Why would I want to pursue Transcranial Magnetic Stimulation?
by Adam O'Neill, PA-C
Sometimes the action that requires the most effort, the most resistance to overcome while facing depression and anxiety, is reaching out for help. Depression symptoms include feeling down, hopeless, and a loss of interest in doing things that were previously enjoyable. As mental health providers we understand this, which is why we work to minimize roadblocks to scheduling appointments or initiating therapies. Gaps or delays in these processes often cause patients to fall through the cracks. Some may not seek treatment again. Even if patients present for treatment, sometimes things do not go as we hope. Traditional depression treatments are not always successful in treating depression.
What can be incredibly frustrating for patients is that often and with little reason, trial depression and anxiety medications don't work as they should. Either the side effects are too great, the benefit is too small, or perhaps there isn’t any benefit at all. In a recent study, as many as 40% of patients on a medication trial for depression did not achieve relief. In another study, nearly 30% did not respond to any conventional treatments. It is in these cases that newer therapies have shown promise.
Repetitive Transcranial Magnetic Stimulation (rTMS), the use of electromagnetic pulses to non-invasively stimulate brain regions associated with depression, is a breakthrough therapy for patients who have not responded to other treatments, or for whom medications have had unfavorable side effects. The advent of this new alternative therapy, which may be performed in an outpatient setting, has signaled a new era of innovative technology in psychiatry practice.
For quite some time electroconvulsive therapy has served as a last-line therapy for patients with severe or treatment resistant depression. This effective therapy was not without its drawback. Patients must present to a facility equipped to perform ECT, traditionally a hospital. In addition patients must be put under anesthesia for the procedure. Even after the procedure it is not uncommon for patients to experience temporary memory loss after ECT. rTMS is different in ways that are truly exciting. Its side effect profile is minimal, reasons it would be contraindicated are low, and though it is performed more frequently it takes only a half an hour.
As a clinician, having rTMS as an available depression treatment in our arsenal has been an incredible blessing. When patients reach out, they display an incredible amount of strength to overcome all the barriers to seeking care. We offer a new effective alternative therapy as a source of light and hope in a dark situation.