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TMS for TRD: The Chosen Alternative To Using Medication

Keerthan Somanath • November 6, 2024
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Treatment-resistant depression (TRD) is a complex and challenging condition affecting millions of people worldwide. While many individuals find depression relief through traditional treatments like antidepressants or psychotherapy, they don't always work for everyone.


TRD occurs when depression doesn't respond to at least two different treatments, leaving individuals feeling trapped in their symptoms despite their best efforts to seek support and recovery. The emotional and physical toll of TRD can be overwhelming, impacting every aspect of a person's life, from their work and relationships to their sense of self-worth and hope for the future.


But a promising development in the mental health field offers a ray of hope: Transcranial Magnetic Stimulation (TMS) therapy.


This innovative, non-invasive treatment offers a new path forward for those who have struggled to find effective solutions through traditional treatment methods. This blog explores what makes TRD so challenging and how TMS therapy could offer renewed hope for individuals searching for the long-awaited relief they deserve.

What is Treatment-Resistant Depression?

Treatment-resistant depression is a form of depression that does not respond to standard treatments, such as antidepressant medications or psychotherapy. It is diagnosed when a person has tried at least two different treatment approaches (often a combination of medications and therapy) and has not experienced significant improvement in their symptoms.


For individuals with TRD, the frustration of seeking help and not finding relief can feel like a relentless battle, one that drains emotional, mental, and physical resources over time.


What sets TRD apart from typical depression is the persistence of symptoms despite following recommended treatment plans. People with TRD may still struggle with feelings of deep sadness, hopelessness, or emotional numbness. Everyday tasks that seem manageable for others (like going to work, engaging with loved ones, or even getting out of bed) become monumental challenges. It also affects concentration, decision-making, and overall quality of life.


Living with TRD can feel isolating, as individuals may feel misunderstood or worry that they are "beyond help." However, it's essential to know that having TRD doesn't mean treatment is impossible. It means finding the proper treatment may require exploring more innovative options.

Limitations of Traditional Depression Treatments

Traditional treatments for depression, such as antidepressant medications and psychotherapy, are the first line of defense against the condition. However, these methods may fall short for those with treatment-resistant depression due to various factors like individual neurobiological differences and the complex nature of the disorder.


Antidepressants, while effective for many, come with their own set of challenges. Side effects like weight gain, fatigue, sexual dysfunction, and digestive issues can be challenging to manage and may lead some patients to discontinue their medications prematurely. Additionally, even when medications work, it often takes several weeks, sometimes months, before patients experience significant relief. For individuals struggling with severe depression, this delayed onset can feel like a lifetime.


Psychotherapy, while incredibly beneficial for many, is not always effective on its own. Some patients may find that therapy alone doesn't provide the depth of relief they need, or they may reach a plateau where their progress stalls. Others may struggle to connect with their therapist or feel that their underlying neurobiological issues are not being adequately addressed solely through talk therapy.


The reality is that depression is a complex condition, and no single treatment approach works for everyone. This is why exploring alternative treatments like TMS therapy is so important. TMS offers a different approach. It targets the brain directly without the systemic side effects of medications, bringing new hope to those who feel they've exhausted their options.

What is TMS Therapy for TRD?

Transcranial Magnetic Stimulation therapy works by using magnetic pulses to stimulate specific brain areas, particularly the dorsolateral prefrontal cortex, which is often underactive in individuals suffering from depression. This stimulation helps to regulate brain activity, potentially alleviating the symptoms of depression without the need for invasive procedures or systemic medications.


TMS has gained significant recognition in the medical community and has been approved by the FDA as a treatment for depression, particularly for those who have not responded to more conventional therapies. Its non-invasive nature, combined with a strong track record of effectiveness, has made TMS a growing option for many patients and healthcare providers alike.

Digging Into the Science Behind TMS Therapy


TMS therapy is rooted in the science of neuromodulation, where targeted magnetic pulses stimulate specific areas of the brain. In the case of depression, the dorsolateral prefrontal cortex (DLPFC) is a critical region of interest. This part of the brain plays a crucial role in mood regulation, decision-making, and emotional responses. TMS aims to "wake up" the DLPFC by applying magnetic pulses to this region, encouraging neural activity that can help alleviate depressive symptoms.


When magnetic fields are applied to the scalp, they penetrate the skull (in a non-invasive, pain-free way) and induce electrical currents in the brain, promoting increased activity in areas that may have been dormant due to depression. 


Over time, this brain activity modulation helps restore a more balanced mood state. Unlike medications, which affect the entire body, TMS focuses solely on the brain, making it a highly targeted and localized treatment option.


Clinical trials have reported response rates of 50-60%, with many patients experiencing significant relief after completing a course of TMS sessions. In some studies, remission rates have reached up to 30%, offering a glimmer of hope for those who had previously found no relief from other treatments.

The TMS Therapy Process: What to Expect

If you're considering TMS therapy, understanding what to expect can help ease any concerns about the process. TMS therapy typically involves a series of sessions, with most patients requiring between 20 to 30 treatments spread over several weeks. 


Each session lasts around 30 to 60 minutes, during which patients remain awake and seated comfortably in a chair. A specialized magnetic coil is positioned over the scalp, delivering painless magnetic pulses to the brain. Most patients describe the sensation as a light tapping or tingling feeling.


One of the key benefits of TMS is that it's non-invasive, meaning there's no need for anesthesia, and patients can resume their normal activities immediately after each session. While TMS is generally well-tolerated, some individuals may experience mild side effects, such as headaches or scalp discomfort, particularly in the early stages of treatment. These side effects are often temporary and diminish as the body adjusts to the therapy.


Because TMS therapy involves direct brain stimulation, it's crucial to work with a qualified and experienced TMS therapist who can tailor the treatment to your specific needs. The precision of the procedure ensures that the right brain areas are targeted effectively, making it essential to have a skilled professional overseeing your care.

Benefits of TMS Therapy for TRD

The potential benefits of TMS therapy are life-changing for individuals with treatment-resistant depression. Because TMS focuses solely on the brain regions associated with depression, the localized stimulation offers relief without the burden of widespread systemic effects. As a result, patients frequently experience:

  • Improved mood and emotional balance
  • Increased energy levels and motivation
  • Better overall physical well-being due to fewer side effects
  • Enhanced ability to function in daily life, both at work and in personal relationships


One of the most compelling aspects of TMS is its potential for long-term results. Many individuals find that, after completing a course of treatment, they experience sustained relief from depressive symptoms. TMS can also help prevent future depressive episodes by reactivating and strengthening brain circuits responsible for emotional stability.


With its ability to provide both immediate and lasting benefits, TMS therapy stands as a powerful, hope-filled option for those struggling with treatment-resistant depression.

Find TMS Therapy for Treatment-Resistant Depression in Georgia and California Today

If you or a loved one is struggling with TRD, don't wait to explore the options that can make a real difference. No one should feel stuck in their search for relief, and TMS can offer new hope.


At Psychiatry Treatment Centers located in Hollywood, CA and Richmond Hill, GA our expert teams provide TMS therapy to help those seeking real relief from treatment-resistant depression. We dedicate ourselves to offering compassionate, personalized care and will guide you through every step of the TMS process.


Reach out to us today and discover how TMS therapy can help you reclaim your life.

Cited Sources:


Somani, A., & Kar, S. K. (2019). Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far. General Psychiatry, 32(4), e100074.

https://doi.org/10.1136/gpsych-2019-100074


Durmaz, O., Ates, M. A., & Senol, M. G. (2015). Repetitive Transcranial Magnetic Stimulation (rTMS)-Induced Trigeminal Autonomic Cephalalgia. Noro Psikiyatri Arsivi, 52(3), 309–311. doi: 10.5152/npa.2015.7618.

Kweon, J., Gobin, P., Fukuda, A., Carpenter, L., Brown, J. C., & Haq, L. (2023). Effect of Insomnia on Repetitive Transcranial Magnetic Stimulation Treatment Outcomes for Depression. Cold spring harbor laboratory.

https://doi.org/10.1101/2023.12.06.23299444


Avery, D. H., Holtzheimer, P. E., Fawaz, W., Russo, J., Neumaier, J., Dunner, D. L., Haynor, D. R., Claypoole, K. H., Wajdik, C., & Roy-Byrne, P. (2005). A Controlled Study of Repetitive Transcranial Magnetic Stimulation in Medication-Resistant Major Depression. Biological Psychiatry, 59(2), 187–194.

https://doi.org/10.1016/j.biopsych.2005.07.003

TMS for TRD: The Chosen Alternative To Using Medication

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