TMS For Treatment-Resistant Depression

40% of males and 20% of females use talk therapy or antidepressants to deal with depression. However, there are five classes of antidepressants, and among those over seventy options, finding the right fit can take months, and each pill has the potential to both not work and come with unwanted side effects. Roughly one-third of all patients that seek treatment for depression find no relief with these more standard treatments. 

Understanding the signs and symptoms of depression will help you know if you or a loved one should be considering treatment options. And among those treatment options, it is crucial to understand that there are other methods out there that have been highly effective.

What Is Treatment-Resistant Depression?

Treatment-resistant depression is exactly what it sounds like. “If you’ve been treated for depression but your symptoms haven’t improved, you may have treatment-resistant depression.” Those who have not responded to two oral antidepressants are considered to have treatment-resistant depression. Psychotherapy or particular medicine may reduce depression symptoms for most people. Still, when standard treatment fails, warning signs return, and your quality of life is affected, you may be suffering from a more severe form of depression. Ketamine and transcranial magnetic stimulation (TMS) may help ease symptoms.

What Are The Symptoms?

Symptoms of treatment-resistant depression are the same as other kinds of depression, except they come back day after day, never responding to standard treatment like psychotherapy or antidepressant medications. Symptoms may include:

• You feel sad, tearful, empty, or hopeless
• You’re easily angered, irritated, or frustrated, even over trivial matters
• You’re not interested in something you used to enjoy doing
• You have trouble sleeping
• You’re fatigued and have low energy
• Significant changes in appetite and weight

What To Know About Treatment-Resistant Depression?

According to the U.S. National Institutes of Health, up to 30 percent of people diagnosed with major depression show little to no improvement following standard treatment. What else to know?

• A person’s age, gender, and health may boost the risk for treatment-resistant depression.
• The exact cause of depression isn’t fully understood, which may explain my certain antidepressants aren’t effective for everyone.
• There are recognized strategies for managing treatment-resistant depression.
• Research into treatment-resistant depression is ongoing.

What Causes Treatment-Resistant Depression?

• Studies show that people with depression appear to have physical changes in their brains, which could help find the source of the illness.
• Faulty neurotransmitters or chemical messengers in the brain affect mood stability and significantly affect depression and its treatment.
• Changes in hormone levels may cause or trigger depression, including during and after pregnancy. It may also be caused by thyroid problems, menopause, or several other conditions.
• Inherited traits.

TMS For Treatment-Resistant Depression

“Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective.

“This treatment for depression involves delivering repetitive magnetic pulses, so it’s called repetitive TMS or rTMS.” It’s a kind of procedure that may be recommended if medicine or psychotherapy hasn’t lowered depression symptoms in some people.

Are there side effects?

TMS is considered safe, but there are potential side effects. Most are transient and occur during the treatment only:

• Headache
• Scalp irritation where the stimulation takes place
• Jerking of facial muscles
• Lightheadedness

TMS involves placing an electromagnetic coil against your head and repeatedly turning it off and on to create stimulating pulses. This generates a tapping or clicking noise that usually persists for several seconds and is followed by a pause. You may also perceive a tapping sensation on the forehead. This part of the procedure is known as mapping.

“Existing evidence to date suggests that less treatment-resistant patients respond better to rTMS than those who are highly treatment-resistant. However, there is much yet to be learned about particular variables that may impact response to rTMS. Researchers are presently conducting clinical studies to evaluate who will benefit most from rTMS therapy.” Research into whether rTMS with antidepressant medications is more effective than rTMS alone is ongoing.

In addition, in a comparison trial, deep TMS (Brainsway) was shown to be significantly more effective than superficial TMS. 

Diagnosis & Treatment

Diagnosing treatment-resistant depression normally involves:

• A physical examination by your doctor. You’ll be expected to talk about personal and family medical history and may undergo tests to find a medical problem for your depression symptoms. If there isn’t a medical reason, you may be referred for a psychiatric assessment by a mental health professional. 
• At a psychiatric assessment, you’ll talk about thoughts, feelings, and behaviors as possible triggers, as well as whether you have a personal or family history of mental illness.
• Comparing your depression symptoms to the Diagnostic and Statistical Manual of Mental Disorders criteria. 

TMS or ketamine may be recommended for treatment.

Final Thoughts

Depression can wreak havoc on your sense of self, your daily life, and your relationships. But there are ways to stop it from getting to this point. Among those, ketamine and TMS have been highly successful treatments. 

Researchers have found that ketamine, when given in an appropriate non-sedative dose, as well as TMS, can help patients that are not receiving benefits from traditional treatment. Our clinic is here to help. Contact us today.