According to the World Health Organization, more than 350 million people around the world suffer from depression. This figure also includes the elderly who have depression at a rate of one in five, or 20 percent. Annually, an estimated one million people take their lives when their depression becomes too much to bear. In the United States, about 28% to 33% of people suffering from this mental condition experience improvement after an initial antidepressant treatment. However, a negative stigma attached to therapy in the US means some may never get the help they need.
Over the past few decades, the medical community has developed several methods in the fight against depression. Some of these strategies include:
- Antidepressant drugs
- Augmentation with patients taking second antidepressant drugs
- Mood stabilizers
- Second-generation antipsychotics
In 2008, the US Food and Drug Administration approved a new depression treatment method called Transcranial Magnetic Stimulation (TMS). Today, doctors recommend using what are called ‘helmet treatments’ for those who suffer from depression.
TMS helmets send out painless electromagnetic pulses toward the scalp and into the brain. The rapid sequence of pulses or repetitive TMS (rTMS) does the following:
- Stimulates parts of the brain with decreased activity
- Improves patient’s overall mood and behavior
- Decreases symptoms of depressions
This technique has shown great promise as an alternative to antidepressants in treating depression. Still, doctors seldom recommend this new technique as not everyone can undergo the treatment. The machine operates like MRI and it greatly reacts to any metallic origin. Additionally,rTMS can do irreversible harm to people with:
- Bullet fragments near head
- Deep brain stimulators
- Electrodes used to monitor brain activity
- Facial tattoos with metallic ink
- Metallic implants
- Other metal device or object implanted in the body particularly in the near the head
During the Procedure
In rTMS, patients are required to wear a helmet filled with electromagnetic coils. These coils send out magnetic pulses to stimulate specific regions of the brain. This causes electrical currents that rouse activity in the dormant area of the brain, which are associated with depression. Underactive neurons are put into use, and during the treatment process, resets brain chemistry to enhance mood behaviors.
As ECT Replacement
Many people make direct comparisons between TMS and electroconvulsive therapy (ECT), but doctors say these two treatments are notably different from each other. Since the 1940s, the medical community has used ECT to treat severe depression, but it requires sedation of patients before strapping them to a stretcher. ECT induces seizures to release neurotransmitters whereas TMS stimulates nerve cells to make them more active. For doctors, TMS acts as a mild and more humane alternative compared to ECT.
Is rTMS safe for Treating Depression?
Over 60 clinical studies conducted worldwide have found rTMS to be a safe and effective method of treating depression. The studies also found out that:
- rTMS can lower the symptoms of depression
- It’s a painless treatment and doesn’t require sedation
- Patients can immediately resume daily activity after each session
- Most patients do not experience serious side effects
However, patients have reported experiencing some temporary minor side effects, including:
- irritation of the scalp
- mild to moderate headache
- Scalp soreness at the site of stimulation
- Spasms or twitching of facial muscles
Because the method is new, additional studies may be needed to determine all of the benefits from TMS as well as to understand the long-term effects of rTMS. For information about the role of TMS in substance abuse, read our report on the topic.