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Transcranial Magnetic Stimulation for Anxiety

Anxiety is a condition that has many forms, including being aggravated by various types of depression. Thus, anxiety is a complex condition that may debilitate a person who has it. It is also important to remember that anxiety varies in levels from hour to hour. It also varies in degrees from day to day. And as far as being responsive to environmental influences is concerned, anxiety can also lead to panic attacks and improper social behavior.

One treatment used for anxiety is prescription medications. Your doctor might prescribe a particular medication to treat anxiety. Other medications may also be prescribed to combat the side effects of the main drug used to treat anxiety. Because of the side effects experienced by people taking anti-anxiety medications, a variety of treatments have been developed as an alternative to or additional support for medication.

One such treatment is Transcranial Magnetic Stimulation (TMS) therapy. TMS can be given to patients who don’t respond to counselling and prescription medications. They can also be given if patients experience extreme side effects with prescribed drugs. TMS has many forms and the responses from patients with anxiety vary. It actually is dependent on various factors:

 

1. Type Of Magnetic Coil

Each TMS machine type has a different magnetic coil. For example, Neurostar’s coil is a figure-8 coil. This type of coil stimulates a relatively focused area of the brain. On the other hand, the Brainsway device has a coil that stimulates a wider area because of its H-shape form.

 

2. Stimulation Location

Certain locations of the brain are stimulated based on the illness being treated. For example, clinical trials stimulate the right dorsolateral prefrontal cortex for anxiety. On the other hand, the orbitofrontal cortex is stimulated for obsessive compulsive disorder.

 

3. Stimulation Frequency

Clinical trials of TMS usually deliver a rapid stimulation of cortex at the frequency level of 10Hz. However, with anxiety, 1 Hz is used. This is because 1 Hz is known to induce inhibitory reactions on cortical activity. On the other hand, 10 Hz is known to have excitatory effects.

Studies have also been conducted on the use of TMS for PTSD, Panic Disorder, and Generalized Anxiety Disorder. For example, one controlled trial showed results that the stimulation of the left dorsolateral prefrontal cortex at 10 Hz is very efficient for core PTSD.

In another study, they have found symptom reduction for those who have panic disorders. In this study, a 1 Hz treatment was used to stimulate the right dorsolateral prefrontal cortex. Remission of patients was also present in another study. This used stimulation of the right dorsolateral prefrontal cortex at 1 Hz. Note: The patients who underwent this study have generalized anxiety disorder.    

   

In Conclusion:

Anxiety can be a difficult condition to deal with, especially since it so often comes side by side with depression. People with extreme anxiety disorders can have an incredibly difficult time trying to live an “everyday” life. The good thing is studies have shown promising results regarding TMS for anxiety. If you have a loved one who has this condition, you can talk to your doctor about undergoing TMS.

It can be an alternative or a supplement to your loved ones’ current therapy sessions and could potentially lead to longer periods without anxiety attacks. To learn more about TMS treatment for anxiety, give us a call Monday through Friday from 9am to 5pm.

 

What is Anxiety?

Anxiety, or Generalized Anxiety Disorder (GAD), is a severe mental illness characterized by excessive and uncontrollable worry. The condition occurs on most days of the week and lasts for at least 6 months. GAD affects about 6.8 million adult Americans or 3.1% of the US population.  The exact cause for GAD is not fully identified but genetics, brain chemistry, and environmental factors seem to trigger the disorder.

The Anxiety and Depression Association of America describe anxiety in adults when they experience at least three of the following symptoms:

  • Restlessness
  • Muscle tension
  • Fatigue
  • Irritability
  • Difficulty in sleeping or staying asleep
  • Problems concentrating

Other symptoms may include stomach upsets, nausea, or diarrhea. In most cases, GAD can overlap other mental disorders with depression being the most common of all. This makes it even harder in detecting and treating anxiety.

Today, treatments like medications and therapy are often prescribed to people suffering from anxiety. Even with these treatments, though, as many as 50% of patients fail to improve.

 

The Neurobiology Behind GAD

GAD affects the frontal and limbic structures of the brain. It can also disturb some of the connectivity between these regions. The frontal region of the brain is commonly associated with anxiety and has become the basis for using TMS therapy in treating anxiety.

TMS therapy can give hope to patients who can’t tolerate antidepressant medications or who’ve tried therapy several times but failed to see improvement.

 

Treating Anxiety with rTMS Therapy

TMS therapy sends out electromagnetic pulses near the frontal region of the head to stimulate nerve cells in the patient’s brain. This region of the brain controls mood behavior. When magnetically pulsed in quick succession, it’s called rTMS or repetitive TMS. rTMS is quite simple and can be administered in a doctor’s office. As a non-invasive method, it does not require traumatic procedures like sedation or anesthesia. It is also non-systemic which means there are no fears of anxiolytic medication side effects.

Various types of research show TMS therapy can help people suffering from anxiety disorder. The US Food and Drug Administration first approved TMS therapy in 2008 for treating major depressive disorder. Two years after its approval, researchers at the University of California conducted a small-open label study of 10 patients. The UCLA discovered that TMS therapy may also be used as an effective treatment for at least some anxiety disorders. The results from that study shows a favorable 60% response rate for people suffering from GAD. This makes TMS therapy at least twice as effective as conventional anxiety treatments.

 

TMS therapy benefits

TMS therapy can still benefit people who have already tried several other anxiety treatments to no benefit. Even for patients who haven’t responded well to their previous treatments can improve through TMS therapy. Some of the benefits include:

  • Greater control of anxiety problems
  • Decrease in the emotional aspects of depression
  • No major bodily changes
  • Fewer muscle pains
  • Fatigue prevention

Most studies shows that TMS therapy will often result in the overall mood improvement of patients.  People diagnosed with an anxiety disorder can now live in worry-free and productive lives with this treatment method and are recommended to look further into their options.

 

Defining Anxiety

Anxiety or Generalized Anxiety Disorder (GAD) in medical terms is a chronic mental illness associated with excessive and uncontrollable worry. The condition occurs on most days of the week lasting for at least 6 months.

Some of the symptoms of GAD include:

  •    restlessness
  •    muscle tension
  •    fatigue
  •    irritability
  •    difficulty sleeping
  •    problems concentration

 

In most cases GAD coexists with other mental disorders with depression being the most common of all. This makes it even harder to detect and treat the anxiety.

People suffering from anxiety spend an inordinate amount of time worrying. Patients often describe the feeling of having considerable worry right after they wake up in the morning. The feeling of uneasiness will continue throughout the day, even without anything in particular to be worried about.

GAD affects the person in a numerous substantial ways, which includes:

  •    anxiety is often associated with a poor health condition like obesity
  •    it prevents the person in enjoying simple pleasures in life
  •    at its peak, anxiety can directly lead to expensive health care services

 

Conventional Anxiety Treatment

Some of the existing treatments for anxiety include:

  •    medications – usually consisting of anxiolytics
  •    medication combined with psychotherapy
  •    counseling and potentially  cognitive-behavioral therapy

 

However, even with these available treatments, as many as 50% of patients fail to improve their mental health conditions. These patients continue to suffer from the devastating symptoms of anxiety.

 

The Neurobiology of GAD

GAD affects the frontal and limbic structures of the brain. It can also disturb some connectivity between these regions. Even though several studies show different findings, the front of the brain is commonly associated with anxiety. Experts consider these findings as the basis for using TMS therapy in treating this condition. According to recent studies, repetitive Transcranial Magnetic Stimulation (rTMS) is believed to be a promising treatment for anxiety disorder.

 

Treating Anxiety with rTMS therapy

TMS therapy sends out electromagnetic pulses near the front of the head to stimulate the nerve cells. This region of the brain controls mood behavior. When the pulses are sent out in quick succession, it then called rTMS or repetitive TMS.   rTMS is a fairly simple procedure and can be administered in a doctor’s office. As a non-invasive method, it does not require traumatic procedures like sedation or anesthesia.

The full extent of rTMS effects are not yet known but it has been shown to effectively decrease depression symptoms. TMS often resulted in the overall mood improvement of patients.

Even though considered an effective alternative treatment, it also has its limitations. These include:

  •    Mental disorders that show signs of detachment from reality
  •    Patients with several years of depression
  •    Patient had any Electroconvulsive therapy (ECT) in the past and failed to show improvement

 

Findings of the study

The US Food and Drug Administration first approved TMS therapy in 2008 for treating major depressive disorder. Two years after its approval, researchers at the University of California conducted a small-open label study of 10 patients. The UCLA lab discovered that TMS therapy may also be used as an effective treatment for anxiety disorder. The results from the study show a favorable outcome of 60% response rate for people suffering from GAD.

For more information about TMS therapy to treat anxiety, please feel free to contact us anytime.

 

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TMS of the Palm Beaches

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