TMS: an alternative solution to depression

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Major depression is one of the most common mental disorders in the United States. Unfortunately, medicine only can help half the time. But some people are getting relief in an unorthodox way.

Kathryn Brokaw said, "I've been depressed all my life."

Simple for you, but smiling has been almost impossible for Kathryn.

"Crying a lot, suicide attempts, hospitalizations, medication after medication after medication after medication that didn't seem to help," she said.

Officially called transcranial magnetic stimulation, or TMS, is doing for Kathryn what nothing else has.

"It's the best thing that's happened since sliced bread," Kathryn said.

TMS turns magnetic waves into mild electrical current, stimulating inactive areas in the brains of people with depression.

Professor and Chair of Psychiatry at the University of South Florida, Glenn Currier, MD, MPH, said, "So instead of applying electricity to the whole brain, or whole body, we can target it to the area that controls mood."

Currier says TMS is an option for people who aren't helped by medication. He says TMS works for around seven out of 10 patients. Some may relapse, but…

"It can be quite life changing actually," Currier said.

It's not a one-time solution. TMS is usually administered about 40 minutes a day, five days a week for six weeks. But Doctor Currier says it's one of the safest and most well-tolerated treatments for depression.

"If it gets to the point where you can't function and it's really getting in the way of your day to day life, we tell people you do not need to walk the world in that state, there are alternatives to that."

And for Kathryn, that alternative is TMS.

"I can enjoy things and I can actually say that I am happy," she said.

Doctor Currier says some patients have to take antidepressants or do another TMS treatment within the first year, but many don't need any more treatment. TMS is also being studied to treat OCD, migraines and post-traumatic stress for veterans.

REPORT #2334

BACKGROUND: Brain stimulation therapies may be used to treat certain mental disorders. Many involve activating or restraining the brain directly with electricity, either through electrodes placed on the scalp, electrodes implanted into the brain, or magnetic fields applied to the head. Brain stimulation therapies have a long history of use, but many newer stimulation therapies are rising as experimental methods with promising futures. One type of brain stimulation therapy, electroconvulsive therapy (ECT) was developed in 1938 and was found effective for many mental illnesses, particularly clinical depression. Due to its connotation and the development of other treatments, use of ECT declined. However, there are now improved treatment delivery methods with improved safety, comfort, and anesthesia management. Other methods have recently been developed such as vagus nerve stimulation, repetitive transcranial magnetic stimulation, magnetic seizure therapy, and deep brain stimulation. Some of these newer methods allow for specific sites in the brain to be stimulated, unlike ECT. These methods are often seen as last resorts. Many doctors will not recommend them unless a patient has been unresponsive to other treatments. Some mental illnesses respond better to certain types of brain stimulation therapies than others.

TYPICAL TREATMENT: For most mental disorders, treatments usually include psychotherapy, followed by medication, and then more intense treatment options are considered. Choosing the right combination of treatments is based on someone's specific personal and medical needs and is based on what his or her doctor believes will be most beneficial. In many cases, psychotherapy alone is the best treatment option; however, a combination of medication and psychotherapy is commonly prescribed. Other therapies may include light therapy, expressive or creative arts therapy, animal-assisted therapy, and play therapy for children.

THE FUTURE OF MENTAL HEALTH TREATMENT: New technology such as mobile phones and tablets are creating new ways to access help, monitor progress, and increase understanding of mental health. Anyone may quickly contact a crisis center, or connect to a peer counselor or health care professional. Due to the possibilities, there are now thousands of mental health apps available for mobile devices, leading to convenient, anonymous, and affordable mental wellbeing support. Some apps use the device's built-in sensors to collect information on a user's behavior, so that when a change is detected, it may signal for help before any crisis. They may also collect data about mental health to provide to researchers. Other apps may simply be used for self-management, coping or thinking skill-training and extra illness support.