The phrase “depression machine” often refers to Transcranial Magnetic Stimulation, or TMS. It is a non-invasive procedure approved by the FDA for the treatment of Major Depressive Disorder. TMS therapy is administered in an outpatient setting and uses magnetic fields to interact with specific parts of the brain.
The Science Behind TMS
Transcranial Magnetic Stimulation uses targeted magnetic pulses to stimulate nerve cells in the brain. These magnetic fields are generated by an electromagnetic coil placed against the scalp. The pulses pass safely and without sensation through the skull, where they induce small, controlled electrical currents within the underlying brain tissue.
For the treatment of depression, the primary target is a region called the dorsolateral prefrontal cortex (DLPFC). This area of the brain is involved in regulating mood, and research indicates it is often underactive in individuals experiencing depression. By stimulating these specific nerve cells, TMS aims to increase their activity, which can help restore more typical communication patterns within the brain circuits responsible for mood control.
The Patient Experience
The treatment process begins with an initial consultation and assessment to ensure TMS is a suitable option. This is followed by a “mapping session,” where a clinician determines the precise location on the patient’s head for coil placement. During this session, the clinician also identifies the specific energy level required to stimulate the appropriate nerve cells, a threshold that varies for each individual.
The patient remains awake and alert, comfortably seated in a chair. The TMS coil is then gently placed against their head at the predetermined location. During the treatment, which lasts approximately 20 to 40 minutes, the machine delivers repetitive magnetic pulses. Patients will hear a clicking sound and often feel a tapping sensation on their scalp with each pulse.
This procedure is performed daily, five times a week, over a period of four to six weeks. After a session, patients can immediately return to their daily activities. While the treatment is generally well-tolerated, some individuals may experience mild and temporary side effects. These can include minor scalp discomfort at the treatment site or a mild headache, which typically subsides shortly after the session.
Candidacy for TMS Treatment
The primary indication for TMS is for adults with Major Depressive Disorder who have not achieved satisfactory improvement from antidepressant medications. This is often referred to as treatment-resistant depression, where conventional therapies have proven ineffective.
There are specific circumstances that would prevent a person from being eligible for TMS, known as contraindications. A main safety concern involves the presence of any non-removable metal in or near the head that could be affected by the magnetic fields. Examples include aneurysm clips, stents, or cochlear implants.
Another important consideration is a history of seizure disorders. Because TMS works by stimulating neural activity, there is a small risk of inducing a seizure, making it unsuitable for individuals with a pre-existing seizure condition. This screening process ensures that TMS is administered safely.
TMS and Other Brain Stimulation Therapies
To understand the role of TMS, it can be compared to another form of brain stimulation, Electroconvulsive Therapy (ECT). A primary distinction between the two is their method of application. TMS stimulates the brain from outside the body using magnetic fields without requiring sedation.
In contrast, ECT involves the application of electrical currents to induce a brief, controlled seizure. For this reason, ECT must be performed under general anesthesia. The patient experience and side effect profiles also differ significantly, as ECT can be associated with more significant side effects, including temporary memory loss and confusion.