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If you’ve been diagnosed with major depressive disorder, you’re likely looking to understand your condition better — and find relief. You’ve likely heard of psychotherapy (talk therapy) and antidepressant medications. These have been used to treat depression for some time and are generally the first treatments tried. However, there are also alternate methods that may be helpful if your depression is severe or doesn’t respond to these traditional therapies. One of these is called transcranial magnetic stimulation, or TMS

Before we go into detail about using TMS to treat major depressive disorder, let’s recap how the Diagnostic and Statistical Manual for Mental Disorders 5, Text Revision (DSM-5-TR) defines this condition. We’ll also go over what qualifies as treatment-resistant depression.

What is major depressive disorder?

Major depressive disorder is a mood disorder in which patients generally experience a prolonged depressed mood and no longer take pleasure in activities they once enjoyed. According to the DSM-5-TR, symptoms must be present for at least two weeks and include at least five of the following:

  • Depression lasts most of the day, nearly every day, as indicated by self or others.
  • Drastically reduced interest in or enjoyment of nearly all activities.
  • Significant weight loss or a persistent change in appetite.
  • An inability to fall or stay asleep or a tendency to sleep too much.
  • Physical agitation or sluggishness that is observable by others. 
  • Fatigue.
  • Feelings of worthless or excessive/inappropriate guilt.
  • Trouble concentrating or making decisions.
  • Repeated thoughts of death, suicidal thoughts or suicide attempts.

What is treatment-resistant depression?

Treatment-resistant depression is defined as depression that doesn’t respond well to at least two different trials of antidepressants. Each of these trials must be conducted with a dose that’s considered to be adequate for depression treatment. In addition, each trial has to last six to eight weeks. Importantly, it’s possible to initially respond to treatment and then develop treatment-resistant depression.

TMS: An alternative treatment option for major depressive disorder

If you’re one of the 30% of people with treatment-resistant depression, you may benefit from TMS treatment for your major depressive disorder. TMS is an FDA-approved, medication-free treatment that uses pulses of magnetic energy to stimulate brain activity. Specifically, it stimulates cells in the dorsolateral prefrontal cortex. This brain area is underactive in people who have depression.

To receive TMS, you’ll sit in what looks like a dentist’s chair, and a magnetic device will be placed lightly against your head. When the TMS device is turned on, it will deliver pulses of magnetic energy to your brain. You’ll hear a clicking noise and feel a tapping sensation on your head. Each session could last around 20 to 40 minutes, and a course of treatment usually consists of six weeks of treatment, five days a week.

How effective is TMS treatment for major depressive disorder?

Although no one treatment is right for everyone, our patient outcomes at Active Path have shown that 79% of people achieve a greater than 25% reduction in their major depressive disorder symptoms with TMS treatment. Approximately 56% of patients have their depression symptoms cut in half. And a third of patients achieve complete remission.

The effects are long-lasting, too: Clinical studies have shown that 45% of patients who respond well to TMS are still in remission a year later. According to anecdotal evidence, those who do see a return of their symptoms typically respond to re-treatment.

Types of TMS

Two main types of TMS are used to treat major depressive disorder:

  • Repetitive TMS, or rTMS — This is the more traditional type. As the name suggests, rTMS involves repetitive pulses of magnetic energy. This type uses a curved, rod-shaped device that’s placed against the forehead. 
  • Deep TMS, or dTMS — dTMS is a newer technique than rTMS that uses an H-shaped magnetic device housed within a helmet. dTMS can target structures that are deeper in the brain. 

Within a TMS type, the strength of the magnet and the frequency and pattern of the magnetic pulse can also be customized to each patient.

Does TMS have any side effects?

The side effects of TMS for major depressive disorder treatment are generally mild and brief. The most common are:

  • Mild discomfort at or around the site of treatment.
  • Contraction or tingling of muscles in the scalp, face and jaw.
  • Mild headaches.

Only 5% of TMS patients stop their treatment course early, emphasizing the high tolerability of any side effects that may occur.

Active Path Mental Health offers TMS treatment for major depressive disorder

If you have severe or treatment-resistant depression and you’re ready to try TMS, Active Path Mental Health can help. We have both rTMS and dTMS devices and can help you develop a personalized treatment plan so you can take charge of your mental health.

Contact our team today for more information or to schedule an initial appointment.

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