Brain stimulation therapies are one way to treat depression. More traditional treatment options include various psychotherapy treatments and techniques, light therapies, and medication intervention. We are likely familiar with numerous depression medication names, but less familiar with brain stimulation treatments. There have been multiple brain stimulation treatments used to treat depression and other psychiatric disorders over time. However, when it comes to choosing between various brain stimulation treatments, there are numerous advantages to TMS over others.
What is TMS Therapy?
Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive brain stimulation treatment option for depression. TMS therapy works by placing magnetic coils onto the forehead. These coils provide magnetic impulses directly to the brain. These impulses stimulate nerve cells in the prefrontal cortex, specifically the left prefrontal cortex, as this area is seen as responsible for controlling mood. Research and clinical trials show that these impulses impact neurotransmitters in the brain and decrease symptoms of depression for an extended period of time.
What is ECT Therapy?
Electroconvulsive Therapy (ECT), which is colloquially referred to as “shock therapy”, has a lot of negative connotation and association. It is a more intrusive procedure, impacts the brain as a whole, and has a higher risk of side effects compared to TMS. Some brain stimulation therapies, such as ECT, are more controversial and still being researched before wide-spread use. These treatments include Deep Brain Stimulation (DBS) and Vagus Nerve Stimulation (VNS). Deep Brain Stimulation is currently an approved treatment intervention for Parkinsons and is being trialed for depression treatment.
What is the difference between TMS and ECT?
There are a few critical differences between TMS and ECT, that gives TMS a stark advantage. One of the main differences is that with TMS treatments, you are not put under general anesthesia. With ECT, you are put under general anesthesia throughout the duration of the treatment. This may be a concern for people who have a reaction or allergy to anesthesia, or simply do not want to be put under for the treatment of depression. ECT targets the brain as a whole, while TMS specifically targets the left prefrontal cortex to stimulate nerve cells. Duration and recovery periods are different as well. TMS is an outpatient procedure that lasts about 20-40 minutes total, with limited to no recovery time. You are able to go about the rest of your day as usual. With ECT, you may need some extended recovery time to recuperate from more significant side effects.
When it comes to side effects, each treatment varies substantially. TMS addresses the direct source of depression – the brain, and specifically the prefrontal cortex. Therefore, there are little to no side effects with TMS therapy. They are largely limited to application site irritation, headaches, light-headedness, or facial muscle tension. With ECT and medication treatments, side effects can be more significant and systemic. TMS also does not interact with any other medications you may already be taking. You are likely able to continue your current medication and dosage without needing to consider further medication changes. Consider talking with your doctor or TMS provider if you have any concerns.
Getting TMS Treatment
While historically TMS may be recommended only if more conventional or traditional methods of depression treatment are unsuccessful, it would be completely normal to continue to seek psychotherapy in conjunction with TMS treatments. TMS can help to alleviate symptoms of depression, and therapy can help continue social connection, challenge isolation, and promote coping skill use and development. TMS also does not need to be viewed as a last resort treatment option. Talk with your therapist, psychiatrist, or doctor to determine if this therapy is one you want to take earlier on in your treatment.
Fortunately, TMS is also covered by most insurance plans. Insurance providers typically hesitate to cover procedures that are considered risky, still in the stages of clinical trial, or ineffective. Therefore, TMS is a legitimate treatment option that can be considered if you have access to a clinic in your area. The advantages that TMS has over other brain stimulation treatments make it an excellent choice.
This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer.
Mayo Clinic. (2018b, November 27). Transcranial magnetic stimulation – Mayo Clinic. Retrieved January 26, 2020, from https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625
National Alliance on Mental Health. (n.d.). ECT, TMS and Other Brain Stimulation Therapies | NAMI: National Alliance on Mental Illness. Retrieved January 26, 2020, from https://www.nami.org/Learn-More/Treatment/ECT,-TMS-and-Other-Brain-Stimulation-Therapies