What is TMS therapy and how can it help with depression?
Depression affects millions of people worldwide. When you're struggling with treatment-resistant depression, it's natural to feel discouraged and wonder if there are other options available. One innovative treatment that's gaining recognition is Transcranial Magnetic Stimulation (TMS) therapy.
What is TMS therapy?
Transcranial Magnetic Stimulation (TMS) is a non-invasive medical procedure that uses magnetic fields to stimulate nerve cells in the brain. The treatment specifically targets the prefrontal cortex, an area of the brain that's often underactive in people experiencing depression. By delivering focused magnetic pulses to this region, TMS aims to restore normal brain activity and improve mood-related symptoms.
Your brain relies on electrical signals to communicate between different regions. When you're experiencing depression, certain areas of the brain, particularly the prefrontal cortex, may show reduced activity. This decreased activity can contribute to the symptoms you're experiencing, such as persistent sadness, difficulty concentrating, and loss of interest in activities you once enjoyed.
TMS therapy works by delivering magnetic pulses that penetrate approximately 2-3 centimetres into the brain tissue. These pulses stimulate neurons in the targeted area, encouraging them to become more active and form new connections. Over time, this increased activity can help restore more balanced brain function and alleviate depressive symptoms.
When is TMS prescribed?
TMS therapy isn't typically a first-line treatment for depression. Instead, it's usually considered when other treatments haven't provided adequate relief.
The most common reason TMS therapy is prescribed is for treatment-resistant depression. This term describes depression that doesn't respond adequately to standard treatments, such as antidepressant medications or psychotherapy. If you've tried at least two different antidepressant medications without experiencing significant improvement, your doctor might consider you to have treatment-resistant depression.
It's important to understand that having treatment-resistant depression doesn't mean your condition is hopeless. Rather, it indicates that your brain may benefit from a different approach to treatment.
Severity of depression required
TMS therapy is typically reserved for moderate to severe depression. Your healthcare provider will assess the severity of your symptoms using standardised depression rating scales. These assessments help determine whether TMS therapy is appropriate for your specific situation.
The severity of your depression is evaluated based on factors such as:
The duration and persistence of your symptoms
How significantly depression impacts your daily functioning
Your ability to work, maintain relationships, and engage in self-care
The presence of suicidal thoughts or behaviours
Beyond depression severity and treatment resistance, several other factors influence whether TMS therapy might be suitable for you. Your healthcare provider will consider your overall health, any medications you're taking, and your personal treatment goals.
Certain medical conditions may affect your eligibility for TMS therapy. Your doctor needs to conduct a thorough medical evaluation to ensure TMS therapy is appropriate for your specific circumstances.
Understanding the risks and side effects of TMS
Like any medical treatment, TMS therapy comes with potential risks and side effects.
The most frequently reported side effects of TMS therapy are generally mild and tend to decrease as your body adjusts to the treatment. These may include:
Scalp discomfort or pain at the treatment site is the most common side effect. This sensation typically feels like a tapping or knocking feeling on your scalp during the procedure. Most people find this discomfort manageable and notice it decreases over the course of treatment.
Headaches may occur, particularly after your first few sessions. These headaches are usually mild to moderate and often respond well to over-the-counter pain medications. Many people find that headaches become less frequent as treatment progresses.
Facial muscle twitching or spasms may occur during the magnetic pulses. This is a normal response to the magnetic stimulation and typically stops immediately when the pulse ends.
While uncommon, TMS therapy does carry some more serious potential risks:
Seizures are the most serious risk associated with TMS therapy, occurring in less than 0.1% of treatments. Your healthcare provider should carefully screen you for seizure risk factors before beginning treatment.
Hearing problems could potentially occur if proper ear protection isn't used during treatment. The magnetic pulses can be quite loud, so you'll always wear earplugs or headphones during your sessions.
Mania or hypomania may be triggered in people with bipolar disorder. This is why it's crucial to have a thorough psychiatric evaluation before beginning TMS therapy.
Long-term Considerations
Research on the long-term effects of TMS therapy is still evolving. It's important to maintain regular follow-up appointments with your healthcare provider to monitor your progress and address any concerns that may arise.
Alternative approaches to treating depression
Psychotherapy: The Foundation of Mental Health Treatment
Psychotherapy, also known as talk therapy, remains one of the most effective treatments for depression. Different types of therapy can help you understand your thoughts, feelings, and behaviours, while providing you with practical tools to manage your symptoms.
Psychodynamic therapy explores how your past experiences and unconscious thoughts influence your current emotional state. This deeper understanding can help you process unresolved issues and develop healthier relationship patterns.
Interpersonal therapy concentrates on improving your relationships and social functioning. Since depression often affects how you connect with others, this approach can be particularly beneficial for relationship-related concerns.
Working with a skilled therapist, you can explore your unique experience and develop personalised strategies for healing and growth. Therapy provides a safe space where you can challenge your thoughts, utilise your critical thinking, and connect with all aspects of your being to understand what's not working and find ways of changing to have a better life.
The Gut-Brain connection: microbiome health
Emerging research has reveals connections between your gut health and mental wellbeing. Your gut microbiome, the trillions of bacteria living in your digestive system, plays a crucial role in producing neurotransmitters like serotonin, which directly affects your mood.
Dietary interventions can support both your gut health and mental wellbeing. A diet rich in whole foods, fermented foods, and prebiotic fibres can promote a healthy gut microbiome. Some people find that reducing inflammatory foods and incorporating omega-3 fatty acids can positively impact their mood.
Probiotics and prebiotics may help restore bacterial balance in your gut. While research is still developing, some studies suggest that certain probiotic strains might have mood-stabilising effects.
Lifestyle factors such as stress management, regular exercise, and adequate sleep also influence your gut microbiome. When thinking about what's happening in your life, you need to understand your patterns and all the parts that are playing a part in your life, so you can see what is happening rather than just recreating and re-enacting old patterns.
Integrative approaches
Many people find that combining different treatment approaches provides the most comprehensive support for their mental health. This might include:
Regular psychotherapy sessions alongside medical treatments
Mindfulness and meditation practices
Regular physical exercise
Nutritional support and gut health optimisation
Social support and community connections
Making informed treatment decisions
Choosing the right treatment approach for your depression is a deeply personal decision that should be made in collaboration with qualified healthcare professionals. Each person's experience with depression is unique, and what works for one person may not be the best choice for another.
Consider asking yourself these reflective questions:
What aspects of my depression are most challenging for me?
What are my treatment goals and expectations?
How do I feel about the potential risks and benefits of different approaches?
What support systems do I have in place?
How do different treatment options align with my values and lifestyle?
Remember that seeking help for depression is a sign of strength, not weakness. Whether you're considering TMS therapy, psychotherapy, or other treatment approaches, taking steps to address your mental health demonstrates courage and self-compassion.
Finding your path to healing
Depression can feel overwhelming, but you don't have to navigate this journey alone. TMS therapy represents one of many tools available to support your healing process. While it can be highly effective for treatment-resistant depression, it's most powerful when integrated into a comprehensive approach that addresses your unique needs and circumstances.
The key to successful depression treatment lies in finding the right combination of approaches that resonate with you. This might include TMS therapy, psychotherapy, lifestyle changes, and attention to your overall physical health. Remember that healing is not a linear process, and it's okay to adjust your treatment plan as you learn more about what works best for you.
If you're considering TMS therapy or exploring other treatment options, reach out to a qualified mental health professional who can provide personalised guidance. Your journey toward better mental health is valid and important, and there are compassionate professionals ready to support you every step of the way.