Just about everyone has experienced a chapter in his or her life when things just looked bleak. An occasional bout with the blues is a normal aspect of the human condition and our physiological and psychological response to hitting a patch of difficult challenges. For most people, the depression symptoms will resolve in a timely manner without the need for intervention. In this case, a person just guts it out and looks forward to life circumstances to improve over time.
When the symptoms of depression persist, hanging on and even worsening over a period of weeks or months, the person may be experiencing major depressive disorder (MDD). Classic symptoms of MDD, according to the DSM 5™, include the presence of five or more of the following:
- Depressed mood most of the day, nearly every day
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
- Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
- Insomnia or hypersomnia nearly every day
- Psychomotor agitation or impairment nearly every day, observed by others
- Fatigue or loss of energy nearly every day
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day
- Diminished ability to think or concentrate, or indecisiveness, nearly every day
- Recurrent thoughts of death, suicidal ideation, or suicide attempt or a specific plan for committing suicide
Antidepressants Not Always Effective
When seeking medical help for MDD, one learns that the standard treatment protocol includes antidepressant drug therapy along with psychotherapy. While this traditional treatment route can be effective for up to 70% of patients diagnosed with MDD, it is ineffective in relieving symptoms of the balance of patients, according to a recent study. Some of the participants in this study had to try four different rounds of treatment with different medications before their symptoms improved. Others dropped out of the study early out of impatience, frustration, or dissatisfaction with the treatment.
Doctors often try different antidepressants with new patients, allowing about six weeks for each drug to show promise for relieving MDD symptoms. This can be very discouraging for those who repeatedly do not respond to the medications. In addition to the increasing despair, side effects caused by these drugs can be intolerable, causing patients to discontinue the trial altogether. Side effects from antidepressants can include:
- Nausea
- Insomnia
- Weight gain
- Fatigue
- Sexual dysfunction and lack of desire
- Dry mouth
- Blurred vision
- Headaches
- Yawning
- Dizziness
- Constipation
- Irritability
- Anxiety
TMS Treats Medication-Resistant Major Depression
Once a patient is determined to have medication-resistant MDD he or she will likely begin to research alternative treatment methods for treating the persistent symptoms of depression. This is where transcranial magnetic stimulation (TMS) can come into play. TMS is a highly effective, safe, and well tolerated therapy for treating MDD, including co-occurring anxiety disorders, and was FDA cleared for treating MDD in 2008.
TMS is a brain stimulation technique, also referred to as electroceuticals, that works by targeting the mood region of the brain with electromagnetic fields. Using technology comparable to an MRI machine, TMS emits magnetic fields through a coil placed strategically on the scalp. The magnetic fields are able to penetrate hair and scalp and then induce an electrical current that reaches a depth of about 2cm into the brain. By targeting the limbic system, or mood center of the brain, in the left prefrontal cortex, TMS therapy can jump-start the sluggish or inactive brain cells associated with MDD.
TMS therapy for the treatment of depression is prescribed for a period of 4-6 weeks, five days a week. The treatment sessions last approximately 40 minutes and are conducted while the patient is fully awake and alert. There is no sedation involved, which eliminates all risks associated with general anesthesia. The patient can drive him or herself back to work or home and immediately resume normal daily activities with no downtime needed.
Over the treatment period, TMS therapy will incrementally begin to reset the individual’s brain chemistry. The positive effects are typically experienced beginning in the third week of treatment, although some will enjoy them sooner. In most cases, the first positive effect noticed is an improvement in sleep quality. As the sessions continue, the individual will begin to notice increased energy levels, improved concentration, and eventually improved mood.
TMS is noninvasive, meaning no surgery or implanting of a device is involved. Patients find TMS therapy to be very tolerable, with few, if any, adverse effects. The side effects that some have reported, such as mild to moderate headache or scalp tenderness, are transient, resolving with no intervention needed as the sessions continue.
TMS Clinical Trials Support its Safety and Efficacy
Completed and currently ongoing clinical trials continue to demonstrate the positive impact that TMS therapy has for patients with medication-resistant MDD. Global and domestic studies have consistently provided data showing statistical significance in the improvement of depression symptoms and remission rates.
One such study out of Northwestern University, authored by Philip G. Janicak, et al., studied 301 patients with medication resistant MDD over a period of 6 months after receiving a six-week TMS therapy regimen. The study authors concluded that, “These initial data suggest that the therapeutic effects of TMS are durable and that TMS may be successfully used as an intermittent rescue strategy to preclude impending relapse.”
Another TMS study involved a metadata review of several TMS trials and published a summary of each. In conclusion, the authors state, “Daily left prefrontal TMS has substantial evidence of efficacy and safety for treating the acute phase of depression in patients who are treatment resistant or intolerant. Following the clinical recommendations in this document should result in continued safe and effective use of this exciting new treatment modality.”
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
Author Bio: Suzanne Jessee, Founder and CEO of Anew Era TMS is a TMS industry expert spreading awareness on the TMS Therapy Success Rate for the treatment of depression. Suzanne is a master’s level clinical therapist and addictions counselor with nearly two decades experience in chemical dependency patient care. Her passion for improving patient’s mental health and her expertise in TMS technology and business make her a leader in the TMS patient services industry. In addition, Suzanne is a published author, PBS show host, educator, and facilitator.
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