What To Do After TMS Treatment

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W. Nate Upshaw, MD

W. Nate Upshaw, MD

Dr. William Nathan Upshaw is the Medical Director of NeuroSpa TMS®. Since receiving training from the inventor of TMS Therapy nearly a decade ago, Dr. Upshaw has been a pioneer, champion and outspoken advocate of TMS Therapy. Dr. Upshaw’s holistic experience in the field has transformed him into Florida’s leading advocate for widespread accessibility to TMS Therapy.

About Dr. Upshaw

Deciding how to treat your depression is a complex, multifaceted decision. Oftentimes, it may require trying multiple courses of treatment to determine which method or modality is best suited for you. Understanding what happens before, during and after treatment can often aid in making a choice that’s right for your specific needs. Medication and traditional therapy are common treatment options for Major Depressive Disorder, however, other options do exist. Transcranial Magnetic Stimulation, also known as TMS therapy, is a non-invasive procedure that stimulates the specific region of the brain associated with Major Depressive Disorder. TMS therapy is commonly administered to patients who have undergone psychotherapy and antidepressant medications, but have seen little or no improvement in their condition. 

 

What To Expect From TMS Therapy

 

TMS therapy is performed through the placement of magnetic coils upon the forehead which deliver stimulating pulses directly to the brain. These pulses stimulate nerve cells in the left prefrontal cortex, the region of the brain responsible for depression and mood regulation. Ample research and clinical trials have shown that these magnetic pulses impact specific circuits in the brain which may decrease symptoms of depression for an extended period of time.

 

TMS therapy is an outpatient procedure and therefore does not require any period of hospitalization or downtime. In order to see an improvement in depressive symptoms, TMS therapy is administered over a series of treatment sessions, often spanning between 6-8 weeks. The length of each treatment session may vary depending upon the number of pulses delivered, but typically lasts around 19 minutes. Generally, sessions can be carried out daily, about five times a week. 

 

In order to make a sound decision on a treatment method, understanding the process is beneficial. What exactly happens after TMS treatment? Since this procedure is non-invasive and does not require any sedation or anesthesia, you can expect to return to your normal daily activities immediately following treatment. With no recovery period needed, you can go back to work, drive yourself home, and go about your day as usual.

 

Are There Side Effects to TMS Treatment? 

 

Following a session of TMS therapy, the most commonly reported side effects are headaches and application site irritation. Johns Hopkins Medicine describes these headaches as typically mild and likely to decrease over the course of treatment. Such discomfort can easily be treated with general over the counter headache or pain medications. About one third of participants may experience scalp pain or discomfort at the application site of the coil, and some participants have reported facial tingling and twitching. However, these symptoms are also likely to diminish over the course of treatment. The application site and intensity of the magnetic coil placed onto the forehead can be slightly adjusted to avoid possible side effects while still providing full impact.

 

As with most forms of treatment, it may take a few weeks to experience any relief in symptoms. Following a full course of TMS treatment, you can expect symptoms of depression to improve significantly or dissipate entirely. 

 

Life After TMS Therapy

 

Following treatment, you’ll likely notice the improvement in your symptoms. You may find yourself sleeping better, feeling less sad or hopeless, being less fatigued or exhausted, or having more interest in things you typically would enjoy. Your lived experience is a great reporting tool. Furthermore, it’s also helpful to monitor your symptoms over time using a quick assessment. The PHQ-9- short for Patient Health Questionnaire- is a brief, self-administered questionnaire that assesses symptoms of depression. The score you get upon completion of the PHQ-9 determines the level of severity of your symptoms utilizing the diagnostic criteria for depression provided by the Diagnostic and Statistical Manual of Mental Disorders. You can take this survey every two weeks to help assess the severity of your depression symptoms. Taking the PHQ-9 prior to beginning TMS treatment will help to establish an initial score of depression. Throughout your treatment journey, you can use your scores to track the improvement of your depression.

 

 

Understanding the pros and cons of TMS treatment, and knowing what happens during and after TMS therapy, are critical components of making the best decision for yourself when it comes to your mental health treatment. Speak to a mental health professional to get guidance on getting started with a depression treatment that is right for you. 

 

 

Works Cited

American Psychological Association. (2020, June). Patient Health Questionnaire (PHQ-9 & PHQ-2). Retrieved February 12, 2021, from https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/patient-health

Mayo Clinic. (2018, November 27). Transcranial magnetic stimulation – Mayo Clinic. Retrieved February 11, 2021, from https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

Mennitto, D. (2019, February 5). Frequently Asked Questions About TMS at The Johns Hopkins Hospital in Baltimore, Maryland. Retrieved February 12, 2021, from https://www.hopkinsmedicine.org/psychiatry/specialty_areas/brain_stimulation/tms/faq_tms.html

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