One of the most difficult concerns that I hear from patients is their frustration in thinking that “nothing works”. About 7.1% of Americans suffer from depression and, in the primary care setting, up to 50% of patients are considered treatment resistant (National Institute of Mental Health). Meaning, the patient has been on multiple medications without achieving any beneficial response in reducing their symptoms. So, what happens next when a patient does not have any adequate response to medication management?
When I come across this situation, I really need to start thinking outside the box to figure out the next appropriate step. The technique that I love most in addressing treatment resistant depression is Transcranial Magnetic Stimulation, or “TMS” for short. TMS is a specialized technique that uses magnetic stimulation to target various cells within the brain that are commonly affected by depression. The bonus? It is painless, noninvasive, and generally has very positive outcomes. TMS is generally performed 5 days a week for 5 weeks in total, and for about 15 to 45-minute sessions. While that seems like a lot, the benefits are abundant. It can help treat other symptoms beside depression, such as anxiety. It helps reduces the dependency of medications. Most patients tolerate TMS very well, with little to no complications. And lastly, full remission of symptoms occurs in about one third of patients who undergo TMS.
There is much more to treating depression than just medications and if you feel that you may be treatment resistant, don’t give up hope. TMS is something that I routinely recommend to patients who are struggling with depression and have a history of minimal response to medications in the past. Keep in mind, not all insurances cover TMS but most commercial insurances do. If you believe TMS can be beneficial for your depressive symptoms, reach out to your provider to discuss this option. PNS currently provides TMS five days a week. If you believe that TMS may be beneficial for your depressive symptoms, please reach out for an evaluation and consultation.
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