Although several therapies exist for people with severe clinical depression, including medication, psychotherapy and electroconvulsive therapy, they don’t all work for everyone.
For many patients with severe depression — characterized by an all-encompassing low mood and loss of interest or pleasure in normally enjoyable activities — who have tried without success to relieve their symptoms with at least one round of medication, there now is a therapy that stimulates the brain, but does so without general anesthesia or lingering aftereffects. Called transcranial magnetic stimulation (TMS), the procedure uses magnetic fields to change the activity in a specific area of the brain thought to influence mood and emotion to improve the symptoms of severe depression, explains Ian Cook, M.D., director of the UCLA Depression Research and Clinic Program.
The procedure is conducted in an office setting; a patient undergoing TMS sits in a chair resembling a recliner, while a large electromagnet is precisely positioned over his or her head to emit targeted electromagnetic pulses. While the patient’s head is gently secured in place, he or she is fully awake during the 45-minute sessions and is able to read, converse, watch videos or listen to music. The therapy is conducted five days a week over four to six weeks.
“Some people like to take a nap. Others like to meditate. All they really experience is the sensation of a tapping on the scalp from the magnetic field, even though nothing is mechanically tapping there,” Dr. Cook says.
Patients wishing to undergo TMS at UCLA are reviewed by a committee, which discusses each case to ensure that the patient is an appropriate candidate. Results from clinical trials have been promising, Dr. Cook points out. After six weeks, about 54 percent of patients reported improvement in their mood, and 33 percent were in remission from their depression.