adolescent depression

How Mental Health Impacts Teen and Young Adult Development

Growing up is difficult, and growing up to be a healthy and functional adult is a challenge in itself. Several things complicate the process. The development process is similar to what happens when we build something. Think of it like constructing a house. If we have the structure of the house built, the electrical wiring or other means of communication throughout the house needs to be established.

Likewise, once we are born, and our basic structure is there, we grow and develop. As far as the brain is concerned, this is mostly a result of the development process beginning in the back region and stem area of the brain and finishing in the prefrontal cortex.


Discovering TMS and Its Importance

Recently a couple of patient discussions happened that prompted me to reflect on my own TMS journey, which I'd like to share in this blog as three stages: discovery, adoption, and advocacy.

In the early-mid '90s, I referred a young lady who had been struggling with depression to a residential treatment center in New England. While there, she deteriorated and was hospitalized at McLean Hospital. When she returned to Nashville, she told me about the research that was being done at McLean and Harvard, which included transcranial magnetic stimulation (TMS).

I closely followed the medical and scientific journals as research developed and was intrigued with the technology and the clinical possibilities. The study looked positive, and when the FDA cleared TMS to treat depression for individuals who had not responded to a course of antidepressant medication, I assumed it would be in the academic space. When I found out that was not the case and that TMS was an outpatient procedure available to clinicians, I investigated further.


Improving TMS Therapy as Technology Advances

Healthcare treatment approaches change over time as discoveries and new technologies are tested and refined. The process of evidence-based research, learning and continuous improvement carries over for Transcranial Magnetic Stimulation (TMS) Therapy for depression treatment.

As a refresher, TMS Therapy utilizes a safe, non-invasive magnetic pulse technology to stimulate brain activity at the area where humans experience depression in the brain. TMS is an FDA-cleared, non-drug treatment option, where the patient is not sedated or medicated and can immediately return to their normal day following the short in-office procedure.

For nearly a decade, my practice has specialized in providing TMS Therapy as a treatment for depression with 75 percent of our patients having a positive response. Historically, the vast majority of our patients had undergone numerous depression treatments including various antidepressants before trying TMS. And while we continue to have a strong track record for relief of depression symptoms, we strive to analyze ways to improve the TMS methodology when it comes to targeting the treatment location.


What does Esketamine have to do with TMS Therapy?

What does Esketamine have to do with TMS?

While this blog focuses on Transcranial Magnetic Stimulation (TMS) Therapy for depression, as good practice, I like to share my thoughts on new treatment options as they become available. Whether it's advances in technologies, psychotherapy approaches or the latest medication, I'm committed to informing my patients on all treatment paths.

In recent weeks, you've probably noticed news outlets abuzz about esketamine - a newly FDA-approved treatment option for depression. So I wanted to take this opportunity to explain the treatment and make some comparisons between esketamine and TMS.

First, let me provide a snapshot of each treatment, TMS Therapy and esketamine.


Industry Meeting: Highlights and Insights in the TMS Field

Last week, February 21 - 23, 2019, I attended the Clinical TMS Society's annual meeting held in vibrant Vancouver, Canada. For the sixth year, this conference bought together TMS providers and researchers from across the globe to discuss the pulse of the industry, discoveries, and what's on the horizon for Transcranial Magnetic Stimulation (TMS) technology as the therapy continues to be a safe and effective treatment for depression.

The three-day conference boasted more than 540 attendees and offered 30+ presentations, panel discussions and workshop breakout sessions—all packed with top-notch data and impactful stories of research success and patient progress.


Snapshot of Patient Success Stories with TMS Therapy for Depression

In this blog feature, while I typically discuss more of the mechanics and scientific aspects of Transcranial Magnetic Stimulation (TMS) Therapy for depression, this time I wanted to sidestep and highlight a handful of patient success stories for individuals that I'm currently treating to share their journey back to health.

As a practicing psychiatrist, I have been involved with TMS Therapy for the past nine years and continue to follow many of the patients we treat, usually meeting with one to two patients a day, and keeping track of their well-being beyond TMS Therapy.

74% of our patients have responded to TMS Therapy meaning that their depressive symptoms improve. So what does this really mean in the life of a patient? Let's explore.


What do we know about Transcranial Magnetic Stimulation (TMS) Therapy?

It is sometimes helpful to recap where we are so we can make the best decisions about how to move forward. It helps to look at the facts and be realistic about where we are, what we know and what more we can learn to gain a fuller understanding of something in its current state and what’s ahead. With this logic in mind, as a practicing psychiatrist, I wanted to expand on what is know about Transcranial Magnetic Stimulation (TMS) Therapy from a clinical perspective.

TMS was cleared by the FDA in 2008 to treat Major Depression that has not responded to one antidepressant treatment. This clearance was expanded to previous antidepressant treatment, no matter the number.


Seasonal Affective Disorder; Not Just the Winter Blues

Sometimes the Grinch visits. It might be winter, or it might be summer. It might be part of a larger picture of clinical depression, or it might be only seasonal. Having first been described in 1984, Seasonal Affective Disorder (SAD) has become a recognizable diagnosis that warrants treatment as a type of depression that displays a recurring seasonal pattern.

To be diagnosed with SAD, someone must have depressive episodes during winter or summer months that meet the criteria for Major Depression for a duration of at least two years, and seasonal depressions must be more frequent than non-seasonal depressions.

Major Depression may include experiencing the following symptoms for two weeks or longer:

Feeling depressed nearly every day
Low energy
Lack of interest
Feelings of hopelessness and worthlessness
Sleep problems
Difficulty concentration
Appetite changes
Agitation or sluggishness
Thoughts of death or suicide


Why It’s Difficult to Find Help For Depression

Over the last few years, it has been harder and harder to find resources for my patients to get the help they need. Being a believer in a multimodal approach to the treatment of psychiatric struggles, I will see people for psychotherapy, medications, Transcranial Magnetic Stimulation (TMS) and until recently I would admit patients to the hospital. Also, I refer to specialists about medication issues and psychotherapeutic treatments I do not provide.