For a long time, the pervasiveness of depression has greatly outweighed the diversity of options for depression treatment. Alternative methods were hard to come by, hard to believe in, and hard to pay for. Finally, despite this historical difficulty, thousands of people from all backgrounds –young and old, rich and poor, man and woman– have seen their lives transformed by simply searching three words: TMS near me.
TMS, or transcranial magnetic stimulation, is a non-drug treatment for depression and OCD, particularly for folks who’ve struggled with antidepressants or other psychiatric medications. While the intervention is ostensibly novel, there’s an ocean of data supporting its efficacy, which has led to FDA approval and widespread insurance coverage. Given that many haven’t heard about TMS, at least in detail, here’s a comprehensive beginner’s guide.
TMS is predicated on the fact that, in depression, the human cortex –essentially where more complex tasks and thoughts are processed in your brain– is significantly under-active compared to the non-depressed brain. Ideally, your cortex (which we aptly call “the smart part of your brain”) can regulate and control your midbrain, the region that is largely responsible for the production of emotionality. Of course, negative emotions are not exclusively a bad thing; it’s healthy to feel sad during a breakup, scared in an alley, or stressed during performance reviews. When these things cannot be put back in their place, though, is when we see clinical depression emerge.
As such, researchers searched for a way to strengthen the cortex and put it back in the driver’s seat. Of all things, magnets have proved to be a fantastic solution! Here’s how that works:
The outcome? If the cortex, and specifically the left dorsolateral prefrontal cortex (L dlPFC) is consistently activated with safe, non-invasive magnetic fields, their resting state will be more charged, and it will be easier for the “smart part of your brain” to regain control over the “emotional part of your brain”.
TMS consists of frequent appointments over a couple-month period. With 36 total sessions that usually last 20 minutes each, most patients come 3-5 times a week into one of our offices in Silver Spring, Columbia, or Towson, MD.
Intake/ Day #1
After a consultation and intake with one of our TMS providers, it’s time for mapping! The purpose of the mapping is to find the exact location of your dlPFC and the exact strength the magnet needs to reach it. Once in the office, you’re seated in a chair much like the one at your dentist, a treater and/or provider gets you comfy, and the mapping lasts 20-45 minutes.
Regular treatments
On the same day as your mapping, you’ll begin treatment. For most people, sessions last less than 19 minutes after being set up. While in the chair, the magnet releases a “train” of pulses for a few seconds, followed by a 10-15 second pause between trains.
Does it hurt?
TMS should not be painful. While some are more sensitive to the sensation than others, most folks describe it as a tapping on the head. The first few sessions can be the most difficult to adjust to, but just about every single one of our patients has become acclimated to it very quickly. Regardless, we always have one of our treaters by your side who can make numerous adjustments to attenuate any discomfort you may feel.
What can I do during sessions?
While in-session, you can do just about anything but sleep. Most folks choose to chat with our treaters; we’ve built some really great relationships even in the short couple months we see each other. If chatting isn’t your forte, you can also be on your phone, read, or watch TV (we have all sorts of streaming platforms). The time is yours!
TMS, both industry-wide and especially in our practice, works remarkably well. Even when using conservative measures, over 2/3 of our MDD patients see a clinically-significant reduction in depressive symptoms, and half see full remission from depression.
Unlike antidepressants which flatten negative affect (and some would argue promote complicity), TMS’s approach to exciting the productive regions of your brain leads to positive behavioral changes, lifestyle adjustments, and mindset shifts.
Most often, we see patients manage stress better, more easily find motivation to perform daily tasks, be less irritable, maintain a routine, and experience less brain fog. As you can imagine, this new toolkit (or as one Silver Spring patient put it, this “new brain”) offers a much more sustainable and tangible foundation upon which sadness, hopelessness, and negative self-concept can be confronted and tackled.
The near-complete absence of side effects is one of TMS’s most compelling advantages. While medication has a whole host of common side effects ranging from weight gain to worsened depression to sexual dysfunction (think of the comically long disclaimers in pharmaceutical commercials), TMS has but one: a minor headache after the first few sessions that can be treated with an over-the-counter painkiller.
Yes, TMS is covered by insurance for eligible candidates. We accept CareFirst (BlueCross BlueShield), Medicare, Aetna, Cigna, and Johns Hopkins health plans. An “eligible candidate” is someone who is (or can be) diagnosed with major depressive disorder (MDD) or obsessive-compulsive disorder (OCD) and has tried at least one round of medication without satisfactory results.
Costs that befall on patients are usually in the form of copayments, which can vary by health insurance provider. Copayments usually range from $0-$30 per session, meaning some folks can spend a few hundred dollars over the course of the 36 treatments. Deductibles and co-insurance apply to TMS, as well.
A strong candidate for TMS (both clinically and in terms of healthcare coverage) is someone who:
If you’d like to get started with TMS or learn more about our TMS services in Columbia, Towson, and Silver Spring, MD, you can fill out the “We Want to Help” contact portal on this page. Otherwise, feel more than free to call us at (410) 538-1149, just ask to speak to the TMS coordinator!
