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TMS offers help and hope for many facing depression

February 13, 2020
Dr Shadi Zaghloul  Kelly ORourke TMS 122019 250x

Each year, more than 16 million adults in the United States experience major depression.

Depression can drain your energy, hope, and drive, making it difficult to do daily tasks. Even thinking about the things that once made you happy—such as visiting with a friend, going out for dinner, or taking a walk—can become unenjoyable and seem exhausting or impossible to do.

“Major depression is one of the most common mental disorders in the United States,” said Dr. Shadi Zaghloul, medical director for outpatient and inpatient behavioral health services at Baystate Wing Hospital.

Common depression symptoms include insomnia or excessive sleeping low energy, feelings of worthlessness or guilt, lack of pleasure in most activities, or recurring thoughts of death or suicide.

TREATMENT FOR DEPRESSION

“It’s important for people to know that needing help doesn’t mean you’re weak, depression can be treated and you can feel better. If you’ve taken self help steps and still find your depression getting worse, then you need to seek professional help,” said Dr. Zaghloul, noting a first visit should be to your primary care provider.

The treatment plan for depression depends on the severity and type of depression a person is experiencing. Some people benefit from psychotherapy, also called "talk therapy" or just plain therapy, a process where psychological problems are treated through communication and a relationship between an individual and a trained mental health professional.

For moderate depression that doesn’t respond to therapy alone, doctors will prescribe medications. Other treatment options for moderate and severe depression include transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) and the newly approved nasal formulation of the anesthetic ketamine called Esketamine.

 

What is transcranial magnetic stimulation (TMS)?

“While medication is often helpful, for people who have not benefited from antidepressant medication, or have experienced challenging side effects, TMS is an FDA-cleared, non-drug, non-invasive medical treatment for patients diagnosed with major depression disorder that has been proven to be safe and effective in treating major depression,” said Dr. Zaghloul.

TMS devices operate outside of the body and use a special magnet to stimulate neuron (brain cell) activity and connections between cells in different areas of the brain that are implicated in the development and persistence of depression.

“TMS therapy uses focused magnetic pulses to awaken areas of the brain that are underactive in depression,” said Dr. Zaghloul. “By stimulating the release of neurotransmitters and increasing the neurons’ activity, this treatment can result in improved mood. It’s like waking up some of your brain cells”.

Is TMS therapy safe?

The Baystate Wing Hospital Griswold Center (an outpatient clinic in Palmer) offers TMS NeuroStar Advanced Therapy®. Since it was introduced in 2008, NeuroStar Advanced Therapy® has been proven safe and effective, with more than 2.5 million treatments delivered. The majority of patients experience relief within several weeks, and continue to feel better after treatment is complete.

“It’s normal to feel nervous about trying a new treatment,” noted Kelly O’Rourke, TMS coordinator at Griswold Center.

“Many of my patients have tried everything but still find it difficult to function day to day because of depression. I talk to them and encourage them to come back the next day for another treatment. Each day, I notice a change as my patients feel a little stronger and more confident in themselves and I remind them that it is the small everyday things that count,” she said.

What is the process for TMS therapy?

TMS is generally prescribed for 6 weeks, 5 days a week, with an additional 6 sessions during a 3-week taper (wind down), for a total of 36 sessions over a couple of months. Each treatment lasts about 20 minutes. TMS requires no anesthesia or sedation, and patients are awake and alert during treatment and people are able to resume normal activities immediately afterwards.

During treatment, the patient is awake in a comfortable chair. A small magnetized wand rests lightly on the patient’s head, delivering focused magnetic stimulation directly to the area of the brain thought to be involved in regulating mood.

How successful is TMS?

“The response to treatment for patients who tried a lot of antidepressants is excellent,” said Dr. Zaghloul. “At the Griswold Center, two thirds of patients showed improvement in their depression scores and a little less than a third had almost complete resolution (remission) of their depression.”

Learn More About Behavioral Health Services at Baystate Health

Baystate Health offers comprehensive mental health and behavioral medicine across western Massachusetts.