how does tms work

How Does TMS Work?

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Transcranial magnetic stimulation, or TMS, is increasingly used to treat several mental health disorders, including major depressive disorder. The increased popularity of TMS therapy has led many patients to question how does TMS work

The Basics of TMS

During TMS therapy sessions, a small electromagnetic coil is placed on the skull above the forehead. This electromagnetic coil creates a magnetic field over the left dorsolateral prefrontal cortex, the area of the brain responsible for mood regulation. 

The TMS therapy system generates very concentrated magnetic fields, similar to magnetic resonance imaging (MRI),  that turn on and off quickly. However, the magnetic field only extends to the portion of the brain directly beneath the skull and treatment coil. 

As the magnetic fields move, they produce small electrical currents that activate cells within the brain that are believed to release neurotransmitters that regulate mood, including serotonin, dopamine, and norepinephrine. 

Many patients with mental health disorders treated by pharmaceuticals may not experience the clinical benefits of these medications. Additionally, some patients suffer from extreme side effects related to depression medication, such as weight gain, insomnia, impotence, migraine, nausea, diarrhea, fatigue, drowsiness, and increased nervousness and anxiety. These patients may benefit from increased brain stimulation associated with TMS therapy. 

tms for depression

Conditions Treated with TMS

TMS treatment plans can be developed for patients suffering from various conditions, including some significant mental health conditions, such as:

  •  Major depressive disorder: TMS treatment can often alleviate depression symptoms when pharmaceuticals and psychotherapy do not alleviate the severe depressive symptoms. Treatment-resistant depression impacts about thirty percent of patients with major depressive disorder. Major depression is often linked to reduced activity in the prefrontal cortex. TMS increases brain activity in this area and stimulates nerve cells. 
  • Obsessive-compulsive disorder: The FDA approved TMS therapy to treat obsessive-compulsive disorder in 2018 when medication and psychotherapy do not help. Patients with this condition often have increased prefrontal cortex and striatum activity. With this condition, TMS works by inhibiting the activity in this area of the brain to minimize the symptoms of OCD.   
  • Post-traumatic stress disorder (PTSD): TMS can also help to alleviate symptoms of PTSD. This treatment targets the prefrontal cortex, which regulates how one processes fear and worry. When combined with cognitive processing therapy, TMS can effectively treat PTSD. 
  • Bipolar disorder: Medications, such as mood stabilizers, antipsychotics, and antidepressants, are commonly used to treat bipolar disorder. However, when these medications fail to help a patient manage this condition, TMS is a treatment option to help with mood regulation.  

In addition to these conditions, repetitive transcranial magnetic stimulation may also assist with treating anxiety, schizophrenia, Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis. It can also help address nicotine addiction and issues related to chronic pain and assist with stroke rehabilitation. 

Limitation of TMS 

TMS may not work for everyone, but it has been shown to have positive effects for the vast majority – 82% – of patients with treatment-resistant depression. 

If you are considering TMS as a treatment option to treat a mental health condition, it’s also vital to understand the potential side effects of TMS. One of the big reasons that TMS has gained popularity quickly is that it doesn’t appear to have any long-term adverse effects, unlike other depression treatments, which can impair memory and mental clarity. 

The potential side effects of this treatment include:

  • Headaches, which are generally relatively mild and can be treated with over-the-counter medication.
  • Scalp sensations at the site of TMS treatment.
  • Muscle twitching in the muscles of the face as the electrical currents pulse during treatment. 
  • Lightheadedness
  • Temporary hearing loss may be experienced if patients do not wear proper ear protection, as there is a loud beep with each pulse. 

In very rare cases, patients may experience seizures due to TMS therapy. Additionally, those with bipolar disorder may experience mania. 

TMS uses magnetic fields, which means that it cannot be used by many patients with metal in the head or neck. Patients with the following may not use TMS treatment:

  • Aneurism clips
  • A stent
  • Deep brain stimulators
  • Metallic ear or eye implants
  • Shrapnel or metal fragments
  • A pacemaker 

Is TMS Right for Me?

TMS is a non-invasive treatment that can be administered at any clinic equipped with the proper equipment and trained clinicians. It is commonly sought as a treatment alternative when medication and traditional therapy fail to positively impact one’s condition. If you are asking yourself “how does TMS work” and “is it right for me?” it might be time to answer those questions.

However, before pursuing TMS treatment, it’s vital that you find a reputable provider to discuss your unique condition and challenges to determine if it’s the right course of treatment. 

We at Memor Health want to help guide you back to optimal balance. We look at the person as a whole and take all aspects of the person into consideration when deciding on the best treatment for your mental health. Contact us today to find out if TMS therapy is right for you.

Yvette Kaunismaki

Yvette Kaunismaki

Yvette Kaunismaki, MD, specializes in psychiatry with a holistic approach, focusing on integrating therapy and medication for women’s issues, depression, anxiety, and bipolar disorder. She emphasizes a team-based method, aiming for balanced mental health through collaborative care with experienced therapists.

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