The newest treatment for clinical depression isn’t a drug or a type of psychotherapy. It’s a medical device that looks like a high-tech hair dryer.
This treatment is called transcranial magnetic stimulation, or TMS, for short.
Inside the La Jolla offices of UC San Diego's Department of Psychiatry, Dr. David Feifel puts an attachment onto a patient's head.
How TMS works
Every 20 seconds, this device generates magnetic pulses to the part of the patient's brain called the prefrontal cortex. That’s the part of the brain that regulates mood.
The magnetic pulses are the same type generated by MRI machines. In TMS, the pulses create small electrical currents, which stimulate the release of mood-lifting chemicals in the brain.
It's been a godsend
Jay Martin said the treatments have been a godsend. He's nearly completed his course of care.
“There’s been a significant change in my whole outlook, both on life and just my general well-being," he said. "So I know it’s been a big difference from where I was.”
Martin has struggled with depression for decades. He tried counseling, numerous anti-depressants and even shock therapy. But nothing seemed to work for long.
Martin said he felt like he was walking around under a black cloud.
“I mean it was like, you don’t enjoy the normal things you would think. And it’d been like 10 years since I smiled, or laughed," he said.
The FDA approved TMS for the treatment of medication-resistant depression in 2008.
Since then, studies have shown some long-term benefits of the therapy. One study found 45 percent of patients had full relief of their depression at one-year follow up.
Side effects
TMS can cause headaches and muscle twitches. It can also cause a seizure, although the risk is quite low.
Doctors at UC San Diego are using the newest generation of TMS machines, called deep TMS.
Psychiatrist David Feifel said this device sends magnetic pulses deeper into the brain.
"The benefit of that, we believe, is that we’re able to activate areas that are firing abnormally that are not reachable with the conventional TMS device, allowing us to produce a more robust change in the brain, and ultimately produce a greater effectiveness," he said.
But this high-tech therapy comes at a high cost.
High tech, high cost
A standard seven-week course of TMS treatments costs around $15,000. At first, patients are required to come in for a session five days a week. After about 30 days, the treatments are tapered off.
Some, but not all insurance plans cover TMS. Those that do require patients to try a number of other options first.
The cost of care isn’t an issue for patients at the True Life Center for Wellbeing in La Jolla.
The center's patients undergo intensive treatments for addiction and mental health issues. These include counseling, drug therapy, and acupuncture.
Executive Director Krista Roybal refers patients with severe depression to TMS. She pointed out TMS isn’t for everyone.
“This is for a very select group who has been through usually more than one psychiatrist, sometimes up to three and above, and usually multiple medication trials," Roybal said.
Major depression has a major impact
Major depression exacts a heavy toll. It affects some 14.8 million Americans, and it’s the leading cause of disability.
The use of TMS for clinical depression is growing in popularity as more psychiatrists add it to their arsenal.
Whether TMS will make a big dent in the problem nationwide remains to be seen. But for Jay Martin, it’s made all the difference in the world.
“And I feel like even if the insurance company refuses to cover anything, it was worth the expense just to be able to feel this much better," he said.
