Blog ”Major Depression and Transcranial Magnetic Stimulation”.
February 2, 2024
Disclaimer: This blog is for informational and educational purposes only. This blog is not taken as medical advice or used as a substitute for such. You should always speak to your doctor or medical professional.
Major depressive disorder (MDD), is a highly prevalent psychiatric disorder. MDD affects between 5% and 17% of all people at some point in their lives, (1) making it one of the most common forms of mental illness.
What Causes MDD?
It is a complex question. MDD is caused by imbalance in neurotransmitters in the brain including serotonin and dopamine. It also can be hereditary and run in the family. In other words, if your mother, father, or direct sibling is affected by MDD, you may be prone to it as well.
However, MDD can also be caused by certain illnesses, medications, or stressful life events, such as childhood trauma or abuse. In other cases, there might be no discernable cause or trigger.
People can become depressed for various reasons. It can happen at any age and can be brought on by a traumatic life event, like a breakup or loss of a job. What differentiates MDD from other types of depression is that it persists daily for two weeks or more and is usually accompanied by other symptoms, such as losing interest in the things you once loved, sleep disruption, low energy/fatigue, increased or decreased appetite, inability to focus or think clearly, and suicidal thoughts.
MDD can also accompany other mental health disorders, such as panic disorder, social anxiety disorder, substance use disorder, and obsessive-compulsive disorder. (2)
If you have symptoms of MDD or if it presents with any of the above symptoms, you must seek a proper diagnosis. Many therapies, medications, and treatments can be a treatment option and help you regain your quality of life.
Medication and Other Treatments for MDD
Psychotherapy, medications, and combinations of the two have been used to treat depression for many decades.
The FDA has approved several types of antidepressants for MDD, the most common being selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These two classes of drugs are generally well-tolerated and have fewer side effects, so they are often the first things prescribed when a patient presents with MDD symptoms.
Tricyclic antidepressants (TCAs), on the other hand, are an older class of psychotropic medication and are not commonly prescribed for MDD today. While effective, TCAs are not as well-tolerated and may come with serious side effects, like blurred vision, weight gain, excessive sweating, and problems passing urine.
SSRIs (Zoloft, Prozac, Celexa, Lexapro, Paxil)
SSRIs prevent serotonin (3) from reabsorbing into brain cells (neurons). In layperson’s terms, this means they reduce depression by increasing the amount of serotonin in the brain. Serotonin acts as a messenger between brain cells and regulates things like appetite, libido, body temperature, and sleep cycles. Too little serotonin can lead to anxiety, depression, and other conditions. (4)
SNRIs (Effexor, Cymbalta)
The effect of serotonin-norepinephrine reuptake inhibitors (SNRIs) (5) is somewhere between tricyclics and SSRIs. Norepinephrine is also a neurotransmitter associated with the “fight or flight” response. Along with serotonin, it helps to carry messages between brain cells. SNRIs can also be highly effective in treating chronic pain and anxiety disorders.
SSRIs and SNRIs are usually highly effective in treating depression. However, they don’t work for everyone. In some cases, even when combined with psychotherapy, patients could experience drug resistance. If this occurs, the individual may experience poor outcomes, including suicidal thoughts, inability to maintain relationships, and loss of quality of life.
Transcranial Magnetic Stimulation (TMS) can be a treatment choice when therapy and medications are insufficient.(6) TMS targets location of depression in the brain, using high-frequency electromagnetic pulses over the left prefrontal cortex, effectively treating behavioral manifestations arising from MDD.
TMS for MDD Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment for MDD. It is medication-free, so it does not come with the risks or side effects associated with psychotropic drugs. TMS is covered by all major insurances, making it an excellent alternative or adjunct therapy for people with an MDD diagnosis.
Here are a few scenarios where TMS might be considered as a treatment option for depression :
· Drug-resistant depression. TMS should be considered if the patient has tried different SSRIs, SNRIs, and combination therapies without significant improvement or if the medications are less effective over time.
· Persistent side effects. Ongoing or increasing severity of side effects can be challenging and may impact the patient’s quality of life. These can include weight gain/weight loss, insomnia, headaches, and sexual dysfunction.
TMS can be an option that can administered as an adjunct to medication therapy and psychotherapy, although the latter options are often first-line. Evidence suggests that the efficacy of all treatments can be enhanced when combined, but individual cases vary, and each patient should be considered individually.
Getting Help for MDD
If you or a loved one struggles with depression, know that there are many options available to you. Speaking to a doctor experienced with depressive disorders will ensure you get help that’s appropriate to your diagnosis.
It’s imperative to seek help if your medications or psychotherapy are not working for you or if you are experiencing side effects that impact your comfort and quality of life. If any of these are the case, TMS may be an option for you.
Transcranial Magnetic Stimulation can work when all other treatments have failed. It is performed as an in-office treatment. It’s painless, requires no sedation, and patients can go about their day immediately after their appointment.
Speak to us to find out if TMS therapy is right for you. We’d be happy to answer any questions and provide all the support you need on the road to feeling better.
Please call us today at 614-768-2700 or email us at firstname.lastname@example.org to learn more about Transcranial Magnetic Stimulation for depression and how to get started.
2. Epidemiology of subtypes of depression. Kessing LV. Acta Psychiatr Scand Suppl. 2007;115:85–89. [PubMed] [Google Scholar]
6. Transcranial magnetic stimulation for the treatment of major depression. Janicak PG, Dokucu ME. Neuropsychiatr Dis Treat. 2015;11:1549–1560. [PMC free article] [PubMed] [Google Scholar]