A Case Study in TMS Therapy for Clinical Depression

Betsy has lived with clinical depression most of her life, diagnosed in her late 20s. But looking back, she knows her depressive disorder began much earlier than that.

Fast forward nearly 30 years. Betsy has been treated by a long list of doctors. She has tried a range of treatments and combinations of medications. Where has it gotten her? Not even close to where she had hoped. Short spells of relief are interspersed with periods of severe depression that have been devastating.

And she is not alone. Treating clinical depression is a tricky thing, it’s causes are hidden deep within the brain. Most drug treatments are aimed at addressing a chemical imbalance. In many cases, a reduction of certain neurotransmitters is found, yet genetic vulnerability, diseases, medication for other illnesses, and stress may all factor in.

For countless sufferers fighting what feels like a losing battle, the great irony is defeat triggers the emotional depression we can all feel, contributing to the downward spiral.

When Betsy finally hit a wall of frustration and pain that she had no ability to overcome, she began a long and desperate search for other options. With nothing to lose, she agreed to try transcranial magnetic stimulation (TMS) therapy, a treatment not yet approved by the Food and Drug Administration (FDA). That meant no insurance coverage, which was the least of her worries.

Would the cost and the need to relocate far from home during the month-long treatment be worth it? Halfway through, Betsy experienced what she called a miracle, what she had been longing for forever; complete relief from her depression symptoms.

It happened after going to bed one night, still in her deeply-entrenched depressed state. She woke the next morning to the light and lightness of a complete release from her symptoms. She was stunned and ecstatic to be able to enjoy an amazing day not clouded by a battle in her head.

It was during Betsy’s treatment that the FDA approved TMS as a treatment for those who suffer from major depressive disorder and who have not had success using traditional methods of treatment. The latter is in line with the current thinking on treatment. More traditional methods, such as psychotherapy and anti-depressants, cost less and are easier to access, making them the expected initial steps, even for the most resistant cases.

 

With FDA approval, TMS therapy facilities began to open across the U.S. The more established facilities, like TMS Health Solutions, currently with seven treatment centers in northern California (including Burlingame, El Dorado Hills, Oakland, Roseville, Sacramento, and San Francisco),  began work to offer viable treatments and support services to those who suffer from a non-responsive major depressive disorder (MDD). TMS partners with many insurance providers to find ways to get treatment coverage for its patients.

Ideally, what will follow is a growth curve of successful treatments that build to TMS as the preferred course soon after traditional methods fail, saving patients from what might be years of suffering.

TMS therapy might be a relative newcomer to the varying treatments of depression, but it offers great hope for many people with severe depression. Additional research is needed to define the best delivery methods, as well as ways to profile the patients who are most likely to benefit.

Brain stimulation in various forms is not a new idea. Yet, proven success is rare. TMS has sparked a new wave of research worldwide as keys are sought for treatment for disorders of the brain and diseases unrelated to mental illness. The potential to unlock something within the brain so that the body can cure itself could not be more intriguing.

Research has already shown that TMS therapy may be effective in treating vascular depression in the wake of a stroke. Vascular depression is a cerebrovascular disease that causes structural damage to corticostriatal circuits. In recent years, a close correlation between cerebrovascular disease and depression in the elderly has become apparent, opening up new pathways of research.

Transcranial magnetic stimulation therapy offers hope for treatment of:

  • Mental illness
  • Schizophrenia
  • Attention deficit hyperactivity disorder (ADHD)
  • Post-traumatic stress disorder (PTSD)
  • Fibromyalgia and other chronic and/or acute pain disorders

 

The Takeaway

Within the TMS community, there is an idea which is driving much of the research behind TMS as therapy for clinical depression. Conceptually, this notion predicts that everyone’s brain cells might be more receptive to treatment if those cells are working cooperatively with one another, reaching for a common goal.

Still, other practitioners contemplate the added impact that TMS therapy would have if done simultaneously with cognitive-behavior therapy. If this line of research proves successful, it would have a major impact on the way mental health is addressed.

It is also fascinating to consider how many ways non-invasive brain stimulation may be used. For instance, optogenetic stimulation, using light to control the cells in living tissue. Studies include using this biological technique to retrieve memories lost by those with Alzheimer’s disease. Ultrasound, in various applications, may offer significant ways to treat mental illness or mood disorders.

 

Resources:

http://www.ncbi.nlm.nih.gov/pubmed/18316673

http://www.apa.org/index.aspx

http://newsroom.ucla.edu/releases/tms-depression-ucla

 

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About the Author: BJ Hetherington

BJ is the lead editor of Meical Daily Times. Fluent in French and proficient in Spanish and Arabic, he focuses on diseases and conditions. BJ is a graduate of York University In Toronto. When BJ isn't busy writing his next piece, he can often be found running the streets of the GTA.

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