Brain Stimulation Therapy

By: Lisa Philippart

Brain stimulation therapies (BST) can play a role in treating certain mental illnesses. Brain stimulation therapy involves activating or inhibiting certain areas of the brain directly with electricity. The electricity can be provided either directly by implanting electrodes in the brain or externally with the electrodes placed on the scalp. While these types of therapies are used less frequently than medications and psychotherapies, they are becoming more readily available and producing positive results, when previously no form of treatment seemed to be consistently effective. Electroconvulsive therapy or ECT is the best studied form of brain stimulation, using an electric current to treat serious mental disorders. Most people think of ECT in an adverse way based on what they watched Jack Nicholson experience in One Flew Over The Cuckoo’s Nest. But other forms of BST now include vagus nerve stimulation, deep brain stimulation, magnetic seizure therapy, and repetitive transcranial magnetic stimulation (TMS.)

Today, I would like to share with you some information on TMS, and I also encourage you to do your own research when trying to decide if this type of therapy may help you. TMS uses a magnet to activate the brain. This therapy was first developed in 1985 as a treatment for depression, psychosis, and anxiety. Unlike ECT, TMS can be focused to a specific site in the brain which is believed to reduce the chances for side effects. In 2008, TMS was approved for use by the FDA as a treatment for major depression for clients who did not respond to at least one anti-depressant medication. At first the evidence supporting TMS was mixed, but in 2010, the first large clinical study funded by NIMH was published showing that 14% of participants achieved remission with TMS compared to 5% who received no treatment. After the trial ended, all clients could enter a second phase, where remission rates reached 30%.

A typical TMS session lasts 30-60 minutes and does not require anesthesia. An electromagnetic coil is held against the scalp in the area most associated with mood regulation. Short electromagnetic pulses are administered through the coil and through the skull, causing small electrical currents to stimulate nerve cells in that targeted area of the brain. For the client, this feels like a slight knocking or tapping on the head. Sometimes the client may have discomfort at the contact site, and the muscles in the jaw or face may tingle during the procedure. Other side effects include mild headaches or brief lightheadedness. A complete round of TMS treatments lasts about six weeks with five sessions per week. In 2013, several commercial health insurance plans began covering the cost of TMS for the treatment of depression. As always the appropriate treatment for improving your mental health is best determined by you and your doctor. When I’m asked for my opinion on BSTs, I present two steps first…Step 1 - Maintain sleep, exercise, nutrition, and stress management techniques, and Step 2 - Talk with a professional therapist and/or psychiatrist for medication.

More information on BSTs can be obtained through the NIMH website.
By: Lisa Philippart
Licensed Professional Counselor

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