In 2010 the U.S. Food and Drug Administration approved a new type of therapy for people suffering from major depressive disorder -- transcranial magnetic stimulation, or TMS.
TMS therapy uses a device that focuses magnetic pulses to a specific area of the brain in order to stimulate neurons which are believed to be underactive in patients with depression, said Rizwan Kahn, DO, a board certified psychiatrist at St. Francis Hospital. TMS therapy is available at The Bradley Center.
Kahn said that as opposed to antidepressant medication or electroconvulsive therapy (ECT, or "shock therapy"), which are systemic treatments that can improve depressive symptoms, but can also cause side effects to other parts of the body, "with TMS it's a very localized area that we're targeting in the brain."
Kahn said when a treatment is administered, doctors look for either response or remission from the patient. Response means that the patient gets 50 percent better from his or her baseline; remission means the patient is basically free from depressive symptoms. So far, six patients who have undergone TMS therapy at The Bradley Center have achieved remission, said Kahn.
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TMS has only been FDA approved to treat major depressive disorder (commonly known as clinical or severe depression), but studies and research are currently being conducted to see what other uses TMS might have for disorders such as chronic pain and anxiety.
"There's burgeoning research with this modality because it's very well tolerated," said Kahn. "If you have a treatment that's well tolerated, that can be a big plus. I think there is a very bright future with this modality as far as broadening its use in other illnesses goes because the data has been very impressive with the results as well."
Patients interested in TMS therapy first have a consultation to see if they're appropriate candidates. A patient can be referred to the treatment from a therapist or contact the TMS coordinator directly.
If approved, the patient undergoes treatment five days a week for a total of 20 to 30 treatments. Kahn said the first appointment takes about an hour, but after that appointments last about 30 minutes.
During the treatment, TMS coordinator Janna O'Loughlin conducts a counseling session with the patient. O'Loughlin, a licensed professional counselor, is also responsible for TMS consultations and administering the treatment.
Floyd Bidleman, a 43-year-old Columbus resident, recently sat down with the Ledger-Enquirer to talk about his treatment. This interview has been edited for length and clarity.
Could you start off talking about some of the other treatments you tried after being diagnosed with major depression? I was diagnosed with major depression two years ago. I went through in-patient treatment at the Bradley Center and then I went through the out-patient treatment and that was in June of last year.
Was that largely therapy sessions? It was therapy sessions, coping sessions and how to deal with the depression and stuff like that. During the process I was going through medication -- I went through all the different antidepressant medications and none of them seemed to work at the time. And this last year, about June this last year, I had another bout and that's when they suggested I go through the TMS.
What were your initial thoughts when they first told you about this kind of therapy and what it was going to do? My initial thought was 'What kind of treatment is it?' and what will it be like and will it help me? And would it stop my depression.
Were you scared at all? To be honest, the first treatment was kind of interesting, to say the least. But it was uncomfortable. But after the first session it was okay. I knew what was going to happen and what it was going to be like.
How many sessions have you gone through? I went through 26 sessions, the whole 26 sessions. I've been through it for end of February was my treatment, so it's been a few months.
When did you start to notice a difference? I started to notice a difference about the fourth week. My mood began to pick up a little bit, I didn't have such a down outlook on life.
What are some of the major changes you've noticed in yourself since going through TMS therapy? I noticed that, like I said, I don't have a (negative) outlook towards life. I've been having a lot more to do with my family. Work doesn't seem to get to me as much and everyday life has become a little better.
So are you able to handle stress better? Yes, I am. Yes, I am.
What has the response been like from your family? They seem like, they think I'm a different person. I'm a better person. I'm not as withdrawn as I used to be.
What were some of the things you were going through during the depressive stages that was having a major impact on your life? My outlook on life was -- I didn't have an outlook. I just, honestly, I just didn't want to be here. Depression can do that do you. I just didn't want to be, per se, alive at the time. I didn't want to do anything. I just pretty much slept and was kind of like a zombie.And now it's a complete 180. I have a lot more to do. My outlook on life is a lot better.
What would you say to somebody who was considering going through TMS treatment? I would say to go through the treatment because if medication hasn't worked in the past, it's a treatment that will work. And if it gets you off medication, it's well worth the process.
And have you had any follow up treatments? Or is it mostly counseling? I have had no follow-ups. I have a maintenance drug, just one little maintenance drug that I take and I do talk to a counselor every week.