A patient's first session is usually the longest, as practitioners need to assess how much therapy is likely to be required and establish a starting point for an individual's needs.
 
Initially, a practitioner will administer TMS therapy to determine a patient's pain tolerance and comfort level, then move on to "mind mapping" to make sure each session is targeting the correct area of the brain. Once a treatment plan has been established, appointments typically last between 20-40 minutes.

Next Steps In A TMS Therapy Sessions

During this time, patients are placed in a comfortable chair and given earplugs to deaden some of the sound emitted by the magnetic machine. The magnet will be activated for a few seconds; when activated, patients may hear a clicking or tapping sound and a similar sensation against the skin.

The magnet will then be deactivated for a few beats and reactivated. Sessions continue in this vein for the duration of treatment and are performed on an outpatient basis. Some patients report slight dizziness or headaches immediately following a session.

How Often Do Sessions Have To Occur To Be Effective?

Most practitioners recommend regular treatment with TMS, which usually means five sessions per week, for a 4-6 week period. Treatment can veer outside of this standard but usually requires at least this great a time commitment. Improvement in symptoms can take several weeks, but some patients report feeling changes as early as the first treatment.

Once treatment has concluded, patients typically go on to use traditional treatment methods, such as talk therapy or medication, to maintain TMS results.

TMS Therapy Cost

The cost of TMS therapy is difficult to discern, as it is still considered somewhat experimental to some insurance companies. For this reason, many patients are only able to undergo insurance-covered treatment after traditional methods have not worked; Transcranial Magnetic Stimulation is often not covered as a primary treatment option.
 
If insurance is not able or willing to cover Transcranial Magnetic Stimulation treatment costs, patients can expect rates between $400 and $500 per session. Fortunately, many insurance companies allow doctors and clients to lobby declined treatment options, and alternative treatments might be more favorably decided upon if no other form of depression treatment has been successful.

How Effective Is TMS For Depression?

TMS has a 30% success rate, which places it just below traditional antidepressants, which typically see a 50% success rate. Individuals who seek TMS treatment and do experience improved symptoms are instructed to continue seeking regular "maintenance" therapy via a traditional therapy modality or medication, to make sure the results delivered by TMS remain intact.

Exact Efficacy Of TMS Therapy

Although the exact efficacy of TMS is not known, as it is still a fledgling practice, some studies have shown that it does demonstrate consistency in treating patients with depression. However, though it seems less likely to assist with other psychiatric disorders.

Part of its efficacy may lie in the time commitment required for treatment; reportedly, many depression patients stop using therapeutic techniques as early as one month after diagnosis, and TMS requires a minimum of 4-6 weeks to conclude treatment. The consistency of treatment, then, may be a significant contributor to its use as a depression treatment.

Who Is TMS Not For?

One of the reasons TMS therapy is gaining popularity is its nature as a non-invasive treatment. Though this might be great for some patients, others are considered poor candidates for TMS. These include individuals with pacemakers, stents, aneurysm coils, metallic implants in the upper body, monitoring tools inserted in the head or neck, bullets or shrapnel in the upper body, or tattoos using metallic ink.

Because the technique uses a magnet, there is the possibility of disruption in implanted devices, such as pacemakers, during treatment. Metallic implants are similarly problematic in that the consistent pulse of a powerful magnet could dislodge or otherwise alter the positioning of an implant.

Tourette Syndrome, Schizophrenia, And More

TMS is also not an ideal match for patients seeking to treat Tourette syndrome, schizophrenia, post-traumatic stress disorder, or obsessive-compulsive disorder.

Although many of these occur concurrently with depression, clinical studies demonstrated that TMS was not an effective therapy for these issues, as patients reported little to no changes in symptoms of each of these disorders following treatment. Instead, TMS has shown improvement in depression and major depression disorders specifically.

Lack Of Insurance Coverage

Due to the likelihood of insurance companies turning down Transcranial Magnetic Stimulation therapy as a first option, TMS is also not an ideal solution for people who have not tried to talk therapy, cognitive therapy, or medication. These individuals are unlikely to receive insurance coverage, and out-of-pocket expenses for the process can be prohibitive.

Online TMS Therapy As Treatment

Fortunately, research shows that online therapy can play a significant role in reducing depression and anxiety symptoms. For example, one study found that online therapy was even more effective than traditional in-person sessions, with 100 percent of participants in the online group showing continued symptom reduction three months after treatment.

On the other hand, individuals in the face-to-face group showed “significantly worsened depressive symptoms” over the same period. This study explores how internet-based treatment compares to regular face-to-face therapy.

Not Sure If TMS Therapy Is Right For You?

Conclusion

Online therapy with BetterHelp could be a great solution. BetterHelp’s platform provides access to trained professionals from the comfort of your home, day or night. And you can be in contact with them on a more regular basis than in a formal office setting, which can be a comfort during the tough times when you may need to speak with a trusted professional. Consider the following reviews of BetterHelp therapists below, from people experiencing similar issues.

Therapist Reviews

“The insight and compassion that Dr. Dougherty has shown me during my treatments sessions has been beyond anything I could ever have imagined. I'm in such a better place now because of her help. I can't imagine having achieved my goals without her help.”

"I’m a therapy newbie, so was feeling incredibly nervous about starting. Katie has been amazing from the get go. Immediately I felt comfortable and safe, she’s warm and kind and I like that we laugh in some of our sessions. It’s early yet but I’m already feeling a change in myself and I’m excited to keep going."

Is TMS Worth It?

TMS is certainly worth looking into if you do not respond to more traditional routes of depression treatment. Although it does not function as a miraculous cure for all symptoms of depression, ongoing studies do suggest that it is a low-risk, non-invasive source of treatment and can be a wonderful option to explore for people who are unable to find relief via standard therapies.

TMS therapy can also be helpful for individuals who do not feel safe or comfortable utilizing talk therapy, as TMS does not require the same amount of vulnerability or discussion that talk-based therapies do and can provide relief without necessarily having to recall painful memories or suppressed information.

TMS can also prove helpful for individuals who experience intense side effects on regular antidepressant medication. While not all antidepressants possess dramatic risk favors, several of the most popular options do run the risk of significant side effects, which can include increased feelings of depression and consideration of self-harm.

The possible side effects of TMS are mild and typically dissipate quickly. While it is not common to experience dramatic side effects of common medications, a history of antidepressant use and subsequent unpleasant side effects could prompt an individual to seek out a qualified TMS practitioner.

While TMS might not be a treatment for everyone, it has shown immense promise in its field and has given researchers some hope for establishing useful, effective treatments for mental disorders using biological alterations to the brain. While it has not shown any sort of application for other mental health ailments, TMS could be a great option for men and women trying to seek out alternatives to the tried-and-true methods of depression treatment.

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