TMS Treatment for Depression: Newfound Hope and Healing

By Kendall Ruth

What do you do when you’re getting support for your depression, but talk therapy and traditional medications don’t seem to help? 

About 10-30% of people who experience depression don’t respond to these treatments alone – a condition called treatment-resistant depression. Don’t be discouraged by the name; there are alternative treatments that have consistent, successful outcomes. Transcranial magnetic stimulation (TMS) is an innovative, noninvasive, proven therapy for treatment-resistant depression. 

TMS has emerged as a groundbreaking option for individuals experiencing depression and its complex cousin, bipolar depression. Part of what makes it so innovative is how little is required of you other than sitting in a chair for a short time during each session (no surgery or medication is involved).

If you or a loved one is struggling with these conditions and has found little relief from conventional therapies, TMS offers newfound hope.

What is treatment-resistant depression?

Most people experiencing depression may find help with prescription medications, but these medications don’t always work. If your depression does not respond to multiple rounds of different antidepressants, then you may have what is considered treatment-resistant depression.

There can be numerous variables that cause treatment-resistant depression, and so far the data don’t show conclusively what causes the resistance. It could be genetics, misdiagnosis or a metabolic disorder, and Pathlight Mood & Anxiety Center (Pathlight) takes all these into consideration when looking at the best options for treatment.

Our evidence-based approach to healing takes into account the whole person, allowing us to individualize treatment across all platforms. This is why we utilize TMS for treatment-resistant depression as a noninvasive approach to relieving symptoms of depression.

TMS for treatment-resistant depression

Depression has a way of reducing the stimulus response in certain parts of your brain. Think of these areas of your brain as light bulbs that are supposed to shine at 100 watts but only get enough electricity for 40 watts.

“With depression these areas of the brain are very hyperactive, the neurons aren’t firing very well so the brain is not performing the way it should be,” explains Melissa Mott, MD, PhD (she/her/hers), psychiatrist at Pathlight.

When your brain doesn’t respond to other treatments, TMS can activate these parts of the brain through magnetic pulses. The results can increase the wattage, so to speak, bringing the “lights” back up to their intended brightness. TMS changes the electrical activity of neurons associated with depression. Dr. Mott explains the psychological experience of TMS as follows:

“With TMS, we are influencing the turnover of neurotransmitters (serotonin, dopamine, etc.) – similar to an antidepressant medication, but in a completely different way. And TMS does it in such a way that patients see effects a little faster.” 

TMS has over 20 years of research behind it and has been approved by the FDA since 2008. It is a noninvasive treatment that shows significant benefits for people experiencing treatment-resistant depression. Unlike electroconvulsive therapy (ECT) or deep brain stimulation (DBS) – which requires the use of implants and is highly invasive – TMS is an outpatient treatment with no implants or invasive procedures. 

TMS operates on the principle that noninvasive electromagnetic stimulation of specific brain regions is associated with mood regulation. By applying focused magnetic pulses to these areas, it encourages the brain to rebalance itself and alleviate depressive symptoms.

What does a TMS session look like?

In order to make sure the magnetic stimulation is focused on the best area for improvement, we start TMS by mapping for impact.

  • Specifically, we are looking for a spot located above the left temple known as the left dorsolateral prefrontal cortex. This is where your brain processes short-term memory and governs your emotional responses to others and the world around you. This area tends to be less active in people experiencing depression.
  • Finding this location actually starts with finding the area where your hand motor function operates. We actually find it by sending magnetic pulses that stimulate hand movement.
  • Once that is located, we get closer to the temple and then start measuring for intensity so you receive the most benefit.

Keep in mind, this whole process is taking place with a cap that holds a magnet in place, delivering pulses, with no significant pain or discomfort. There are no needles or incisions involved. Magnetic pulses do the work with the guidance of our clinicians.

TMS treatment for bipolar depression

TMS stands as a proven alternative treatment for depression as well as bipolar depression, offering renewed hope for individuals who have struggled to find relief through conventional therapies. The difference resides in how the brain functionally operates with bipolar depression over general depression. 

“The same depression protocol can be used for the treatment of bipolar depression,” explains Dr. Mott. She elaborates that clinicians keep an eye on symptoms to ensure TMS treatment isn’t triggering a manic episode in patients with bipolar depression.

TMS treatment for depression and anxiety

Depression and anxiety often go hand in hand, creating a complex web of emotional distress. TMS, originally developed to address depression, has shown promise in alleviating symptoms of anxiety too. The underlying neural circuits associated with depression and anxiety are similar, making TMS an attractive option.

Studies show TMS to be a positive treatment for anxiety, with long-term benefits for responsive individuals.

Side effects of TMS treatment for depression

In general, there are minimal side effects of TMS treatment for depression, mostly related to the actual session and not persisting for the long term. You may experience scalp discomfort from having the magnetic device on your head. The most common report from those receiving treatment is slight headaches. Other side effects are reported by less than 8% of those who have received treatment.

TMS and antidepressants

For those experiencing depression, the question may arise, “How does TMS work with antidepressants? Does this mean I no longer need to take my medications?” Dr. Mott explains,

“The advantage of TMS is that patients can receive treatments while staying on their medication regimens or continuing to adjust or change this regimen. In addition, some research shows that TMS can be used to improve the effectiveness of antidepressants. Any decision to come off antidepressants should be examined on a case-by-case basis and in close supervision with the individual’s outpatient psychiatrist.”

What are the effects of TMS on sleep?

Sleep is an important factor in managing depression and its effects. Disrupted sleep can perpetuate symptoms of anxiety and depression. The good news is patients who have received TMS for depression or anxiety have, for the most part, reported an improvement in their sleep. There are some instances of insomnia among those who receive treatment. However, the general consensus is that sleep improves as depression symptoms ease with treatment.

Finding healing

On your journey to recovery, it's essential to work closely with health care professionals who can guide you through the process, assess your individual needs and tailor TMS treatment accordingly. Pathlight’s mental health professionals will find what works and is best for each individual’s experience.

TMS offers a promising path toward a brighter, more balanced future for those experiencing depression or bipolar depression. Remember, you are not alone. Learn more about individualized treatment options for mood disorders and anxiety disorders, or call 877-825-8584 to connect with a mental health professional today. 

This piece was clinically reviewed by Maggie Moore, MA, LMFT.

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Written by

Kendall Ruth

Kendall Ruth is a writer and photographer in Colorado with years of experience translating the complex into more understandable words. If he is not writing or clicking shutters, he is running long…