Treatment Resistant Major Depression (TRD) is one of the most dreadful conditions that anyone could ever suer from. TRD is a painful existence devoid of happiness and pleasure. TRD, the most severe grade of depression de- ned by multiple medication and therapy failures, often becomes a hopeless situation. Quality of life suffers, as do personal relationships. Functional capacity is impaired and progressively declines over time in afflicted individuals. Many people raise the white flag and surrender, believing that chronic depression is their said lot in life. Others want to keep fighting but do not know what to do. After 1 or 2 bad years of failed treatments, those affected by depression start to fear they are running out of options. Major advances in Psychiatry over the last decade have created new and powerful options for the treatment of TRD. Transcranial Magnetic Stimulation, referred to as “TMS” is the most groundbreaking of these new options.
Q: What is TMS? TMS is the acronym for Transcranial Magnetic Stimulation, which is a cutting edge treatment for depression that involves stimulation of brain tissue using electromagnetic pulses. This noninvasive procedure improves symptoms of depression by activating the parts of the brain associated with mood control and depression. TMS has grown in popularity due to the high degree of eectiveness for Treatment Resistant Depression while having very few side eects and absolutely no circulation of medication in the bloodstream.
Q: What is the TMS procedure like? The process starts with the placement of an electromagnetic coil over the scalp near the forehead. The motor strip, the area of the brain responsible for movement of limbs and muscles, is then mapped out. This is necessary in order to subsequently determine the location of the lateral pre-frontal cortex. The actual procedure involves a delivering a sequence of magnetic pulses to the left lateral pre-frontal cortex to induce stimulation. The magnetic pulses pass through the scalp and the skull to reach the target brain tissue. TMS activates the actual neurons by inducing an electrical current in the part of the brain cell called the axon. This current travels to the nerve cell body and then aects other connecting brain cells. This stimulation ultimately creates the powerful antidepressant effect.
Q: When is TMS indicated? TMS is indicated when conventional treatments for Major Depression have not worked. Insurance coverage is typically approved for individuals who have been diagnosed with Major Depression and have failed at least 4 different medication trials. TMS can be used to treat pregnant women suffering from depression, with the notable advantage of not exposing the unborn child to any potential ill effects from medications. TMS is also an option for individuals who suer from Major Depression and do not wish to take medications, even as a first line option.
Q: When was TMS approved by the FDA? TMS was approved by the FDA for the indication of treatment resistant depression in 2008. Deep TMS, possible with the newer generation of TMS technology, was approved by the FDA for the indication of treatment resistant depression in 2013.