Transcranial Magnetic Stimulation (TMS)

So next time you're in a jungle fight
And you feel the presence near
Or hear a voice that in your mind will lie
Just be thankful that you're not alone
-- Stan Ridgway

TMS tweaks electricity in a person's brain. This causes short-term activity in the brain that has been shown to have longer-term effects in some people. The goal is to decrease troublesome symptoms when the proper parts of the brain are tweaked. That's the summary of how TMS can treat illnesses like major depressive disorder.

In a bit more detail, Transcranial Magnetic Stimulation (TMS, which may also abbreviate the devices "Transcranial Magnetic Stimulators" which provide said stimulation) is a noninvasive way to have neurons fire (or not fire) more (or less) in the targeted region of the brain. It is noninvasive in that the magnetic fields are started outside of the body by a device, typically stationary in a psychiatrist's office, with part of it held to the patient's head. The magnetic fields are directed to pass through hair, skin, skull, etc, then up to several centimeters into the brain without the complications normally associated with electricity contacting the body or invasive anesthesia/surgery. In the brain the magnetic fields "work" on the neurons. How magnetic fields have an influence on neurons and the nervous system in the short-term requires a fair amount of electromagnetism and biochemistry and that, while fascinating, I will not attempt to delve into in this post. How doing this over and over can help some people for weeks or longer after TMS treatments are concluded is a matter of continuing study.

So with any novel medical treatment, the main questions are about cost and safety/efficacy. Considering the large costs associated with developing, testing, manufacturing, and supplying a new medical device, the costs to patients are likely to be high for a while. The US Food and Drug Administration (FDA) has recognized (and I use that term for sake of brevity -- spend a couple hours reading documents on the FDA's website and all the references sort of blend together what with being cleared for marketing, the difference between Class III and Class II devices, Class II devices requiring special controls, various guidance documents, etc) certain TMS devices as safe and effective for treating certain symptoms.

So is TMS only available to wealthy people? Yes unless you have an insurance company that covers its use in treating your diagnosis. Medicare and a couple other major health insurance companies have begun to recognize that TMS is worth covering for depression. More insurance companies are likely to do the same and, since the magnetic fields are being tested in other areas of the brain for other treatments, the future is bright for TMS.

As I have referenced in previous entries, I am desperate for help with my treatment-resistant depression. There are a couple different types of TMS available through different psychiatrists in my area and I have begun treatments with one. And it is really expensive but the best case scenario is it works well enough that I can reduce visits to my main psychiatrist, reduce visits to my therapist, and reduce my reliance on expensive medications. Since all of these things are paid for mainly by my insurance company, this best case scenario would be an argument for my insurance company to pay something toward my TMS treatments, basic economics and all.

Discounting some bizarre mishap that made my depression worse, the worst case scenario is TMS does not help at all and I keep blundering down the path of trying other medications/treatments but with my wallet considerably lighter.