If you’ve landed on this page, you’re likely already looking into transcranial magnetic stimulation, or TMS, to help alleviate those feelings of helplessness and despair that can accompany a major depressive disorder.
TMS uses magnetic fields to energize or stimulate neurons in your brain to lessen the symptoms that come with depression. There are two types of TMS. The first is called repetitive transcranial magnetic stimulation, or rTMS, and the second is called deep transcranial magnetic stimulation, or dTMS. And it is the latter that has been shown to offer more benefit to more people.
Let’s take a quick look at how dTMS works and what you can typically expect to happen during a dTMS treatment.
Brief Overview of TMS
Both forms of TMS treatment are cleared by the Food and Drug Administration and are non-invasive — so no instruments enter your body.
Both forms also use short magnetic pulses to stimulate certain neurons — the nerve cells in your brain. Those rapid pulses raise or lower the neurons’ activity level, based on what is prescribed by your treatment team for you; as cited in the “Expert Review of Medical Devices” by Aron Tendler and others.
The goal is to rebalance the part of your brain that regulates your moods by altering your brain chemistry. This rebalancing can help take away the feelings that come from depression.
What Makes dTMS Different?
Deep transcranial magnetic stimulation allows the magnetic pulses to reach deeper into the brain than they can with rTMS. And that’s a good thing. It means the magnetic pulse reaches more neurons, which translates into a far better chance of getting the right target. In fact, dTMS can affect more than a cubic inch of the brain compared to rTMS, which cover just under 3/16 of an inch, according to Tendler.
When you are struggling on a day to day basis with depression, and you just want to lift the veil and weight of depression, the more neurons touched in the targeted area, the better.
What to Expect in dTMS Treatment
At Achieve TMS, we’ve been working with TMS since it was first cleared and our experience and success have positioned us as a leader in the field. Because so many of our patients have had great results from the treatment, we’ve been opening new clinic locations at a very strong pace.
Here’s what you can expect to happen when you contact us.
The first thing that will happen when you call us with an interest in dTMS treatment services is scheduling of a consultation where we will be able to answer any questions that you have regarding dTMS . We’ll schedule a convenient time for you to visit one of our facilities that is close to you. During this time, you’ll talk with one of our psychiatrists about your depression, your symptoms, and your past treatments. We’ll go over what’s worked and what hasn’t, and then the two of you will decide whether dTMS is the right choice for you.
How Long Does Treatment Take?
A dTMS treatment session lasts about 20 minutes. Typically, you’ll receive a treatment five days a week for six weeks.
dTMS Treatment Steps
Step 1 – When it’s time for your first treatment, you’ll go into a room with a comfortable chair and will see a cart like the one pictured here.
It consists of a:
- Computer to regulate the duration of the magnetic pulses
- Machine that creates the magnetic bursts
- “Helmet” that holds the H-coils that deliver the magnetic pulses
Step 2 – Once seated, a soft cap will be placed on your head. (See the photo on the left.) Then, the therapist will use a flexible tape measure to help find the location in your brain that should be targeted by the magnetic bursts.
Step 3 – At this point, if it’s your first visit, the psychiatrist will do what’s called a cortical mapping, to determine the exact location in the brain (cerebral cortext) for subsequent treatment.
Step 4 – We supply you with earplugs to diminish the noise made by the machine, which works similarly to an MRI.
Then, the helmet of the machine — the component that holds the H-coils — will be lowered until the coils are situated just above your scalp. The psychiatrist will move it into the proper position on your head to ensure the magnetic pulses are directed at the correct area.
Step 5 – Once everything is in position, you’ll be able to listen to music or watch TV.
Then, the magnetic pulses begin. You might hear a tapping sound and perhaps even feel as if someone’s tapping gently on your head. We deliver the pulses, called trains, in short bursts. A typical session consists of approximately 55 trains with 20 seconds of rest in between each pulse. Total treatment time lasts approximately 20 minutes.
Step 6 – Once all the trains are provided, we’ll take off the cap and the helmet, and you’ll go home or back to work. That’s it.
There’s no need for sedation or a driver. You immediately resume your daily life.
You might have a slight headache or scalp irritation, but most people don’t. And if they do, it’s mild and doesn’t usually last beyond the first treatment.
Subsequent dTMS Treatments
You don’t need the mapping before every treatment. However, we will map a few times more during the six-week period to make sure that you’re getting the greatest benefit possible through the pulse trains.
How You’ll Know dTMS Is Working
Manish Sheth MD, a board-certified psychiatrist at Achieve TMS, outlines what you might expect once treatments have started:
- An improvement in sleep, often in the first week
- The ability to concentrate better, often as early as the second week
- Depression symptoms lessen
- After four to five weeks, many people start to feel between 70% to 80% “more normal.”
- At six weeks, many find that most of their symptoms have disappeared
Large independent studies have demonstrated a 75% response rate (30% lessening of symptoms) with an almost 50% remission rate (disappearance of symptoms).
Even for those who do not respond, there’s hope. A Brainsway pivotal trial, enrolled patients who hadn’t responded after six weeks of d-TMS treatment. They were then given treatments twice a week for up to an additional 12 weeks. Nearly 61% of them did “eventually respond with continued treatment.”
Yes, There Is Hope
Achieve TMS has been helping people with mental health concerns for 20 years. Our staff of board-certified psychiatrists, neurophysiologists, naturopathic doctors, and trained TMS technicians ensure that each patient receives the highest level of care at every dTMS session. We work in collaboration with your physicians, psychiatrists, and other therapists to provide a comprehensive treatment plan. Call us today for more information about this exciting new therapy for MDD at (877) 447-6503.