TMS stands for Transcranial Magnetic Stimulation. It is a safe, non-invasive, non-medication treatment for clinical depression and other mental health conditions that uses magnetic fields to stimulate the specific part of the brain known to control mood.
TMS is used on people with mental health conditions that have not seen success with medications and/or antidepressants. TMS has extremely limited side effects, especially when compared to traditional medications and antidepressants, so it is also a treatment option for people who may be suffering from side effects while trying to experience relief from their condition.
Many patients find that TMS is an amazingly effective treatment option. The FDA labeled TMS therapy to be marketed as a treatment for clinical depression in 2008. Since then, further studies have shown that it has the potential to treat a wide range of conditions, many of which can be debilitating. Although the Mindful Health Solutions team focuses primarily on alleviating the symptoms of treatment-resistant depression, our clinics also provide treatment for other conditions like anxiety, obsessive-compulsive disorder (OCD), body dysmorphia, memory disorders, and mild cognitive impairment, PTSD, and disorders that result in chronic pain.
TMS therapy is often administered in conjunction with other types of treatment, such as psychotherapy or (possibly continuing) medication management. At Mindful Health Solutions, our expert providers will work with you to create the best treatment plan for your specific needs.
TMS therapy can be a great option to consider for adolescents—generally over 15—if medications or antidepressants have not been working for them. It can also be a treatment option for adolescents if there is concern about them experiencing the side effects of medications or antidepressants.
TMS should not impact the medications themselves. However, as TMS treatments continue, there may no longer be a need for the medications that were being used as part of the original mental health treatment plan.
Unlike antidepressants, which temporarily impact mood and behavior by working through the bloodstream, TMS stimulates the brain and delivers localized electromagnetic pulses to the prefrontal cortex, which is the area of your brain that regulates mood. These electromagnetic pulses stimulate neurons, which release neurotransmitters and hormones such as serotonin and dopamine. Many experts believe that depression and other mental health conditions are linked to an imbalance of these neurotransmitters. TMS works to restore that balance and can provide a more lasting impact on relieving depression symptoms than other treatments, such as antidepressants.
However, mental health treatments are not one-size-fits-all situations. Because of this fact, treatment plans will vary depending on each patient’s unique needs and concerns. Treatment plans could follow these paths:
If adolescents were already taking medications before beginning TMS treatments, they may or may not continue to take them.
If adolescents were not already taking medications before beginning TMS treatments, they may or may not be prescribed medications to supplement their TMS treatment plan.
Overall, patients will work closely with their providers to collaborate on a treatment plan that works best for them. And as treatments continue, the plan will be adjusted as needed to make sure patients are continuing on their path to wellness.
There are numerous therapies and medications for depression, but very few have received FDA approval for use in adolescents. Only two medications are FDA-approved for use in adolescents. In the realities of clinical practice, multiple medications are used “off label” (not FDA-approved) for Adolescent Depression, including numerous antidepressants, mood stabilizers, and antipsychotic medications.
Unfortunately, the use of such medications is often limited by either side effects or lack of response. Adolescents typically have a higher risk of medication side effects compared to adults, and can include:
- Increased suicidal ideation
- Long-term weight gain
- Insomnia
Also, adolescents’ response to antidepressants is inconsistent.
Because of side effects and/or inconsistent responses, adolescents can experience prolonged symptoms without relief. Consequently, adolescents may have to go through multiple treatment options before finding one that might alleviate their symptoms.
To avoid situations such as these and to get adolescents relief sooner, there has been a search for new treatments, and Transcranial Magnetic Stimulation (TMS) is at the forefront of this movement.
Compared to antidepressants, TMS has very few side effects while also offering highly effective results. One in two patients treated with TMS had a 50% reduction in their symptoms, and after six weeks of treatment, one-third (33%) of patients had no symptoms of their depression or were in remission.
TMS is a safe treatment. While it is a relatively new mental health treatment, it was FDA-approved for people 18 years and older in 2008. Since then, there have been millions of individual treatment sessions performed in the United States. Although TMS hasn’t been FDA-approved for people younger than 18, multiple studies have shown that TMS is safe for adolescents.
For adolescents, TMS is generally used on older teens who are 15 years and older. It usually has mild and short-lasting side effects, especially when compared to antidepressants and medications.
Our clinicians who administer TMS treatments are professionally trained and put each patient’s comfort first.
TMS treatments do not hurt during or after each session. There are very few side effects of TMS therapy. Most side effects are mild and short-lasting, and can include:
- Headaches
- Sleepiness
- Lightheadedness
- Scalp discomfort
- Twitching or tingling of the facial muscles
Many patients find it to be uncomfortable on their scalp and mild headaches are common during the first few treatments, but these generally go away within the first two weeks as people get used to the sensation. It is rare that anyone drops out of TMS because of side effects.
More serious side effects happen very rarely, but can consist of:
- Seizures
- Hearing problems from the loud clicking noise that occurs during treatment
- Mania, which is more likely to occur if an adolescent has bipolar disorder
However, our expert providers will use their professional knowledge to further help avoid serious side effects like the ones listed above. It is most likely that some adolescents may experience a mild headache.
Generally, patients will feel just like their normal selves. They will be able to drive and go back to their regular activities. Some people report feeling a little tired or having a mild headache, but that usually goes away after the first week or two. Other people report more energy and better focus, as well as the ability to ignore obsessive, anxious thoughts after treatment.
TMS delivers localized electromagnetic pulses to the prefrontal cortex, which is the area of your brain that regulates mood. These electromagnetic pulses stimulate neurons, which release neurotransmitters and hormones such as serotonin and dopamine. Depression and other mental health conditions are linked to an imbalance of these neurotransmitters. TMS for adolescents works to restore that balance and can provide a more lasting impact on relieving depression symptoms than other treatments, such as antidepressants.
During a TMS treatment, the patient sits in a comfortable chair while the TMS coil is properly set in place on their head. (While this may sound intimidating, it really isn’t!) After the headpiece is in place, electromagnetic pulses are sent to the prefrontal cortex, which is the area of the brain responsible for mood.
While the pulses are being sent to the brain, adolescents can watch TV, listen to music, or talk with our staff. If they want and are comfortable, they can also have a parent in the room with them during their TMS treatment session.
Each treatment lasts about 20-30 minutes. The full course of treatment of TMS for adolescents will generally be five days a week for four to six weeks. We know that coming in five days a week for weeks on end is a commitment, but the results could impact your mental well-being for a lifetime.
After each treatment, the adolescent can go back to their regular activities! In fact, some people
experience more energy after each session.
Adolescent Depression is a challenging, and often debilitating, disease that needs to be diagnosed and treated as soon as possible to achieve the best results.
To begin the process, it’s important to talk to your adolescent. If they are undergoing stress and/or emotional changes, talk to them about it and observe their methods of coping. Ask your child and yourself these important questions:
- How are they coping with the stress? What coping skills do they have?
- Is their daily routine (sleep, appetite, energy, motivation) being affected in any way?
- Are there changes in grades, peer interactions, or engagement in family activities?
If they choose not to communicate with you about these questions, then ask yourself:
- Are they staying in their room all/most of the day and/or avoiding social interactions?
- Do they cry more days than not?
- Do they have a change in their appetite or weight?
- Are they no longer interested in hobbies or activities that used to bring them joy?
- Are they quick to anger or agitation?
- Do they hurt themselves?
- Are they not taking care of their physical appearance?
- Are they participating in risky behavior?
You could also ask them to complete this Depression Screen.
If the answers to the above questions or if their results from the Depression Screen are concerning, then your radar for depression should be high.
The next step is to seek professional assistance from a psychologist or psychiatrist to clarify the diagnosis. Depending on the diagnosis, the doctor can work with your adolescent to come up with an individualized treatment plan that works for them and their needs. This treatment plan can consist of psychotherapy, medication management, and/or TMS therapy.
A strong support system for your adolescent is extremely important during this process, and the sooner they get treatment, the more likely your adolescent will achieve remission in this episode, which decreases the risk for future episodes as well.
Yes! Most major insurances cover TMS, and we’ll work directly with your insurance provider on your behalf to help you get covered.
According to one study, antidepressants resulted in 5-10% improvement among adolescents on their standardized depression scores. However, with there being only two FDA-approved antidepressants for adolescents, the use of such medications is often limited by either side effects or lack of response. Adolescents typically have a higher risk of medication side effects compared to adults, and their response to antidepressants is inconsistent.
On the other hand, TMS therapy has shown significantly better results than antidepressants. One in two patients treated with TMS had a 50% reduction in their symptoms and about 30% of patients experience full remission, which means that their symptoms go away completely.
While most patients begin to show improvement after two to three weeks of TMS treatments, it can take up with six weeks to achieve the maximum benefits.
It is important to understand that mental health treatment plans are not a one-size-fits-all situation. Because of this situation, treatment plans may take longer or require different treatment option combinations in order to work best for certain patients. It is important for patients to communicate clearly with their provider about how their treatment plan is working. Collaboration between patient and provider can greatly impact the results of a patient’s wellness journey.
