Individuals who suffer from major depressive disorder (MDD) often feel trapped inside a foggy gray bubble that holds them captive all day long. MDD is a debilitating mental health condition that saps energy, limits productivity, taints relationships, and generally wreaks havoc on one’s quality of life. Major depression is nothing to be ignored or minimized, as potentially devastating consequences can occur as a result of untreated depression. Understanding what is MDD disorder and getting timely treatment can literally be lifesaving.
One of the challenges of an MDD diagnosis is finding a treatment protocol that is not only effective in minimizing the symptoms of depression, but is tolerable as well. Antidepressant drug therapy is renowned for adverse effects, making that option sometimes very disappointing. In addition to the multiple side effects of the drugs, antidepressants only help reduce depression symptoms in about half the patients who trial them.
Transcranial magnetic stimulation (TMS) offers a safe and effective solution for individuals who have not experienced successful outcomes with antidepressants. TMS is noninvasive, which means there is no anesthesia involved, no incisions or surgical procedures, and no down time required. For someone who is suffering from MDD and has not responded to traditional treatment, TMS offers new hope.
What is MDD Disorder?
Major depressive disorder is a serious mental health disorder that impacts over 17 million Americans each year. Learning about what is MDD disorder begins with understanding what it is not. MDD is not the feelings of sadness or low mood that accompany a difficult life event. Those temporary bouts of the blues are directly attributed to a specific negative event, such as the death of a loved one, a divorce, a job loss, or some other event that results in feelings of sorrow. Most of us recover from such events over a period of weeks or months without the need for any intervention by a mental health practitioner.
MDD typically features a cluster of symptoms that have persisted for more than two weeks for most of the time in that period. These symptoms include:
- Persistent sadness, hopelessness, despair
- Diminished interest in usual activities or hobbies
- Change in appetite leading to weight gain or loss
- Insomnia or hypersomnia
- Feeling sluggish or agitated
- Feelings of inappropriate guilt, worthlessness, or shame
- Problems with concentration or decision-making
- Thoughts of suicide
Because depression is a complex and often mysterious mental health disorder, it is often not known exactly what causes MDD. However, factors that have been identified as potentially causal include a family history of depression, medical conditions, brain chemistry imbalance, traumatic life events, and co-occurring substance use disorders.
The Effects of Untreated Depression
Unaddressed depression can have devastating effects on everyday life. Depression can impact relationships, work productivity, and physical health. This is due to the effect the symptoms have on functioning, possibly leading to serious impairment. Beyond the emotional suffering involved, when the symptoms are allowed to persist, long-term depression can lead to health complications, such as:
- Increased risk of heart disease
- Loss of libido
- Weight gain or loss
- Chronic pain
- Debilitating fatigue
Suicide is the most serious consequence of untreated depression. Individuals suffering the debilitating effects of prolonged depression symptoms may become so hopeless and despairing that they give up on life. According to the Centers for Disease Control, 47,000 Americans died by suicide in 2017. In young people ages 10-34, suicide was the second leading cause of death. Approximately 60% of those who died by suicide had a mood disorder, including MDD, bipolar disorder, and dysthymia, or persistent depressive disorder, reports the U.S. Department of Human Services.
Treatment For MDD
The standby treatment regimen for MDD continues to be a combination of antidepressant drug therapy and psychotherapy. With a wide range of antidepressants available, the mental health professional will select the one considered most likely to help. Treatment effects take 4-6 weeks, so the trialing period can be quite prolonged. When a doctor selects an antidepressant they weigh the potential benefits against the side effects and hope to find the best fit. However, side effects from antidepressants, such as weight gain, fatigue, sexual dysfunction, insomnia, dry mouth, blurred vision, and nausea can make the drugs intolerable.
Psychotherapy is useful in providing an outlet for patients with MDD to discuss their personal issues with a therapist. The therapist will often utilize cognitive behavioral therapy (CBT) to help the individual shift any negative self-talk toward more positive and affirming thoughts. CBT is a short-term therapy and can be very helpful in modifying the disordered thought patterns that might be contributing to the depression.
TMS For MDD
Only about 50% of the individuals place on antidepressants for MDD treatment actually experience relief from their symptoms, unfortunately. After trialing a few different drugs or tweaking dosing, if there hasn’t been any measurable improvement in the depression then the patient is diagnosed as having medication-resistant MDD. Science has not yet determined why an antidepressant will work for some patients but not others.
For these individuals, TMS therapy provides a very promising treatment alternative.
TMS is a noninvasive neuromodulation technique that is safe and effective for treating medication-resistant MDD. TMS therapy works by harnessing magnetic fields that deliver electrical currents into the brain through a coil positioned on the scalp. The electromagnetic energy is directed to the left prefrontal cortex, or the limbic region. This area of the brain is responsible for emotion-regulation and other executive functions.
The electrical currents penetrate the brain tissue and target the underactive brain cells that are associated with MDD. The consistent application of these 40-minute treatment sessions can potentially reset brain chemistry in the depressed patient by stimulating dormant or sluggish neurons in the mood center of the brain. After 4-6 weeks of sessions, the individual may experience boosted energy, better sleep quality, sharper concentration, and improved overall mood.
Is TMS Safe?
During the in-office TMS therapy sessions the patient is wide awake and needs no sedation. There is no recovery time needed after the sessions, so patients can immediately return to their daily routines. TMS therapy is very well tolerated with only fleeting minor side effects sometimes reported, such as headache, facial numbness or tingling, or scalp tenderness. There is a very remote risk for seizures.
TMS therapy is not appropriate for everyone, however. There are some situations that will prevent an individual from being a candidate for TMS. These include individuals with:
- Aneurysm coils or clips
- Deep brain stimulators
- Metallic implants in eyes or ears
- Stents in the brain or neck
- Electrodes that monitor brain activity
- Implanted devices, such as pacemakers
- Facial tattoos with magnetic or metallic ink
- Any metal devices or objects implanted in or near the head
- Bullet fragments or shrapnel in or near the head
How Long do TMS Effects Last?
Because of the complexity of MDD it is impossible to predict how long the positive effects from TMS will last, as this varies among patients. Most patients report an average of six month of MDD relief, but some may achieve longer lasting results. As more is learned about TMS response and remission rates, it is increasingly advantageous to be proactive about prescribing TMS booster protocol. This involves periodic treatments to help prolong the clinical effects of the initial round of TMS treatments. Some patients may receive maintenance TMS sessions once a month, where others might receive them for three consecutive days every other month.
One meta-analysis of TMS studies [Janicak and Carpenter] reviewed several clinical trials that sought to establish the durability effects of TMS on medication-resistant MDD. One such trial followed patients for a period of four years, finding about half of the participants achieved a sustained remission averaging five months. Another trial followed 42 patients who had achieved response or remission after the first round of therapy. After six months, 62% of them were able to retain the results with TMS maintenance sessions.
Anew Era TMS Provides Comprehensive MDD Treatment
Anew Era TMS is a leader in the field of TMS therapy for treating people with medication-resistant MDD, and serves Orange County, California and Austin, Texas. These TMS experts are dedicated to helping patients overcome the effects of MDD and restore their quality of life. Anew Era TMS offers a full array of mental health services as well as TMS therapy. For more information or to ask what is MDD disorder and are you a candidate for TMS, please contact Anew Era TMS today at (888) 503-1549.