Depression is a complex mood disorder that we don’t understand very well. But we’re getting closer, thanks to TMS.
Stanford University conducted a TMS treatment experiment on 21 volunteers with depression. 19 of them got better.
The physical manifestations of depression
In 2016, Jianfeng Feng and his team discovered how depression affects the brain. According to their study, the brain’s reward center (medial orbitofrontal cortex) has impaired functionality. It also has weaker connections with the memory regions; which makes it difficult to remember positive experiences.
Further, the punishment center (lateral orbitofrontal cortex) instead is more active, and has stronger connections. And that antidepressants usually reduce its activity.
Depression is not always a chemical imbalance
For a lot of people, depression is a chemical imbalance. For almost half of all patients though, anti-depressants are ineffective because they try to address a non-existent chemical imbalance.
Much more than a cocktail of chemicals, the brain is an electric neural network. That’s where transcranial magnetic stimulation (TMS) comes in. TMS works by hitting specific regions of the brain with intense magnetic pulses for a few minutes a day. This provides a “shock” to neurons that allows them to start creating more connections where they were stuck.
In Stanford’s study, TMS showed incredible results. 19 of 21 participants showed enough improvement to no longer score as “depressive” on diagnostics.
Another study from 2018 showed almost a third of all participants went into remission, with more than half of them showing some improvement.
Stanford’s study wasn’t perfect, however. Not only was the sample size small, but it was also unblinded. This means the participants were fully aware of the study.
Even so, it’s difficult to ignore such impressive results.
TMS is the new gold standard of depression treatment
“There’s never been a therapy for treatment-resistant depression [that breaks] 55 percent remission rates,” said Nolan Williams, Stanford psychiatrist. “Electroconvulsive therapy is the gold standard, but it has only an average 48 percent remission rate.”
60 year old Deirdre Lehman participated in the study to see how TMS would affect her bipolar diagnosis.
TMS is FDA-approved for depression, although it’s likely to treat many more conditions including chronic pain. For now, the hope is to continue observing positive results in studies before making it more available.