Depression is considered one of the more common—and persistent—mental health disorders. The symptoms associated with this condition are diverse and go beyond the more commonly attributed feeling of sadness. Among the available depression treatment options is transcranial magnetic stimulation (TMS), a non-invasive medical device therapy that has been gaining professional recognition and popularity. So how does TMS treatment work? What makes TMS effective in treating depression? And how does TMS affect symptoms? Read on to find out.
The American Psychological Association (APA) defines depression, or major depressive disorder (MDD), as a mood disorder marked by a decrease in well-being which is linked to a reduction of positive emotion (more on that in a moment). Depression has been shown to affect roughly about one in 15 adults, or 6.7% of the adult population. 17.3 million adults (or 7.1%) have experienced one or more depressive episodes during their lifetime.
Reflecting its deficit of beneficial attributes, depression is characterized by a sense of lacking that can manifest in a number of life arenas:
Major depressive disorder has been linked to several possible contributing factors. Among them are:
Major depressive disorder is considered the central depressive disorder included in the APA’s Diagnostic and Statistical Manual’s fifth edition (DSM-V). An MDD diagnosis can be considered after at least two weeks of symptomatology. Furthermore, MDD is not usually associated with instances of depression that continue beyond one year in children and two years in adults.
The DSM-V does, however, recognize several other depressive disorders beyond MDD. The common thread among them is the centrality of sadness, emptiness, or irritability to the individual’s mood, together with physical and cognitive changes that significantly affect their ability to function. They differ from one another in terms of duration, timing, or presumed causation.
In addition to MDD, depressive categories that describe instances of substance abuse and cases that do not meet the official requirements for any specific depressive disorder, the depressive disorders family includes:
Despite certain common traits, MDD is distinct from several other adverse states. Three mental health issues that are commonly confused with depression are sadness, grief, and bipolar disorders.
Different states and countries define which mental health professionals are allowed to diagnose major depressive disorder according to their own parameters. However, a general consensus is that psychiatrists possess the knowhow and professional status to legally be permitted to diagnose depression. Many countries also list licensed psychologists among those allowed to diagnose this and other mental health conditions. Such professionals often offer depression treatments, as well as the possibility of a diagnosis.
Following an initial diagnosis of depression, patients often seek out mental health professionals who can offer them a viable treatment option for their condition. In addition to first-line treatments such as psychopharmacology and psychodynamic therapy, the more recently developed transcranial magnetic stimulation (TMS), has been gaining recognition among mental health professionals.
Transcranial magnetic stimulation was first developed in 1985 as a medical device treatment option for various mental health conditions. The treatment utilizes electromagnetic fields to safely and effectively regulate the neural activity of brain structures found to be associated with the condition targeted. With depression, one of these structures is the bilateral prefrontal cortex.
TMS is an FDA-cleared, non-invasive treatment, and as such does not require anesthesia, an extended recovery period, or a chaperon to and from each session. It generally does not cause any long-lasting or significant side effects, with the most common one being a passing headache during initial sessions.
Due to its non-invasive nature, TMS can be incorporated with other treatments for depression, including medication, to increase their overall efficacy.
There are currently two kinds of TMS treatments available on the market: traditional TMS and Deep TMS:
Traditional TMS has been FDA-cleared since 2008 to treat depression. It uses a handheld device that focuses on a relatively small area of the brain. As a result, traditional TMS can encounter targeting issues, with treatment sessions sometimes missing the sought-after structure. To avoid this, some traditional TMS providers incorporate neuronavigational equipment into treatment sessions, to better identify and reach the targeted area.
Deep TMS has been FDA-cleared to treat depression since 2013. It utilizes its own patented H-Coil technology, which is held inside a cushioned helmet. The helmet is fitted onto the patient’s head, allowing the projected electromagnetic pulses to simultaneously reach wider areas of the brain. At the same time these pulses are directly regulating the neural activity of brain structures located within the brain’s deeper regions. This in turn helps it avoid the targeting issues raised with traditional TMS, while maintaining a high safety standard that does not induce significant side effects.
TMS has been shown to specifically alleviate symptoms of depression. The benefits of this treatment are expressed in two central ways:
Symptom Severity: The overwhelming and debilitating severity of major depression symptoms have repeatedly been shown to decrease following TMS treatment.
Symptom Duration: The pervasive nature of depressive symptoms, which can gradually erode the individual’s sense of well-being, has also been shown to be mitigated due to TMS treatment.
In addition to treating depression, TMS has been recognized for its ability to offer symptom relief of other mental health and neurological conditions. While traditional TMS has been FDA-cleared to treat migraine headaches and obsessive-compulsive disorder (OCD), Deep TMS has been FDA-cleared to treat OCD and smoking cessation. Deep TMS has additionally been CE-marked in Europe to treat a number of other conditions.