Depression is one of the most prevalent mental health disorders worldwide, affecting over 280 million people around the world. A mental health disorder includes any disabilities or conditions that affect your brain. As your brain is your body’s control center, when damaged, it can negatively affect a lot of things, such as your sensation, memory and even your personality. 

Mental illnesses are health conditions involving changes in emotion, thinking and/or behavior. Mental illnesses are often associated with distress and/or problems functioning in social, work or family activities. Nearly one in five U.S. adults, or 19 percent, experience some form of mental illness. It is important to remember that mental illness is absolutely nothing to be ashamed of as it is a medical problem, just like heart disease or diabetes. It is also important to note how prevalent mental illnesses are as about 4 percent of U.S. adults have a serious mental illness. 

Globally, it is estimated that five percent of adults suffer from depression. Characterized as a mood disorder, depression is often experienced as having persistent feelings of sadness and disinterest in daily activities. When left untreated, depression can cause severe health complications that have long-lasting impacts on both your physical and emotional health. Depression can interfere with or limit one’s ability to carry out major life activities, and it can impact your relationships and work life, causing the person affected to suffer greatly.  Some symptoms of depression may include:

• Feeling restlessness
• Lack of energy
• Changes in appetite (causing weight loss or gain)
• Feeling sad
• Feelings of anxiousness or guilt
• Loss of interest or pleasure in activities once enjoyed
• Difficulty sleeping or sleeping too much
• Thoughts of death or suicide
  

There is effective treatment for mild, moderate, and severe depression. Antidepressant medications and psychotherapy are the first option of treatment prescribed in patients suffering from depression. However, these treatments do not work for all patients. 

Transcranial magnetic stimulation, or TMS, is a treatment option for depression that is becoming more common amongst patients due to the successful outcomes of the treatment over the past decade. This treatment is a brain stimulation therapy that is non-invasive and shows promising potential for many patients. If you or a loved one suffer from depression that isn’t showing any signs of improvement from medication or psychotherapy, it may be worth considering TMS. 

What is Brain Stimulation Therapy?

Brain stimulation therapies are potential treatments used to relieve symptoms of certain mental or neuropsychiatric disorders when medication and therapy are unsuccessful in doing so. Brain stimulation therapies involve activating or inhibiting the brain directly with electricity, magnets, or implants. The electricity can be induced to the patient directly by electrodes being implanted in the brain, or noninvasively by electrodes being placed on the scalp, or by using magnetic fields and applying them to the head. 

Although brain stimulation therapies are used much less in comparison to medication, they have been quite successful in improving treatment outcomes for patients suffering from mental disorders that do not respond to other treatments. 

Specifically, the brain stimulation therapy, transcranial magnetic stimulation (TMS) has shown very successful outcomes in patients suffering from depression. 

What is Transcranial Magnetic Stimulation Therapy (TMS)?

Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. This treatment for depression involves delivering repetitive magnetic pulses, so it's called repetitive TMS or rTMS.

TMS has shown great promise in treating the depressed patient, but is also being studied for possible treatment of other conditions such as Parkinson's disease, schizophrenia, attention deficit-hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). 

How does it work?

During an rTMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved in mood control and depression. It's thought to activate regions of the brain that have decreased activity in depression.

Though the biology of why rTMS works isn't completely understood, the stimulation appears to impact how the brain is working, which in turn seems to ease depression symptoms and improve overall mood.

With the recent nature of this therapy’s development, there are different ways to perform the procedure, and techniques may change as experts learn more about the most effective ways to perform treatments.

What can the patient expect during the transcranial magnetic stimulation (TMS) procedure?

Transcranial magnetic stimulation (TMS) procedure is usually performed while the patient is awake and in a chair, seated. The doctor places a device with an electromagnetic coil near the patient’s left prefrontal cortex (or the front side of the scalp). The left prefrontal cortex is an area where a lack of functional and metabolic activity is found in a depressed patient. 

The device is held in place for about 40 minutes as a steady electric current is passed through this part of the brain, causing neurons, or nerve cells in the brain to send electrical impulses. These impulses will then trigger a chemical reaction that will over time help lift the patient’s mood. 

As this type of pulse usually does not reach any farther than two inches into the brain, the doctor is able to specifically target the portion of the brain to treat. This precision also lessens the chance for side effects that may occur with other procedures. 

Doctors usually recommend 30 sessions of TMS therapy, given five times per week for up to six weeks. 

What are possible side effects of transcranial magnetic stimulation (TMS) treatment?

Doctors report that there are minimal side effects for patients being treated with TMS therapy. Side effects may include headaches, scalp discomfort, or brief lightheadedness. Some patients may feel a tingling sensation around the face, cheek or scalp during the procedure. Although rare, it is possible that the procedure could cause a seizure.

Conclusion 

The introduction of transcranial magnetic stimulation (TMS) in 1985 has rekindled interest in the use of brain stimulation methods for the treatment of psychiatric disorders. TMS enables the clinician to focally stimulate specific areas of the brain noninvasively and painlessly. The efficacy of TMS in the treatment of depression has been extensively studied, allowing for TMS to be considered to be the gold standard therapy for pharmacologically resistant depression due to the successful outcomes seen in patients. 

Psychiatric populations perceive the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) for mental health conditions to be beneficial, safe, and no more dangerous than conventional therapy options like medication.

Although this treatment shows promising potential for many patients due to the successful outcomes of the treatment over recent years, further study is much needed in order to establish efficacy, safety, economics, and education revolving around rTMS due to the recentness of the development of this treatment.