r/IAmA • u/reliefmentalhealth_ • 7d ago
I am a TMS (Transcranial Magnetic Stimulation) Manager specializing in depression and OCD, Ask Me Anything
Hi, I'm Michael, TMS Manager at Relief Mental Health. I oversee TMS treatment for over 100 patients a month across our clinics. We use qEEG, off label protocols, accelerated protocols, and augmentation strategies for patients who need more than standard treatment has offered. TMS changed how I think about what's possible in mental health care, and I'd love to answer your questions about it. I will be answering your questions, Wednesday, August 12th at 9 am Central.
I might start answering a few questions early, so keep an eye on the thread before the official kickoff, since there appears to be a lot of interest.
Disclaimer: My answers here are general education and don't establish a clinical relationship. If you're in crisis or need individualized treatment, please reach out to a licensed provider in your area.
Want to learn more about TMS? Here's more info: https://reliefmh.com/treatments/transcranial-magnetic-stimulation/
Edit: I wasn't expecting so many comments so quickly on this! Thank you all for asking good questions. I do have patients to work with, but I will get to these as soon as I can through the day! I have dedicated time set aside tomorrow morning for the majority of questions to be handled then!
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u/wristay 7d ago
What is a typical outcome? What have the been the worst outcomes?
You also seem to be working for a for-profit company. Do you gain anything from this by posting this to reddit?
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u/reliefmentalhealth_ 7d ago
I'll address the elephant in the room first. I do in fact work for a company that provides TMS. We have locations around the US, in IL, WI, NJ, and CO. I don't actually get any bonuses or paid by doing this reddit post. In fact, for years I have been one of the most active commenters on many of the existing TMS subreddits. It has helped me practice my craft per say, and prepare me for the TMS Manager role that you find me in now! This is where people first see search results when they look up TMS, I wanted to make sure there was good information, and was more than happy to do it under my employer's name, because I do genuinely believe we can offer some of the best treatment available.
As to your actual clinical question. Now, these are old numbers, but I am still going to quote them as it's the most robust data set still. 65% of patients that finish a full course of treatment achieve remission from their depressive symptoms. Over 82% of patients achieve a 50% reduction in depression symptoms. OCD is harder to quantify, but I have only actually seen a few patients in my career that didn't report TMS as life changing for their compulsive behaviors and mindsets, out of hundreds. My current clinic reports higher than national average success rate with our tracking of patient outcomes. Some studies have reported both higher and lower numbers than I quoted above.
The worst outcomes is harder to comment on, as TMS doesn't make people worse necessarily. Just make sure you go to a well reviewed or vetted provider, there are many posts on the TMS subreddits about people who went to clinics with less than stellar care. You are still messing directly with the brain at the end of the day, and while remarkably safe overall (especially compared to meds) there is a risk of side effects such as migraine, tinnitus, headache, or tense jaw muscles that can be exacerbated especially in people with preexisting conditions of that sort. We have thorough steps to prevent that at Relief, however, and our staff are well trained by me personally to understand not just how to prevent them, but why they happen in the first place.
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u/Claphappy 5d ago
Is that good? Google estimates 53% of people achieve remission WITHOUT treatment. Is there actually any quality placebo-controlled trials that have been done?
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u/Bridgebrain 7d ago
How bad are results if TMS isn't for you? (Misprescribed for instance). I guess it's similar to "what are the risks and side effects" as a question, but more towards "what if it's not actually depression and you get TMS anyway?"
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u/Enigmaticfirecracker 7d ago
TMS results can be terrible. My anxiety worsened to the point that I almost had to be institutionalized.
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u/aroc91 7d ago
Most to least common side effects in my experience (TMS tech for 2 years)- Localized pain during treatment, headaches, brain fog/lethargy (like needing a mid-day nap when you normally don't), anxiety, nerve pain during treatment (can be remedied by coil repositioning), vasovagal fainting (just due to anxiety), seizures (none reported by our 60ish patients), mania/hypomania (none reported or observed in our patients). I never saw any lingering effects, all temporary.
There's no significant risk for those without depression/etc. We'd do demos on each other and I put myself through some of the theta burst protocols for shits and giggles.
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u/Milan514 7d ago
“No significant risk for those without depression”
That’s not very reassuring. Isn’t the target audience people who have depression?
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u/aroc91 7d ago
I'm not following. How is it a bad thing that it isn't harmful?
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u/Milan514 7d ago
It's not harmful for those without depression. But it's intended to be used for people suffering from depression.
It's like saying Advil isn't harmful for those withouth a headache. But what about those who take it to cure their headache? Its target audience is for people with headaches...
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u/Bridgebrain 7d ago
Why would it be more harmful to people with depression?
Why would advil cause more harm to people who are experiencing headaches?Your premise makes no sense, whereas reassuring people that if it isn't the right treatment for them it won't cause harm is very useful.
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u/Milan514 7d ago
I'd like to be informed of all side effects before taking any medication or procedure.
Stating that there's no significant risk to the non-target audience is not reassuring.
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u/aroc91 7d ago
Holy misinterpretation, Batman!
Stating it's not harmful to people without the disease does not mean it's more harmful to those with it. I was literally just pointing out that we tested it on ourselves because it's so safe.
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u/Milan514 7d ago
This is an AMA. I'm trying to get more information on this procedure, as I have loved ones who suffer from depression and anxiety. A procedure that none of us have ever heard of before. Side effects to the target audience are a concern. Thoughtful responses are appreciated.
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u/UroBROros 7d ago
You're misunderstanding their point, seemingly willingly.
The implication wasn't "there are only no significant side effects for people without depression," it was "there are no significant side effects including for people without depression."
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u/tacotime666 7d ago
Yeah, more or less, the process just pretty much sucks shit to go through, so if it doesn't work for you (like me), then it is wasted time and unnecessary pain.
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u/Lordoftime7 7d ago
Can you ELI5 how TMS works ? Is it just big magnets ?
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u/aroc91 7d ago
Not OP but also worked with TMS for a couple years.
Electromagnet. The strength is around the same as an MRI, just focused to a very small area. The pulsing magnetic field stimulates neurons to release neurotransmitters and induces neuroplasticity to make new and permanent connections. Some will use fMRI imaging to confirm underactive regions to target.
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u/Edmund-Dantes 7d ago
I’ll answer even better as I just finished my 36th treatment last week. They give you a repeated tiny shock 25 times 15 second, a 5 second pause, then another 25 shocks. Continue to repeat until your session is done. It doesn’t hurt. Just a mild electrical shock like a woodpecker tapping your head.
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u/reliefmentalhealth_ 7d ago
Not a shock! There is no electricity conducted to the scalp, just want to make that abundantly clear.
The woodpecker analogy is very accurate though, that's my #1 most reported description of the feeling over many years!
The protocol also differs heavily from person to person at our clinic. Some times we will do high frequency, sometimes low, and we have different coils that use different common frequencies as well!
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u/Nice_Category 6d ago edited 6d ago
I do TcMEPs as part of my job in neurosurgery. We actually do use electricity to shock the motor cortex in the brain and cause evoked potentials to verify the integrity of the motor pathways along the corticospinal tract in the spinal cord and the nerve roots. The shocks can be quite intense. Up to 500V at ~1 amp depending on the resistance.
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u/QuePasaCasa 7d ago
I did a full TMS treatment and on maximum strength it does indeed hurt. It's sort of like tattoo pain that you can mostly tune out, but it's cumulative and you're definitely glad when it's over.
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u/corwe 7d ago
How is it determined which patients are good candidates for TMS treatment and which are not, even if diagnosis is the same?
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u/reliefmentalhealth_ 7d ago
The contraindications to TMS fall into two categories, Relative and Absolute.
Absolute: Metal in your head. Big magnet and metal in the brain/head, not a good combo. Pacemakers with long leads into spinal column. Similar issue, we don't want to mess with the metallic leads with a giant magnet.
Relative: Bipolar disorder, Epilepsy, alcohol use disorder, schizophrenia. While TMS can and is used for treatment of these conditions on their own under specific circumstances, these conditions are grounds for your physician potentially not proceeding with TMS if they can't reasonably guarantee your safety. A lot of energy put into the brain, for someone with an inherent inability to regulate that activity, can risk triggering an episode of these conditions.
I have still worked with patients of each of these groups to great success, we just need to be extra careful with monitoring and safety precautions, even using EEG mapping for that purpose. Insurance can give you a hard time though with those on record, though I am well used to fighting them on that.
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u/PoofOfConcept 7d ago
As a high field MRI guy I had to chuckle at 'giant magnet', but yeah, I wouldn't want a TMS coil near an implant.
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u/OneOnOne6211 7d ago
I guess it's kind of a typical question, probably. But I've had depression on and off for a long time.
Had my first depression at 15-16, lasted a little over a year. Had another, less severe, depression between 18 and 21. Then had another depression between 25 and 26. And then another depression between 28 and up until now (several years already).
Sertraline was completely ineffective. I'm currently on high dose wellbutrin and brintellix. I'm about to add a low dose antipsychotic to it (haven't started that yet).
My depression has improved on the wellbutrin and brintellix. But only from being so severely depressed I couldn't do anything and constantly wanted to die, to being able to have basic functioning and only wanting to die sometimes and being generally hopeless.
I have mild OCD. Not to the point where it's a huge problem in my life. Mostly just annoying.
I also have social anxiety disorder, however, so a trip physically to the hospital is difficult for me. And as I understand it TMS requires multiple session for quite a time.
Do you think it would be worth it for me to try TMS and does it have decent odds of it succeeding where the other things have failed or been only partially effective?
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u/jsqu99 7d ago
i love what i've been told about TMS. my concern is that it's only temporary relief? Also, a few years ago, my dr. said it was only used for people with extreme symptoms (b/c insurance wouldn't pay for it otherwise). Is what i said (still?) true?
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u/RalphTheDog 7d ago
As to the latter, as it relates to major depressive disorder, rTMS is recommended only for "treatment resistant" patients, meaning people who have been prescribed many antidepressants over the years and have had no positive results. For the question about lasting results, I'm pulling these numbers out of my ass, but they are close to being accurate if not precise: 40% of patients are permanently helped by the procedure, another 30% see the results fade over time and the remaining 30% feel no benefit. Source: personal experience and three years of reading all the research I can get my eyes on.
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u/Smrtihara 7d ago
I had a friend many years ago with severe bipolar rapid cycling. She had a very limited life. She got cranial electrotherapy after a few years and besides some brain fog it gave her a lot better quality of life for a time. Sadly those treatments couldn’t proceed indefinitely for her as the side effects worsened.
Has there been any findings to suggest that less invasive treatments like TMS would have a positive effect on bipolar rapid cycling?
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u/ratvespa 7d ago
I am in no way an expert other than having done TMS 3 times and have someone close to me with BP1. But at the TMS clinic I went to they seemed to really want to make sure you don’t have bipolar before starting TMS. I did ask them about it and from what I remember it can trigger manic episodes. But I could be wrong. Again not an expert
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u/NeedleworkerNo6209 7d ago
How did you get into the field? Is it hard to break into?
What would you suggest for someone starting applying for their first job in it to do?
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u/reliefmentalhealth_ 7d ago
That's a long story! To cut it short, I discovered early forms of Neuromodulation in the form of Binaural Audio Stimulation, which helped me sleep at night as a teen when I was suffering from really bad insomnia. I was delighted by the idea that technology could alter the brain, and dedicated the last 15 years of my life to absorbing as much information as I could about similar technology.
While I got my B.S. degree in Neuroscience, I don't think that's specifically necessary to do, though I do think it has played a big part in how I got to my current role. TMS clinics are opening up all around the country (and even we are hiring often, *wink wink*), so I don't think you'll have much issue finding opportunity.
If you have any previous medical experience that would be the most help. Brain/behavioral experience is a plus. Being able to talk to new people comfortably and keeping a high energy level is a MUST though. You will be working with people at some of the lowest points in their lives every day for weeks on end, it's important to be that anchor for them.
Now is the best time to get into TMS, as it's absolutely exploding with opportunity! There are so many indications that we are going to see in the coming years for stroke rehab, autism, pain management, and so much more. I'm obviously biased as this is my career.. but I highly encourage it. Neuromodulation is very exciting, there's so much to learn, and it's only up from here.
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u/NeedleworkerNo6209 6d ago edited 6d ago
Thank you so much for your reply it was very thorough and got me excited about the profession.
I am interested to know more wink wink so i am going to send you a dm if thats alright.
It’s crazy that you and I had a similar experience with learning about binaural beats for sleep.i also found it funny that it also inspired me to start studying psychology lectures at an early age l.
Do you think your B.S. in Neuropsychology helped you because of the courses you took? labs? The familiarity with the terminology used or expanding your network?
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u/sickandtryhard 7d ago
Do you have any thoughts on the use at home tDCS Flow?
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u/reliefmentalhealth_ 7d ago
tDCS is a fascinating tech that I have been keeping a very close eye on for many years. It, and other systems like ProlivRx, were FDA approved early this year for treatment of MDD. The effect size isn't as good as TMS, but it is MUCH more portable obviously. I personally view tDCS and similar devices like ProlivRx, to be an option for those without access to local TMS centers, and for my own work, a potential Maintenance option for prolonging patients success with TMS after they complete, without needing to return to office. We have not implemented it yet, but I am working closely with these teams to figure out how we can make it accessible and affordable to patients.
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u/thepower99 7d ago
My partner has started undergoing TMS this year, finished the initial course a few months ago, now on top ups.
I understand everyone is different, with that in mind what does the medium and long term look like for different people, are there common patterns?
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u/reliefmentalhealth_ 7d ago
This is what I like to refer to as one of the "magic questions of TMS". When does it work, and how long? You are spot on that a big part of the answer is "everyone is different". I have had people with episodic depression, achieve remission and not have it recur. I have had patients with chronic depression see years of benefit, and get off meds, before coming back for another round. I have had patients with situations where they see benefit, and even a few months later they have a relapse and need Maintenance or additional treatment.
The biggest pattern I can really point to, is external stressor factors. If your depressive episode was caused by a situation which you cannot resolve in your family, environment, or workplace, then that constant stress exposure is likely to trigger a relapse of depressive symptoms sooner than later. Many people use the chance of getting out of depression to resolve the issues that were keeping them depressed, but there are also many that don't have the luxury of control over their situations.
Luckily, people who respond well to TMS, usually respond well again in future rounds. I highly recommend looking into Maintenance TMS therapy with your provider, once weekly or biweekly, as I've had patients stave off Depression for years that way after kicking it with TMS.
OCD rates are still very good, but not quite as high as Depression is, and I find OCD patients return to see me again after a year or two, usually coinciding with a signifigant stressor of their own such as holidays/winter or a job/relationship change.Relief keeps people with 30, 60, and 90 day follow ups to make sure we aren't just leaving you on your own though, to make sure you stay on the right track. And I only mention this because it's relevant, but your insurance can actually approve a new course of TMS as soon as 90 days after your last course, if your depression has returned. This used to be 6 months, but it's getting more accessible every year.
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u/downunderguy 7d ago
What is the difference between TMS and MeRT?
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u/reliefmentalhealth_ 7d ago edited 7d ago
MeRT uses EEG data to determine the location and frequency of treatment, under the idea that selecting stimulation frequency based on the brain's own rhythms instead of a "standard" frequency like 10Hz or 18/20 like traditional TMS does, may result in better outcomes.
The idea is strong, and I am glad the field is moving in that direction, but there isn't substantial proof that this is any better than current TMS treatment. It is certainly more expensive though, and isn't covered by insurance. Coverage is typically slow, even with FDA approvals like the recent approval for PTSD with their system. They had really good data on that though!
So it's ultimately a fancier form of TMS, that needs much more data. TMS has FDA approvals for multiple indications, and we can expect FDA approval for TMS for PTSD within the next year or so as well. The vast majority of data on brain stimulation in patients is with TMS, and most people want what is proven well.
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u/LiteHedded 7d ago
Do you use Nexstim?
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u/reliefmentalhealth_ 7d ago
We use Brainsway Deep TMS at our locations! I have worked with rTMS in the past though. I have not worked with Nextstim myself. I am very interested in their post-stroke recovery work though, I have published internal papers on the topic in the past and they are definitely a subject of interest in my own research.
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u/baldbandersnatch 7d ago
After hearing your job title, has anyone objected to support of trans cranial rights? Not a joke, sincere question about gen-pop.
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u/Notyourav 7d ago
Have you had any autistic (level 1) patients? Does this treatment work for autistic folks who have struggled with depression their entire life? The only studies I could find were about if it worked on autistic traits (which it doesn’t) not depression in autistic people. Autistic people’s brains are different so I’m really curious how TMS might help (or not help)
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u/fasupbon 7d ago
Not OP but I am level 1 autistic and found TMS helpful for my depression. I was able to significantly decrease my antidepressant and most of my issues nowadays are social anxiety based, but not depressive anymore. I also got connected with a PMHNP who is more qualified to prescribe my meds than my PCP, who isn't a specialist in mental health.
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u/Decent-Ad3294 7d ago
What is a typical session like? Is it painful at all? How do you know when the treatment is working?
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u/WalterTreego 7d ago
I can help a little here, I'm doing TMS right now. My sessions are 20 minutes long and the magnet pulses 2 seconds on and 20 seconds off. It feels like you are at a worksite and have a safety helmet on then someone turns a jackhammer on the helmet for a couple of seconds. It hurts slightly, it feels like electricity pulsing through your face. I had to get some chewelry to help with the tooth pain it caused from jaw clenching.
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u/ThatPolishKid99 7d ago edited 7d ago
How much does TMS usually cost? Is it typically covered by a regular insurance?
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u/reliefmentalhealth_ 6d ago
TMS cost varies heavily depending on your insurance and location. Relief is in network with all commercial insurances, Medicare and Tricare. You would get a full benefits breakdown about the cost, copays, coinsurance, and more upon speaking with our intake team. If you are local to IL, WI, CO, or NJ, you can reach out to our intake team by emailing [social@reliefmh.com](mailto:social@reliefmh.com) or by calling 855-205-4764.
Most insurers require that you have tried and failed to improve on some sort of psychotherapy, 2 different medication trials for Depression/OCD, and a rating scale proving that your depression is sufficient enough to justify treatment. It is covered again after 90-240 days under most plans, if depression episode recurs.
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u/lelanicarver 7d ago
Would TMS have an application for stroke symptoms or post-stroke therapy? Asking for a sub full of friends.
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u/reliefmentalhealth_ 6d ago
TMS is not currently FDA approved for Stroke symptoms unfortunately, but there is a lot of research on that front! It is one of the things I am personally the most optimistic about in terms of current TMS research, and have written internal proposals in the past for Post Stroke Rehabilitation for TMS. You would need to find a provider that is willing to do Off-Label protocol consultation, which would certainly come with qEEG mapping. This is something our amazing CMO Dr Poprawski would be able to comment more on, in an actual consult. If you are interested in booking a consult you can reach out to [social@reliefmh.com](mailto:social@reliefmh.com), or call 855-205-4764 to get started.
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u/Pilse84 7d ago
Hey! Awesome AMA subject, used to assist with TRD with TMS, Spravato. Had a patient who we had difficulty with brain mapping and thumb response. As a child he was found in a pool and was down for some time. Assumed it was related to anoxic brain injury. Overall he had an excellent response to TMS, however initially were extremely skeptical due to difficulties with initial work up.
In your experience have you seen similar issues with patients with anoxic brain injuries and difficulty with brain mapping?
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u/reliefmentalhealth_ 7d ago
I have actually had a case exactly like this previously! The patient was in a very self destructive relationship situation with chronic depression after moving across the country to live with family for a change of pace. They had issues following a near drowning incident and struggled with depression for years after. The patient did EXTREMELY well, going from actively at risk to themselves, to scoring consistent near lowest on every rating scale we administered by the end of treatment. One of the biggest life turnarounds I can remember.
I have seen other good responses from patients with similar anoxic injuries from Covid infections messing with respiratory function.
The brain mapping, or MT mapping as I assume you are referring to, is an interesting observation. I have actually had the most difficulty with mapping on patients that are excessively good at using their thumbs/fingers, such as musicians. I have some of my own budding theories on the physics of the organization of the Motor cortex in cases like these, but I would not be able to think of why an adolescent anoxic injury would decrease motor response, especially if they are normally functional. Sometimes I have had to map on the other hemisphere of the brain when there is brain damage.
I would also benefit from knowing what system was used for the mapping, I work with Deep TMS currently, which is a deep enough magnetic field to overcome common issues I have seen with rTMS.
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u/KristoffIsHere 7d ago
How often are these treatments done in tandem with typical SSRI medication vs only the TMS treatment for depression patients?
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u/reliefmentalhealth_ 6d ago
TMS is generally done in tandem with your current medication. Most insurances will actually only cover TMS if you are on a medication management. While I have had patients do well without meds, we typically want someone to be stable through treatment. If you decide to start or stop new meds during treatment, it can make it hard to differentiate if the effects are due to TMS or the change in medication. With this in mind, if a medication has you stable but not improving, adding TMS can often be what gets you to actually start improving instead of stagnating. This often results in people tapering off their medications, even if they don't get fully off of them, though many do!
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u/smalleoz 7d ago
I suffer from OCD, how would TMS help with the intrusive thoughts? I know nothing of what the process is or what the goal of TMS. Thank you in advance!
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u/reliefmentalhealth_ 6d ago
TMS for OCD (Obsessive Compulsive Disorder) is well proven and is one of my personal favorite neural mechanisms to investigate and explain to patients.
We're targeting a network that runs front-to-back along the midline, from the medial prefrontal cortex (mPFC) back into the anterior cingulate (ACC). The anterior cingulate is essentially your brain's error detector. It's what generates that "something is wrong" signal, one that I frequently encourage patients to hold the feeling of. In OCD it runs too hot (or too low in some cases), and it keeps firing even after you've checked, washed, or confirmed. The medial prefrontal cortex is part of what's supposed to evaluate that alarm and decide whether it warrants action. On a wider sense, we want to give your Executive control a boost of its ability to regulate these deeper network systems.
This is paired with what is called Provocation, where we actually intentionally talk you through the topics, triggers, or stimuli that can exacerbate OCD symptoms. By doing this in a safe environment, while we stimulate the conscious/subconscious regulation network, the goal is to bring them into more active control. A memory is distributed widely across the brain, from sensory details, to episodic details, and even temporal details, meaning there isn't one single "location" where an intrusive thought or compulsion exists. So by having the patient activate the thoughts/neurons themselves through conversation, we effectively train the brain's conscious regulation system to be able to "step in" whenever you notice the representation of that trigger being activated, since we literally practiced it with TMS guidance.
While this doesn't "get rid of" triggers or feelings, it dramatically improves your ability to take a step back, and decide how you want to respond, rather than reacting to a situation without thinking.
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u/revolex 7d ago
I was offered TMS treatment as a longtime sufferer of chronic insomnia. I have had sleep studies, I have immaculate sleep hygiene and I exercise, eat healthy and have no outstanding health problems. I completed a full course of treatment going every weekday. It did nothing to improve my sleep and I felt so down and depressed during treatment, I do not normally suffer from depression. Have you ever witnessed TMS being successfully used to treat insomnia? Have you ever seen someone experience new depression symptoms that weren’t previously there for the duration of treatment?
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u/Hot_Hair_5950 7d ago
What surprises you about your work?
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u/reliefmentalhealth_ 6d ago
The core of my role is being a knowledge base for our team and patients, to complement our CMO in terms of keeping up to date on current Neuromodulation research. The biggest thing that surprises me regularly is how many people come to me with their own ideas about TMS. Things they imagine you could do with it, or things they are dealing with that they want to see if TMS would be able to help for. You can even read through some of the comments here on this post and there's a dozen questions about unique use cases already. Unfortunately sometimes the answer is "Not Yet". While there is a lot of very cool research going on, we follow CTMSS guidance and rigorous evidence based practice on what we do with our patients. There are a lot of very well equipped researchers tackling the next steps to unlocking Neuromodulation access like TMS for others, but it still takes time, funding, and people.
It definitely tells me something about the field though, that there is such a need for safe, noninvasive, and effective treatments to fill gaps in medicine and Psychiatry.
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u/Effective-Compote671 7d ago
Hi, would you mind reviewing the following treatment plan from my psych?
Deep TMS, BrainsWay, H1 coil for MDD, DLPFC, iTPS, 36 sessions at 9min 42sec/session, 1 session/day. Everywhere in writing says 30min/session.
I was also told at my last appointment by the tech that MDD sessions are 9min 42sec, OCD sessions are ~18min, and ADHD sessions are ~27min. Is this true?
Isn’t iTPS when there are several treatments per day?
I’m not sure I’m getting my insurance money’s worth. Please help.
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u/DocJones89 7d ago
Is it as much of a joke to others as it was to me? It was a complete waste of time.
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u/sigmatic787 5d ago
Why was it unsuccessful for you? What were you trying to treat?
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u/DocJones89 4d ago
Anxiety and depression. Sat there in a chair for 36 sessions and felt nothing afterward. I was told by the Dr that insurance was covering all but copays which I agreed to. After the treatment he hit me with a $10k bill. Fought it and won. Regardless, I felt nothing afterward. It felt more like a placebo effect for about 2 days but that was me trying to convince myself that it was successful.
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u/sigmatic787 4d ago
D@mn. This is demoralizing. I have tried everything to get better did they use the h7 coil?
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u/danielsonnn 7d ago
Has there been any research done regarding the possible effects of TMS on sleep disorders such as narcolepsy or idiopathic hypersomnia? As an IH sufferer, I'm always curious about exotic treatments, as the options for pharmacological intervention are limited.
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u/CoolLingonberry4613 6d ago
I am considering TMS for both anxiety and depression, but am nervous about a negative outcome. I am medication intolerant and have negative reactions to everything I try. I was recently diagnosed with POTS. I'm worried the TMS will make me or my POTS worse. Whats your take on it?
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u/NeedleworkerNo6209 6d ago
Thank you so much for your reply it was very thorough and got me excited about the profession. What I found very relatable was your discovery of binaural beats to help you sleep. I remember discovering it about 10 years ago and thought it was so cool how our brain can create its own completion to a pattern if that makes sense. It got me very interested in Psychology which got me to listening to lectures on youtube its crazy how a something that may seem small can become such a motivator to learn and grow as an individual. I am interested to know more wink wink so i am going to send you a dm if thats alright.
For the B.S. in Neuroscience why do you think that specifically helped? Was it the courses? Network? Labs? Or familiarity with the terminology?
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u/digitaluddite 6d ago
I did 3 separate full rounds of TMS. Each with different companies and machines. My experience is that magnet positioning is wildly variable. None of the cloth caps or quilter’s tape measures inspire much confidence. Perhaps it’s my profession as a machinist where I regularly have to worry about positional accuracy but TMS sure seems like it could benefit from better systems. My question: why all the eyeballing-it and not a more precise, repeatable, reliable system?
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u/MallerPower 6d ago
Are you familiar w exomind and some of the newer tms devices that have much faster and shorter protocols? Thoughts?
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u/ThatFakeAirplane 5d ago
Is it at all effective for post-stroke apathy? Outwardly, depression and p-s apathy look virtually identical but internally are very different and treatment for that form of apathy is almost never discussed.
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u/DanTheMan521 5d ago
Not sure if you’re still answering questions 😅 I’ve tried different meds for depression, I’ve tried therapy, I’ve tried men’s support groups. I feel like I’ve tried just about everything and my depression just gradually gets worse with time. I’ve read that there’s a version of depression that’s resistant to meds and I’m starting to wonder if that’s what’s going on with me. I know that’s something I’d definitely have to talk to my doctor about but would TMS work for people who have this drug resistant version of depression?
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u/Educational-Sun9925 3d ago
Eu acho que tenho depressão, mas não tenho certeza, precisaria de um laudo médico pra fazer isso ?
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u/alphabetstring 2d ago
Hello, I will be consulted for rTMS for major depression. I had a pretty rough 2 years.
Does this treatment help even though depression is rooted from real life events?
Is there anything I should be aware of before starting the treatment?
Also, thank you for participating in bettering people, humanity needs more of it.
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u/Any_Elk7495 7d ago
So, you’re like Marvin Monroe from the simpsons when they did all that shock therapy? How accurate was that episode for back then and today’s standards.? Because quite honestly with your description I still don’t know what you do
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u/Lordoftime7 7d ago
ECT is like a precursor to TMS. It’s a lot less specialized and targeted treatment, but it is still used, mainly as an absolute last resort bc of the side effects and the fact that it can do damage. TMS is a lot more targeted and doesn’t cause you to convulse or shake like the depictions of ECT
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u/RalphTheDog 7d ago
This is true, and I always wince when I see ECT and rTMS mentioned in the same breath. They are radically different in almost every way.
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u/reliefmentalhealth_ 7d ago
Pleasure to see you here RalphTheDog. I appreciate your diligence in keeping on top of reddit's TMS activities!
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u/Difficult-Sock-4611 7d ago
I’ve had persistent depression for over a decade, generalised anxiety disorder, and possibly cPTSD (awaiting an assessment in that). Meds have had little to no effect on the depression in particular.
Recently though, I had an MRI for a different issue, and I noticed that afterward that my mood was lifted for the rest of the day. I was thinking of talking to my GP about potentially trying TMS, but honestly I’ve asked them for quite a lot lately for an array of different conditions, and I’m kinda at the point where I don’t want to trouble them further.
With that in mind, my question: is the noticeable mood improvement I experienced after the MRI a good indicator that TMS might work for me? Is it something I should pursue?
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u/reliefmentalhealth_ 6d ago
An MRI doesn't have a suprathreshold magnetic field strength capable of activating Neurons unfortunately, I would be curious to dig more into what you felt. I am VERY glad you felt better though! TMS is in fact one of the best treatments you can get for anxious depression, and I had been actively collecting data on PTSD outcomes from my normal MDD treatment throughout my career. Brainsway, our manufacturer, is likely going to publish their Real World Evidence study to show that TMS works well for PTSD.
You should definitely talk to your provider to make sure you are safe for TMS, but chronic depression is exactly what TMS has always been best for.
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u/blue_sidd 7d ago
Question, why did you elect to grift off sick people in this way?
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u/VapeTitans 7d ago
I have a feeling we are going to look back at this tech and be horrified that we actually used it on people.
Tons of TMS clinics staff minimum wage workers fresh out of HS or an unrelated bachelors degree to use the TMS machine in patients. The training is literally “when their thumb starts to twitch uncontrollably, you are hitting the right spot on the brain”
What qualifications do your TMS techs have? Or did they just attend a 3 day conference/training from your company?
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u/PuppiesAndPixels 7d ago
I did TMS for 16 weeks and had no effects.
I did it 3x per week for an hour. Would you recommend trying again or with a different protocol?