For many people who battle episodes of depression, transcranial magnetic stimulation (TMS) is a modern-day medical miracle.
When antidepressant drugs and other therapies have proven to be ineffective (often complicating the condition with intolerable side effects), TMS has offered relief.
A lot of the credit for TMS, as it exists today, belongs to Anthony Barker and his colleagues at the Royal Hallamshire Hospital in Sheffield, England. That group introduced electromagnets – as opposed to direct currents applied to the scalp – into the procedure. This greatly reduced the discomfort experienced by the patient, and made the present-day version of the treatment viable.
Are you a candidate for TMS?
If you have an implanted medical device (like a pacemaker) or a history of epilepsy, you’ll need to explore other options. Also, pregnant women, children, and elderly people might not be eligible.
Transcranial magnetic stimulation is generally not a doctor’s first choice. In fact, the average TMS patient has tried 2.5 other therapies (from antidepressants to psychotherapy) before undergoing TMS.
But if you have had no success with other methods, or have had enough of drug therapies, you may be a prime candidate. In the end, though, it’s your physician who is in the best position to know for sure.
What can you expect in a TMS treatment?
If you decide to undergo a TMS session you’ll be seated the entire time, and fully awake. You’ll be able to talk to the doctor during the treatment. Before you begin, you’ll remove any hair clips, earrings, and glasses.
You may want to use earplugs or listen to music during treatment, which generally lasts about 35 minutes. Having said that, durations can vary depending on your condition and the discretion of your doctor to achieve the best results.
The doctor may begin by performing a test to identify your motor threshold – that’s the amount of magnetic field strength that results in a movement of your right thumb. This test pinpoints the level of the magnetic field that will be used in your treatment.
As you begin, your doctor will place an electromagnetic coil against your forehead near the area of your brain that regulates mood. That coil passes magnetic pulses to a targeted part of the brain, inducing an electrical current into specific nerve cells.
(Believe it or not – and you really should believe it – you won’t feel any pain, despite how frightening the above paragraph might sound.)
Your doctor will deliver magnetic stimulation at set intervals throughout the session. These will feel like a tapping on your scalp. If you find this tapping uncomfortable, your physician may be able to make adjustments to reduce those effects.
You might experience a headache or discomfort at the site of stimulation. That’s a common side effect which usually subsides with additional sessions. However, if those symptoms persist, your doctor can temporarily reduce the strength of the magnetic field pulses to make treatment more comfortable.
Most TMS patients see noticeable results by the fourth week of treatment, but as with any type of therapy it might take shorter or longer periods of time for individuals to see improvement. In any case, it’s a good idea to discuss your depression and treatment symptoms with your physician throughout the treatment course.
Finally, the odd truth is that although the successful results of TMS are well documented, the reasons for the marked improvement in people with depression remain a medical mystery. Scientists believe the magnetic stimulation can reset brain wave frequencies to normal levels and improve symptoms of depression, but so far the reasons for how or why that happens remain elusive.
Then again, if TMS reduces or does away with your symptoms of depression, you probably won’t care very much about how it works. Only that it does.
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Jack wrote for HealthCentral as an editor on vision care, skin care, and mental health.