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TMS: Another Hope Against Anxiety Disorders

It’s perfectly normal  to feel anxious, especially during times of stress or tension, such as the brief moment when your boss contemplates just after you asked for a raise. Anxiety is our brain’s way of preparing itself for danger. Not exactly to combat it, but to ensure that if we ever fight, or flee, our body is ready to act as best as it can.

 

When a person starts to feel anxiety outside where they should, problems start to arise. When anxiety occurs outside normal circumstances, and happens for days, over a course of more than 6 months, it’s classified as a disorder. The medical disorder is known as Generalized Anxiety Disorder, GAD for short.

 

It’s generalized because it has a number of causes, some of them unique to the person. It causes restlessness, fatigue, irritability, sleeping issues, and concentration problems, all of which make a significant dent in a person’s quality of life. What’s worse is that GAD is often accompanied, or causes other mental complications like depression.

Treatment via drug therapy is the most common solution, with counseling or Cognitive-Behavioral Therapy being the go-to for long-term treatment and recession prevention.

One downside to the otherwise effective ways to treat GAD is the high costs and the possible adverse effects due to the medication. If a person has good health insurance, that can be mitigated somehow, but not everyone has it.

Transcranial Magnetic Stimulation: A New Hope

As the procedure is called, Transcranial Magnetic Stimulation (TMS for short) is a relatively novel way to treat anxiety disorders. TMS was already in use decades ago in order to map out brain function in stroke patients. They figured that since our brain cells respond to weak pulses of electromagnetism, it could be used to stimulate brain cells to restore their function.

The idea is simple. An electromagnet is placed on top of your head and a machine regulates the electricity flowing to the magnet, creating minute pulses of electromagnetism. The targeted area of the brain is affected by the waves and they activate or at least react to the stimulation. Like physical therapy on a newly recovered leg or arm, the procedure will “train” and “massage” the target area of the brain to work back to normal. These procedures normally last about an hour and are done daily for 4-6 weeks.

 

Magnetic Pulses

The magnetic pulses are set to a low frequency of 1 Hz. Think of this as music. Lower Hz is slow, calm music while higher ones are the intense, fast beats. The low “hum” causes an inhibitory effect on the brain, calming activity as if listening to calming soul music. The pulsing is then aimed at the area of the brain where the cause of GAD is identified, such as the left prefrontal cortex. (The area above your left eye.)

The inhibitory effects showed remarkable results in reducing anxiety. Clinical trials with different experiments show consistent positive results, especially with continued TMS therapy. Currently, the only way to get TMS treatment for GAD is participating in clinical trials, but with solid evidence of improvement on patients, it’s only a matter of time before it’s approved as a treatment method.

 

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.

 

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