Anxiety is a growing problem in the United States, and it’s only getting worse. Reported rates of anxiety in the US have been steadily increasing over the last decade and spiked significantly in the wake of the pandemic. Environmental risk factors for anxiety like financial strain, social isolation, and substance abuse have all contributed to this issue. With these unprecedented levels of anxiety, clinicians and mental health experts are searching for new and more effective forms of treatment.
Recently, transcranial magnetic stimulation (TMS) therapy has been gained attention as an effective treatment for anxiety disorders and anxious depression. Initially approved by the FDA for the treatment of major depressive disorder, TMS therapy has been indicated as an off-label treatment for anxiety disorders such as social anxiety disorder, post-traumatic stress disorder, and panic disorder.
Anxiety disorders are the most common mental health disorders in the United States, affecting over 40 million adults each year. Despite the availability of various treatment options, such as medication and therapy, many people with anxiety disorders do not fully respond to these treatments or experience unwanted side effects after trying conventional medications. TMS is a promising treatment option that provides powerful relief, especially for those who have not found success with other treatments.
What is TMS Therapy?
Transcranial magnetic stimulation (TMS) therapy is a non-invasive treatment that uses magnetic pulses to stimulate nerve cells in the brain. These magnetic pulses pass through the patient’s scalp and into the brain, where they stimulate nerve cells in a specifically targeted area to alleviate anxiety symptoms.
Although TMS has been studied by scientists for decades, it received FDA approval in 2008 for patients with major depression and FDA approval to treat obsessive-compulsive disorder in 2018. While TMS has been used primarily to treat depression and OCD, recent research suggests that it may also be effective in treating generalized anxiety disorder.
TMS is administered on an outpatient basis; with each session lasting around 20 minutes. The number of sessions required for effective treatment can vary depending on the severity of the patient’s symptoms, but most patients undergo between 20 and 30 sessions. One of the advantages of TMS therapy is that it is a non-invasive procedure, meaning that it does not require surgery, IVs, or any other intrusive medical modality. Additionally, TMS therapy does not cause any systemic side effects, such as weight gain or sexual dysfunction, which are commonly associated with many anxiety medications like SSRIs or anxiolytics.
For individuals who do not respond to medication, or cannot tolerate the side effects of medication, TMS for anxiety is an excellent option. Even for people who don’t want to depend on medication, transcranial magnetic stimulation therapy for anxiety is definitely something worth considering. It is also possible to use TMS along with existing anxiety medication to more effectively treat anxiety symptoms
How Does TMS Therapy Work?
Our brain is an electrical organ that operates via electric signals with the help of chemicals called neurotransmitters. Any imbalance in the level of neurotransmitters can lead to conditions like anxiety and depression. TMS, or Transcranial Magnetic Stimulation is a safe and non-invasive therapy for treating anxiety and anxious depression. In TMS, powerful magnets are used to produce positive therapeutic effects in the brain. Patients who undergo TMS therapy respond very quickly to the therapy and report better mood, sleep, and energy levels.
During the therapy, coils that can generate a strong magnetic field are placed near the skull. The magnetic field secondarily induces a weak electric current in the brain. This magnetic field can increase or decrease activity in the part of the brain that is being targeted, depending on what TMS protocol is prescribed.
TMS for Anxiety Disorders
Transcranial magnetic stimulation (TMS) is an FDA-approved therapy that was designed to treat major depressive disorder (MDD). Early clinical research on the therapy focused solely on MDD, and as such, the 2008 FDA indication was limited to this sole application. However, in the years since, hundreds of studies have demonstrated TMS therapy’s efficacy in treating a broad range of psychiatric disorders, including generalized anxiety disorder (GAD) and anxious depression.
What is an Anxiety Disorder
At its core, anxiety is a survival mechanism. It’s the body’s way of alerting us to potential threats and danger. When we feel anxious, our bodies release stress hormones like cortisol and adrenaline, which prepare us for a “fight-or-flight” response. This response can be helpful in certain situations, such as when we’re facing a physical threat or danger, however, when anxiety becomes chronic or excessive, it can lead to a range of negative psychological and physical symptoms.
Generalized anxiety disorder is a rather common psychiatric disorder, characterized by uncontrollable worry and central nervous system hyper-arousal. Some of the physical symptoms of anxiety may include rapid heartbeat, sweating, trembling, and muscle tension. Psychologically, anxiety can cause irritability, difficulty concentrating, restlessness, and trouble sleeping. In severe cases, anxiety can also lead to panic attacks, which are characterized by intense feelings of fear and physical symptoms like chest pain, shortness of breath, and dizziness.
Anxiety can be triggered by a variety of factors, including stress, trauma, genetics, and environmental factors. For some people, anxiety may be a chronic condition that persists for years, while for others, it may be more episodic, occurring in response to specific stressors or life events.
Related: What is Anxiety?
TMS for Anxiety
A recent double-blinded, placebo-controlled study, published in The British Journal of Psychiatry in 2016, demonstrated the efficacy of TMS in treating anxiety. Using standardized anxiety measurement scales both before and after treatment, the researchers found that the response and remission rates were significantly higher in the real-TMS group (the group that received transcranial magnetic stimulation) than in the placebo group (the group that did not receive transcranial magnetic stimulation). Even more interestingly, when subjects’ brains were studied in MRI scans, the researchers found that patients in the real-TMS group had significantly higher brain activity in their dorsolateral prefrontal cortex, a change that is correlated to symptom improvement1.
Unfortunately, due to the politics and cost limitations of the FDA-approval process, TMS therapy for anxiety has yet to be FDA-approved. As a result, insurance providers do not generally cover the treatment yet, despite its demonstrated efficacy.
What is TMS Therapy Like?
During the procedure, you remain completely awake and conscious and can relax, listen to music, or watch television. No sedative or anesthesia is used. Once you get used to the tapping sensation, the therapy proceeds virtually unnoticed. The duration of each treatment session is approximately 30 minutes and is normally administered daily, 5 days per week for 6 to 9 weeks. Trained TMS technicians will continuously monitor you during the procedure to ensure proper coil positioning and comfort level. Since no medications are administered during TMS therapy, there are no systemic side-effects or cognitive after-effects such as inability to concentrate or memory difficulty. Therefore, there is no restriction on work or other activities before or after the therapy. You can resume regular activities, including driving, immediately after the therapy session.
TMS therapy is an excellent anxiety treatment option that helps correct neurotransmitter deficiencies known to cause anxiety symptoms. Our team of psychiatrists and nurse practitioners will review your symptoms with you to determine the best course of action to treat your anxiety. In conjunction with TMS, you can take advantage of our other complimentary therapies known to be effective in the treatment of anxiety, including medication management and psychotherapy. To learn more about our anxiety treatment services, contact Neuro Wellness Spa today.
References
- Diefenbach, G. J., Bragdon, L. B., Zertuche, L., Hyatt, C. J., Hallion, L. S., Tolin, D. F., Goethe, J. W., & Assaf, M. (2016). Repetitive transcranial magnetic stimulation for generalised anxiety disorder: A pilot randomised, double-blind, sham-controlled trial. The British Journal of Psychiatry, 209(3), 222–228. https://doi.org/10.1192/bjp.bp.115.168203