Transcranial magnetic stimulation (TMS) is gaining attention as an alternative treatment for people struggling with conditions like depression, especially when traditional methods haven’t worked. But is it the right option for you? We’ll break down the pros and cons of TMS therapy, so you can decide if it’s worth considering for your mental health.
TMS therapy is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It works by targeting specific areas of the brain, such as the prefrontal cortex, which regulates mood and emotions. The treatment involves:
TMS is FDA-approved for several conditions and is supported by growing evidence for treating mental and neurological disorders. These disorders include:
TMS is also being researched for other conditions such as PTSD, chronic pain, and substance use disorders.
Although TMS is still relatively new, research has shown that it can have several potential benefits. Here’s a closer look at some of the advantages of participating in this breakthrough therapy.
For individuals who have tried multiple treatments like medications or traditional therapies without success, TMS offers hope. TMS therapy has specifically been shown to be effective for those with treatment-resistant depression (TRD). A randomized, double-blind, placebo-controlled study found that TMS is:
Another benefit of TMS is that it’s non-invasive. Unlike other interventions, TMS doesn’t require surgery, invasive procedures, sedation, or anesthesia. Each session is quick and relatively painless with no need for recovery time. Patients stay fully awake and alert, which allows them to return to their normal activities immediately after treatment.
Unlike medications that affect the entire body and may lead to systemic side effects, TMS delivers stimulation to brain areas that may play a role in mood regulation. While TMS primarily stimulates surface-level brain regions, new research shows its potential to indirectly affect deeper brain structures.
For example, a recent study looked at using TMS to target regions like the subgenual cingulate (an area involved in depression). It showed that TMS can potentially improve outcomes by activating critical nodes in brain circuits involved in mood and emotion. The benefits of this include:
This focused stimulation not only improves the effectiveness of treatment, but it also allows providers to directly address symptoms that are rooted in specific brain circuit dysfunctions.
In addition to its benefits for mood regulation, TMS has been shown to improve cognitive function. By promoting neuroplasticity, TMS helps the brain adapt and reorganize, which can improve functions like learning, memory, and recovery.
Neuroplasticity refers to the brain’s ability to adjust to environmental changes and form new connections. Research shows that TMS can boost neuroplasticity by:
These changes help the brain become more adaptable, which can be helpful for those struggling with memory or cognitive challenges.
TMS can also improve sleep quality. Studies using the Pittsburgh Sleep Quality Index (PSQI) found that patients with MDD experienced significant improvements in their sleep after repetitive TMS (rTMS) treatment. This is important since poor sleep is common in those with depression.
Research also shows that rTMS has benefits for people with primary insomnia. By targeting brain areas involved in regulating sleep, rTMS helps to address the underlying issues that disrupt rest.
TMS has shown potential in boosting motivation by influencing areas of the brain involved in reward and goal-oriented behavior. However, the effectiveness of TMS in improving motivation depends on the stimulation area and the type of coil that’s used.
The H-Coil, for example, has been found to affect motivation more significantly than the Figure-8 coil. This may be because the H-Coil:
TMS mainly affects the cognitive parts of motivation like goal-setting and reward-driven actions. The treatment targets areas like the dorsolateral prefrontal cortex (DLPFC) and deeper structures like the subgenual anterior cingulate cortex (sgACC), which helps modulate connectivity in the brain’s reward network.
Treatment-resistant depression affects millions of people in the United States and has annual healthcare costs that reach around $43.8 billion. Patients with TRD who rely on treatments like pharmacotherapy and psychotherapy face higher societal costs, including:
TMS is a cost-effective alternative that reduces the need for ongoing and intensive healthcare services. Access to interventions like TMS can:
Just like with any treatment, TMS also comes with some drawbacks. When determining if this therapy is the right choice for you, take the following cons of TMS into consideration.
While TMS is generally well-tolerated, some patients may experience minor side effects, including:
These side effects are usually temporary and tend to go away as the treatment continues. However, some individuals may experience a TMS dip, where symptoms briefly worsen during the early stages of treatment. This dip is typically short-lived, and most patients see improvement after a few weeks as their brain adapts to the stimulation and their mood begins to stabilize.
One of the challenges of TMS therapy is the time commitment required. Sessions are commonly scheduled five days a week over the course of several weeks. Each session lasts about 20 to 40 minutes, depending on the treatment plan.
This daily schedule can be inconvenient for individuals with demanding work or personal responsibilities, particularly if they need to travel to a clinic for treatment. While newer protocols are exploring shorter or more intensive schedules, the traditional time requirement remains a barrier for some patients.
Like any treatment, TMS is not a one-size-fits-all therapy. Similar to medications or other therapies, its effectiveness can vary from person to person. Some patients may not respond to TMS, which may require adjustments in protocols or alternative treatments.
It can also take time to determine whether TMS is the right fit for an individual’s symptoms. This trial-and-error process can be frustrating for those looking for immediate relief.
Access to TMS therapy isn’t as widespread as it could be, and this can be a major hurdle for people who need it. Setting up a TMS clinic requires specialized equipment, trained staff, and a dedicated space, which limits how many centers are available. This is especially evident in rural or underserved areas.
For those who live far away from a clinic or have difficulty with transportation, the daily sessions TMS needs can feel impossible to manage. These logistical challenges make it harder for many people to take advantage of a treatment that could improve their mental health.
Getting insurance to approve TMS therapy can be a frustrating and complicated process. Many insurance companies have strict guidelines that make it difficult for people to access this treatment. Patients are often required to:
These policies can feel like unnecessary roadblocks for those who have already struggled through multiple treatments that haven’t worked. Even though TMS is backed by strong evidence as a safe and effective option, some insurance companies are still hesitant to approve it. This leaves patients waiting and fighting for access to a therapy that could make a difference.
Having a firm grasp on the pros and cons of TMS therapy is an important step in deciding if this treatment is the right choice for you. While TMS is effective for individuals with treatment-resistant depression and other conditions, it’s recommended to weigh its benefits and limitations based on you and your needs.
If you’re ready to take control of your mental health, reach out to our qualified TMS providers to discuss how TMS therapy could fit into your treatment plan.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
