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Dr. Stephen Manlove

Eight Common Misconceptions About TMS Therapy for Depression

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Transcranial Magnetic Stimulation (TMS) is the most passive yet effective treatment available for depression, anxiety, PTSD, OCD, and schizophrenia. However, there are a lot of misconceptions about this treatment option.

Our psychiatric providers often recommend TMS to patients for a variety of reasons, but patients are often hesitant to give it a try because they are concerned about something they have heard about it. Often, the concerns of our patients are quickly resolved once they speak to their mental health provider.

If you or someone you know is hesitant to try TMS therapy for depression or other mental health conditions, read more about the eight common misconceptions below.

Misconception #1:

“TMS is the same as Electroconvulsive Therapy (ECT)”

Fact:

            TMS therapy for depression is an entirely different treatment modality than ECT. Both treatments address treatment-resistant depression, but that is where the similarities end. ECT deliberately triggers a controlled seizure passing a small electrical current through the brain. General anesthesia is necessary for this procedure, and patients may experience confusion and memory loss immediately following the treatment.

TMS is a much milder treatment that uses electromagnetic pulses (similar to an MRI machine) to stimulate parts of the brain that are underactive in people with treatment-resistant depression. No sedation is necessary for TMS, and the patient is fully awake and alert throughout the process. TMS patients are immediately cleared to resume their daily activities, such as driving or returning to work because there is no recovery time required after treatment.

 

Misconception #2:

            “TMS works immediately.”

Fact:

            While some patients may report an improvement in their symptoms within the first week, TMS therapy for depression is not intended to offer immediate relief from depressive symptoms. Most patients can expect to begin noticing improvements within 3-4 weeks of their first TMS treatment. This timeline for improvements is similar to that of a medication trial.

 

Misconception #3:

            “TMS is painful.”

Fact:

            TMS treatments consist of tiny electromagnetic pulses that are administered through a figure 8 coil. Your TMS provider positions the coil to rest lightly on your scalp. While TMS treatments do create a clicking sound and an odd sensation on the scalp, it should not be painful. Patients have described TMS as “a tiny woodpecker” or similar to “a TENS unit on my head”.

If you experience discomfort, your technician can make adjustments to make the experience more comfortable. For example, your TMS provider may lower the intensity of the pulses or adjust the placement of the coil.

 

Misconception #4:

            “TMS patients must stop taking all their medications.”

Fact:

            Almost all medications are safe to take while you are receiving TMS therapy for depression. The only exception is medications that lower seizure thresholds, such as Wellbutrin.

Patients are urged to abstain from street drugs and alcohol during the course of their treatment since those also carry the risk of lowering their seizure threshold.

 

Misconception #5:

            “TMS is new and unproven.”

Fact:

            The technology behind TMS dates to the 1980s and has been FDA-approved for severe depression since 2008 after many studies proved that it is a safe and effective treatment. TMS is also FDA-approved for OCD and smoking cessation. Tens of thousands of patients have been successfully treated with TMS.

TMS is one of the safest mental health treatments and is one of the best options for pregnant patients.

 

Misconception #6:

            “TMS is too expensive.”

Fact:

            For most patients, TMS therapy is covered by insurance. Most insurance companies will cover all or part of the cost of TMS treatments due to their low risk and high success rate. 

We accept Medicare Part B with a qualifying secondary insurance or supplemental plan. Read our blog for more information about Medicare’s coverage of TMS therapy, including does Medicare cover Transcranial Magnetic Stimulation?

 

Misconception #7:

            “TMS is too time-consuming.”

Fact:

            It is true that TMS is administered daily for 30 treatments plus a taper phase. However, after the initial appointment, most appointments are only 30 minutes. Since TMS is a non-invasive procedure, patients are able to drive themselves home and immediately resume daily activities. Your Rapid City TMS provider will do everything possible to accommodate work schedules and other appointments.

TMS can provide lasting depression relief. Depression medications, on the other hand, typically must be taken daily for the rest of your life. TMS could give you the relief you are looking for without the side effects that are often experienced with antidepressant medications. The time that you commit to yourself with these treatments

 

Misconception #8:

            “TMS can alter my personality or destroy my memory.”

Fact:

            TMS targets a very small area of the brain that is underactive in patients with chronic depression. This treatment is very mild, and the intensity of the treatment is carefully monitored. The areas of the brain responsible for processing and storing memories are out of range of the pulses, leaving them unimpacted by the treatment. This also holds true for concerns about TMS therapy for depression altering a patient’s personality.

 

TMS is a safe and effective treatment option for most patients with depression, anxiety, PTSD, OCD, and schizophrenia. If you have not yet spoken to a mental health provider to see if TMS is right for you, give us a call to schedule an initial appointment with one of our mental health providers in Rapid City, SD.

If TMS is not the right fit for your needs, Manlove Brain and Body Health offers a full spectrum of psychiatric interventions, including cutting-edge treatment options. Our team is here to help you find the right fit for your mental health needs.

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Dr. Stephen Manlove

TMS Newly Approved for Teens – Drug Free Treatment For Depression

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Transcranial Magnetic Stimulation FDA-Approved for Teens 15 & Up

Transcranial Magnetic Stimulation (TMS) treatments are now FDA-approved for teens ages 15 and older. This gives parents and their teens a low-risk, non-medication depression treatment option to consider that can provide a longer-term solution for teen depression compared to medication options.  

While this depression treatment has been newly approved for teens, TMS has been used to treat adult patients for nearly two decades. It’s powerful enough to fight treatment-resistant depression and safe enough to be the recommended depression treatment for pregnant patients.

Get to know this safe and effective treatment for teen depression, and give us a call to talk to a provider to see if TMS is right for your teen. 

How does TMS work?

When we look at the brain scans of depressed patients, we see low levels of activity in their DLPFC (dorsolateral prefrontal cortex) compared to the average brain. TMS works by sending electromagnetic pulses into the brain to stimulate specific areas that control our mood. 

A TMS machine works similarly to an MRI machine and results in an increase in brain activity for most patients. Roughly 75% of patients report a significant lift in their mood after completing their TMS treatment series. 

TMS treatments are completed in short 30-minute appointments over a 6-week period. Some patients may require maintenance treatments at a decreased cadence after the initial treatment series.

Why was TMS therapy FDA-approved for teens?

TMS was FDA-approved for ages 15 and up for several reasons, including:

  • TMS therapy has been effective in treating adults with depression with minimal side effects. Roughly 75% of adult patients respond to TMS treatment (50% or greater improvement in symptoms). Side effects are temporary and can be minimized with the help of your teen’s TMS technician. Scalp discomfort and headaches are the most common side effects, but they begin to fade as soon as the TMS machine is turned off and completely subside after a good night’s rest. Serious side effects are rare. 
  • Unlike antidepressant medications, TMS does not affect other parts of the body. Because no medication is used with TMS treatments, there are no risks that are typically seen with antidepressant medications for teens. And, the electromagnetic pulses only affect the area of the brain that is involved in mood regulation. 
  • Increasing research over the years shows that TMS is safe for adolescents. In a recent article, A New Treatment for Adolescent Depression: FDA Approves Transcranial Magnetic Stimulation (TMS), Len Lantz, MD cites several studies that support the safety and effectiveness of TMS for teen depression.
  • TMS provides lasting depression relief. The magnetic pulses created by a TMS machine stimulate neuronal activity and growth in the brain. In 2023, Stanford Medical research found that TMS corrects the abnormal flow of electrons in the brain. Whether your teen’s depression is caused by an abnormal flow or low activity levels in the brain, TMS can resolve these potential problems, resulting in long-term depression relief.
  • TMS can be safely used in combination with other treatment methods or medications. Since TMS is a drug-free treatment and is completed via a non-invasive procedure, it can be safely combined with medications or other treatment methods. In severe depression cases, TMS can be safely combined with other treatments to improve symptoms rapidly.

Getting Your Teen Help For Depression

If this is your first time seeking help from a behavioral health specialist for your teen, you may have some additional questions. Here are some common questions I receive from teens and their parents at their first psychiatric appointment at our psychiatry clinic in Rapid City, SD. 

Is this depression? 

If you or your child are concerned they might have depression, don’t hesitate to see a medical provider. Depression in teens has become increasingly more common, especially after the COVID-19 pandemic. Likely, if you are concerned that your teen may have depression, they likely do have diagnosable depression. 

It’s common for parents or even practitioners to mistake teen depression symptoms for typical adolescent developmental changes or “growing pains”, so it’s best to seek help right away because the symptoms have likely been there for a while. Due to delayed diagnosis, teenagers tend to have more severe symptoms than adults when they are first seen by a mental health provider. 

If you think your teen may have depression, schedule an appointment with a psychiatrist to discuss their symptoms. Whether your teenager has a depressive disorder depends on their symptoms, severity, length, and frequency. Note any symptoms your teenager experiences, when they began, and anything that improves or worsens their symptoms to help provide your psychiatrist with the details they will need to make an accurate diagnosis.

The National Institute of Health states that suicide is the third leading cause of death among individuals between the ages of 15-24. (It’s the number one killer of children ages 10-14.) Treating depression is the number one way to prevent teen suicides. We encourage parents to always take their child’s concerns seriously. The earlier you seek treatment, the better. 

DON’T HESITATE: If you think your child is in crisis or suicidal, call or text the national suicide prevention hotline at 988 immediately.  

My child seems depressed. Did I do something wrong?

It is not unusual for a parent to feel like they did something wrong if their child has a mental health concern. Yet half of the world’s population will have a mental health disorder at some point in their life, and most begin in childhood, adolescence, or young adulthood (Queensland Brain Institute).

If your child comes to you with a mental health concern, that is a good sign. That means you have taught your child to recognize when something is wrong and to ask for help when they need it. The same goes if you recognize symptoms first and turn to professionals for help. 

In today’s world mental illnesses are recognized as part of life and no longer carry the stigma they once did. Especially among teens themselves, there is much less of a concern of social isolation if your teen opens up about having a mental health condition. If your teen has a mental health issue, you have the chance to show them two very important lessons: seeking help when you need it and putting your health first.

What are the safest and most effective treatment options for depression in teens?

The best treatment for your teen will depend on their unique symptoms. For example, some patients have difficulty sleeping, which we can address with certain types of depression medications.

Generally speaking, however, TMS is the safest and one of the most effective depression treatments on the market. And, now that it is FDA-approved for teens, TMS is the safest depression treatment available for teens.

Will my child need depression treatment their entire life?

Depending on the treatment that you, your teen, and their medical provider decide, your teen may need depression treatment for years. One of the greatest benefits of TMS treatment for teens is that it can provide lasting relief. After the initial 6 weeks of treatment, some patients will not need any further treatments, while others will require occasional maintenance treatments.

If being tied to an antidepressant medication for years is a concern, TMS may be the best option. Schedule an appointment today to talk to a provider to see if TMS is right for your teen. 

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Dr. Stephen Manlove

Medicare Increases Coverage of TMS Therapy for Depression

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A recent change in Medicare coverage will now make transcranial magnetic stimulation (TMS) therapy for depression much more accessible. After seeing the significant improvements in patients with treatment resistant depression along with its non-invasive nature and minimal side effects, Medicare will now cover TMS for patients with severe depression after failing just one antidepressant medication.  

Before this change Medicare – like most insurance companies –required that patients try 4 or more antidepressant medications before TMS would be covered. This change will help people with severe depression get the relief they need quickly. 

This will give severe depression patients a proven and non-medication treatment option to help them get their life back. 

We are hopeful that other insurance companies will follow Medicare’s lead to make TMS treatments for depression accessible to those who need them. 

What is TMS Therapy for Depression?

TMS is a non-invasive procedure for depression that uses magnetic fields to stimulate specific areas of the brain that regulate mood. During TMS treatment, you will be seated in a comfortable chair for the 15-30 minute session. A TMS technician will gently rest a plastic coil on your head which will produce an occasional beeping sound and a tapping sensation on your forehead. 

Side effects may include headaches, lightheadedness, or tiredness which are typically mild and dissipate quickly once the TMS machine is turned off. 

Patients may resume normal activities immediately following treatment. Patients may drive themselves home or return to work, making treatment sessions easy to work into your normal schedule. 

Most patients receive TMS therapy treatments 5 days a week for 6 weeks, followed by one treatment per week for an additional 6 weeks. Some patients see their depression go into complete remission after the initial treatment series and others may require occasional maintenance treatments.

At Manlove Brain + Body Health, we have seen a 75% success rate when we use TMS for treating depression. 

“TMS was miraculous for me and I do know a couple of other people who have had the same results with no relapse of symptoms. Give it a try.” – Shawn, Manlove Brain and Body Health TMS patient.

Is TMS “electric shock” treatment?

TMS is very different from “electric shock” treatment. ECT or “electric shock” treatment sends an electrical current through the brain to trigger a seizure while the patient is under general anesthesia. ECT is one of the most effective treatments for depression, but can come with serious side effects such as difficulties with learning and memory. 

TMS therapy for depression does not trigger a seizure and does not deliver electric shocks. You will remain awake during TMS treatment. A TMS machine uses electromagnetic waves that will produce a light tapping sensation and a beeping noise. TMS does not cause memory or learning problems, which can be associated with ECT treatments. 

Have another insurance provider?

No problem! We accept a wide variety of insurances. Give us a call or send us an email to see if your insurance provider is accepted at our psychiatry clinic. 

Get Started Today!

Call Manlove Brain + Body Health at 605-348-8000 or email [email protected] to talk to one of our mental health specialists to see if TMS therapy for depression is right for you.

Dr. Stephen Manlove

Transcranial Magnetic Stimulation (TMS): How it works, what to expect, side effects.

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Transcranial Magnetic Stimulation (TMS) was developed in 1985, and has been  FDA-approved since 2008 as an alternative treatment for depression. TMS is covered by most health insurance plans for those with treatment resistant depression (TRD) which is defined as a patient who has tried 4 or more antidepressant medications and therapy without relief. It can also help people with symptoms of PTSD, panic attacks, suicidal thoughts, social anxiety disorder, seasonal affective disorder, and other mental illnesses.

Read more