What Is TMS Therapy? An Overview Of Transcranial Magnetic Stimulation (TMS)

Researchers in psychology and therapy are always looking for innovative ways to treat mental health issues, which now affect nearly one in every five Americans. One newer treatment, called transcranial magnetic stimulation (TMS), was approved by the Food and Drug Administration (FDA), though it remains somewhat controversial. Read on to learn more about what it is and why you might consider exploring TMS therapy for yourself or a loved one.

What is TMS therapy?

Although this is a newer treatment, people have explored the use of electric current as a treatment for centuries now. One famous example is electroconvulsive therapy, also known as electroshock therapy, which remains somewhat controversial to this day. 

The goal of TMS is to help alleviate certain types of pain, treat certain mental health disorders (such as depressive disorders), and potentially help assess damage from brain injuries (such as the kind incurred by strokes).

TMS therapy typically requires multiple sessions. The patient should expect to participate in several sessions before seeing any kind of results, and it’s normally conducted by specialists like neurologists or psychiatrists, rather than primary care providers.

Applications of transcranial magnetic stimulation (TMS)

Diagnosis

According to one study from The Journal of Clinical Neurophysiology, clinical studies are finding that TMS “offers the hope of targeting and ameliorating the circuitry underlying psychiatric disorders” beyond treatment resistant depression. For example, one study found that TMS may help reduce symptoms of obsessive-compulsive disorder for 45% of people who try it. As such, TMS can help test various hypotheses concerning the brain and mental illness.

TMS is thus quite useful as a tool for diagnosing and testing various brain-related issues. One such application, for example, is with strokes. After a stroke, TMS can help determine the extent of the damage to the brain. This information may help doctors treat the stroke in a more effective, targeted manner.

TMS has also been used to explore damage from other injuries, including multiple sclerosis (MS), motor neuron disease, and spinal cord injuries. If you yourself have experienced a brain injury, TMS may be used as a way of diagnosing the problem.

Treatment

TMS may help treat multiple ailments, including, notably, major depressive disorder. If you have neuropathic pain, which often occurs following chemotherapy, TMS may also be an effective way to treat it. It has also been tested as a possible treatment for autism.

As mentioned above, TMS may be an effective method to address treatment-resistant depression that has previously proven difficult to manage with conventional medication and therapy. While the exact effectiveness of the treatment is still not fully known, it's been recognized by the FDA as an effective treatment for some situations.

Possible downsides of treatment through TMS 

The truth is that the jury is still largely out when it comes to the effectiveness of TMS therapy, despite some promising results so far (referenced and linked above).

So, one downside of TMS therapy, which is true for many novel treatments, is that it may simply not work. This could potentially mean that a great deal of money is spent without receiving any real benefit. More research is still needed to help determine exactly what TMS can help with and how.

On that note, TMS therapy can be expensive, particularly for those who are uninsured or for whom their insurance won’t cover it. The prices will vary, but TMS therapy typically costs around $500 a session. You may need ten sessions to get the full effectiveness of TMS, so you're looking at a significant investment. For many, this is unfortunately unaffordable without insurance.

Ultimately, however, TMS therapy—specifically the NeuroStar variety—has been FDA-approved since 2008, meaning that you shouldn’t have to worry about any kind of severe health risks if you undergo treatment. Reported side effects—primarily fainting and seizures—are both rare and relatively minor, though they may increase depending on the frequency of the procedure.

You should also be sure to discuss any electrical implants you have with your doctor before starting any TMS therapy, as the procedure can damage them.

What you can expect from a TMS session

First, you may need to undergo a health screening to ensure that you qualify for TMS. After you’ve cleared the screening process, you may begin an initial test run to figure out which frequency works best for you.

Since the TMS magnetism varies in frequency level, some people find that certain frequencies work better for them. While some may need very little, others may benefit more from full power. By experimenting with these levels and seeing how you respond, the therapist can determine the best frequency for future sessions.

During each session, which generally lasts 30 to 60 minutes, a magnetic coil will be near your head. This coil generates a magnetic field, and the coil will be positioned for various parts of the brain. This helps locate the area for brain stimulation.

As mentioned, TMS may take several sessions for full efficacy. Since you may not see results until a few sessions have passed, don’t worry if your first session has not “worked.” 

TMS insurance details

Fortunately, TMS is beginning to get recognition from health insurance providers. It's only been more widely recognized since 2013 or so, but now Anthem, Blue Cross Blue Shield, and Health Net are examples of health insurance providers that may cover TMS. Of course, you should talk to your health insurance provider directly to see if you qualify.

While many providers are starting to recognize the potential effectiveness of TMS, some believe that the science is still out on the treatment, and they are thus not amenable to covering the procedure.

As for Medicare coverage, it will depend on which jurisdiction you're in. Some cover it, and some don't. Some included it for a while and then stopped coverage. Speaking directly with your Medicare provider can prevent you from getting a sizeable bill in the mail. As the effectiveness of TMS can vary, the last thing you want is to pay a lot of money for a procedure that didn't work for you.

Effectiveness of TMS in treating mental disorders

As mentioned earlier, some health insurance providers do not recognize TMS as an effective treatment. Do they have a point, or is this another case of bureaucracy refusing to accept an emerging form of medical treatment?

Unfortunately, it is a little tough to say at present, as further research needs to be carried out. At the time of writing, there have not been many studies on animals because there are no working coils suited for animal brains.

Nonetheless, the science of TMS is building. It's already showing promise as an effective way to diagnose brain injuries and help with neuropathic pain, but what about treating mental disorders?

When it comes to depression, TMS may be promising for those with treatment-resistant depression. Major depressive disorder (the most common type of depression) can be challenging to treat, with some forms subsiding with medication and/or therapy and others proving more stubborn. Sometimes, no matter what you do, it seems that your depression simply won't go away. In such cases, TMS may be a treatment worth considering.

Limitations of TMS

That said, some mental disorders don't show any response to transcranial magnetic stimulation. For example, PTSD, obsessive compulsive disorder (OCD), and schizophrenia may not be as suitable for TMS therapy. As always, it’s important to consult with a doctor who is well-versed in the science behind TMS and other possible treatments.  

Mental health treatment through online therapy

In the meantime, do not hesitate to reach out to a mental health professional, like those available through Regain, to discuss any mental health issues you may be experiencing. Licensed therapists will be able to discuss possible treatment plans in addition to traditional talk-based therapy. Sessions can be held anywhere you have an internet connection, including from your own home, and many of our therapists are able to operate outside of traditional work hours.