All Posts in Category: Depression Treatments

Q&A From Our Facebook Live Event on TMS Therapy & Depression

In a Facebook Live event today, Dr. William Sauvé, Medical Director with Greenbrook, along with Jennifer Marshall of This Is My Brave, Inc. discussed all aspects of TMS Therapy as a treatment for depression.

For those of you who tuned in to our live event, there were a few questions from our viewers that we didn’t have time to answer. We have provided the answers here.

Is this a ‘permanent’ solution? As well, are there maintenance treatments after the full treatment?
While there is no permanent cure for any mental health disorder, TMS has been shown to be effective in about 70% of patients according to FDA Clinical Trials. There is peer reviewed literature showing that 1 year post TMS about 14% of patients could have some sort of relapse of symptoms varying in severity. Should those people have additional TMS (maintenance or another acute induction) greater than 90% responded the second time around.

How experienced is Greenbrook TMS and its doctors with TMS?
Greenbrook TMS was established in 2011 and has prided itself in delivering an ultimate patient experience. Led by some of the most experienced doctors, Greenbrook TMS is the largest provider of TMS Therapy in North America with over 2500 patients and over 80,000 treatments performed …-and still growing. As a leader in the industry, Greenbrook TMS is committed to patient care.

What is the ballpark cost without insurance? Or if insurance doesn’t cover.
Across the US, an acute phase of TMS which includes 30-36 sessions runs approximately $10,000-$12,000 if a patient does not have insurance. If insurance doesn’t cover, Greenbrook typically charges the applicable insurance rates which range based on demographic region. Greenbrook also offers financing plans for private pay patients as well as patients with financial need to help cover the cost of deductibles, copays, and coinsurance.

Can someone with Chiari Malformation get this treatment safely?
Per the FDA the only absolute contraindications for TMS include a history of seizure disorder and/or metallic implants in or around the head.

Can it trigger mania?
While there is not clinical trial data to confirm or deny triggering a manic episode, the TMS physician along with the patient, must determine the risk/benefit analysis. Insurance companies currently do not cover bipolar disorder as bipolar and unipolar depression are very different disease states and more clinical trials are needed to confidently answer this question. Greenbrook has successfully treated patients suffering from Bipolar II but we have exercised great caution in patients with Bipolar I.

Does United Behavioral Health cover it?
Yes, all major insurance companies cover TMS to include Medicare, Blue Cross, United, Cigna, Aetna, and Tricare.

Side effects? Anesthesia (as in ECT)?
Side effects can include headache or scalp discomfort, facial nerve twitching during pulse activation (i.e. not permanent), and a less than 1% seizure risk.
ECT requires hospitalization, anesthesia, and induces a seizure all which require significant down time and the need for a caregiver during recovery. Patients undergoing TMS are able to drive themselves in and out of their appointments and resume normal daily activities. There is no need for down time, no sedation, no systemic side effects, and no hindrance to immediately return to work, school, or take care of their families.

How soon will a patient feel relief?
Most patients can start to notice a difference in mood around session 15, or week 3. This is not applicable to all patients as each person’s response time may vary. 3-4 weeks is average. It is important to note that ups and downs in mood are to be expected while undergoing TMS and patients should relay any changes in mood and behaviors to their TMS provider.

Is anxiety treatable with TMS?
Depression and anxiety are what we call comorbid conditions and are very commonly found as dual diagnoses. Typically if TMS can alleviate depression, the anxiety component will dissipate as well. There are times where anxiety and/or panic disorder may not be a result of a unipolar depression and we have the ability to manipulate the TMS devices to include not only a stimulation effect but inhibitory pulse sequences as well. While there are many conditions TMS may be effective, the FDA and insurance companies currently state TMS is used as a treatment option for depression, although we have had success getting insurance coverage for other disease states if depression is also a component.

Can TMS be used for children too?
Currently the FDA says TMS is used for adults, however there are currently clinical trials being performed studying the adolescent population. Greenbrook has successfully treated the teenage population and found they typically respond quicker than adults, however insurance coverage is not guaranteed in this population.

Thank you for joining us and be sure to keep checking back for our next Lunch & Learn.

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Online Event: TMS Therapy for the Treatment of Depression
Tuesday, June 27th at 12 PM EST

Please join us on Tuesday, June 27th, 12:00 pm ET for our Facebook Live & Instagram Live event on TMS Therapy for the Treatment of Depression.

Dr. William Sauvé, Medical Director with Greenbrook TMS NeuroHealth Centers, along with Jennifer Marshall of This Is My Brave, Inc. will discuss all aspects of this safe & effective treatment for depression as well as answer FAQ’s about TMS Therapy.

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National Suicide Prevention Week, September 5 – 11, 2016

13108_AFSP_SPW_SocialGraphic_d1Whether you have personally lost a loved one to suicide or are struggling with depression and suicidal thoughts, you are not alone. Suicide is the 10th leading cause of death in the US, and every 1 in 5 people who die by suicide are veterans. But there is always hope. The American Foundation for Suicide Prevention (AFSP) is the leading national not-for-profit organization dedicated to understanding and preventing suicide, as well as the driving force behind National Suicide Prevention Week this September 5-11.

The best way to help yourself or a loved one is to learn about the suicide warning signs, risk factors and where to reach out for help.  Although about 75% of those who die by suicide exhibit some warning signs, it is important to be aware that some people do not show any signs at all. Recognizing the risk factors and warning signs of suicide is something we can all do to help prevent the loss of more lives, so take some time to familiarize yourself.

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Frequently Asked Questions About TMS Therapy

When other treatments may not be enough, physicians are prescribing Transcranial Magnetic Stimulation Therapy (TMS Therapy) to treat depression. TMS Therapy is a safe and effective, FDA-cleared medical treatment for individuals diagnosed with depression that can be used in conjunction with medication or as a stand-alone treatment. It offers a non-invasive, non-systemic, and non-sedating in treating depression. TMS Therapy applies magnetic stimulation to specific areas of the brain involved in mood regulation- areas known to be underactive in people suffering with depression.

Common Patient Questions about their TMS Therapy

We have compiled several questions that patients have commonly asked TMS NeuroHealth Centers about their TMS Therapy treatment.  Whether you are a prospective patient or currently receiving TMS Therapy, we hope that you find our responses helpful.  It is important for you to personally consult with your treating physician regarding all questions that you have about your TMS Therapy treatment.

What is a TMS Therapy treatment session like?

While treatment varies by individual, a typical TMS Therapy treatment session is approximately 30-40 minutes. During treatment, patients relax in a treatment chair and remain awake and alert. The TMS Therapy device will deliver magnetic pulses to specific areas of the brain known to regulate mood. These pulses will feel like tapping on the scalp. The technician can make adjustments if the taping is uncomfortable. After a treatment session, patients can immediately return to their normal routine, including driving.  Click here to learn more about a Typical Treatment Session.

When will I feel better?

When will I feel better?

The acute phase of TMS Therapy ranges from 20-30 treatments over a 4-6 week period, and since every patient is different, response time varies as well. Some patients begin noticing a reduction in depressive symptoms after week two, while others begin to feel the benefits of therapy at week 4 or 5.

How can I tell if it’s working?

Initially, most patients notice positive changes in their behavior or mood, such as getting a better night’s sleep and feeling more rested in the morning, feeling “good” about themselves, being more social, feeling ready to go back to work, or making more independent decisions. All of these incremental changes indicate improvement, and should likely progress as treatment continues—and beyond.

Do I need to continue TMS Therapy after the acute phase?

While some patients may need maintenance therapy in managing their depression, a majority of patients will not. Variables such as a patient’s available support system, sleep patterns, diet, and exercise can all influence a patient’s recovery from a depressive episode. This is why TMS NeuroHealth Centers works with each patient to help them understand their situation, recognize potential triggers, identify a support system, and find the right combination of diet and exercise to help maintain their improved mood.

I’m feeling more depressed/anxious/having trouble sleeping after my TMS Therapy sessions. Is this normal?

Dips in mood and irregular sleep patterns are common among patients with depression, and while they are also common among new patients undergoing TMS Therapy, it’s important for you to speak with your TMS Therapy provider about any emotional or physical changes you experience throughout treatment.

My last TMS Therapy session is almost here—and I’m nervous about ending treatment. What should I do?

It is not uncommon for patients to report feeling nervous that their treatment is nearing completion, especially when having made improvement in their mood and quality of life. Seek guidance and support from your TMS Therapy provider, treating psychiatrist, therapist and loved ones to develop strategies that will help you navigate your feelings during this transitory period from the near ending of treatment to its conclusion and beyond. With guidance, it is also important to develop strategies that support a healthy quality of life post-treatment, such as regular exercise, healthy nutrition plan, psychotherapy (if indicated), and enriching social activities. Positive and activating lifestyle strategies will be of great benefit to you in maintaining your improvement or remission from depression.

If your current treatment is not enough, contact us at 1-855-333-4867 or visit TMS NeuroHealth Centers at www.tmsneuro.comWe provide a Free Consultation!

If you have questions about TMS Therapy or would like to share your experience, we welcome your input below.  Thank you for joining our conversation.

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Mental Health Apps Help Track Mood and Symptoms

App Character EmotionsIndividuals enduring the symptoms of mental illness such as Anxiety, Depression, Obsessive Compulsive Disorder and/or Bipolar Disorder, usually treat with psychotherapy, medications or a combination of the two. Often therapists recommend that patients’ journal their emotions, behaviors and symptoms on a consistent basis as a tool to gain greater insight of their condition.  Tracking patterns and potential triggers can be extremely helpful to patient and therapist in managing their disorder, including the critical advantage of early recognition of changes that might lead to an exacerbation of their condition. With greater insight and ability to act early, frequency of therapy sessions and/or medications can swiftly be modified to prevent a worsening of a patient’s condition. In addition, greater insight and journal feedback may encourage patients to seek immediate professional support during a crisis.

Daily journaling can sometimes feel cumbersome and time consuming, but with digital technology, this doesn’t have to be the case.  Software Developers are creating Apps to help those with mental disorders track and manage their symptoms. However, users should bear in mind that a psychiatric/medical background is not required to create a mental health app, and that this software should only be utilized as an additional part of a comprehensive treatment plan rather than a replacement for treatments such as prescription drugs, therapy, or TMS Therapy.

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The Link Between Chronic Pain and Depression

Human-With-Pain-DotsWe all experience pain of some kind from time to time – we stub our toe, pull a muscle, suffer with a headache, etc. But the American Chronic Pain Association estimates that one in three Americans (over 50 million people) suffers from some type of chronic pain1. Chronic pain is described as ongoing or recurrent pain which lasts beyond the usual course of acute illness or injury and adversely affects an individual’s well-being. Simply put, chronic pain is pain that continues when it should not. It may present as pain in the lower back, abdominal region, joints, neck, and even headaches, depending on the individual. Pain may be felt as aching, burning, shooting, or electrical and can affect sleep, cause fatigue and weaken the immune system.  Beyond the physical discomfort and stress upon the body, chronic pain also affects thought, mood and behavior, and can lead to isolation, immobility and drug dependence. If those symptoms sound familiar, it may be because there are many similarities and connections between chronic pain and depression.

Pain is a depressing experience, and depression can cause and/or intensify pain. In fact, over 66% of individuals diagnosed with Major Depressive Disorder (MDD) also suffer from chronic pain2, and depressed patients are three times more likely to develop chronic pain3.  Depression can cause a variety of physical symptoms even including affecting the body’s natural sleep cycle. This minimizes the amount of restorative sleep realized each night and exacerbates both chronic pain and depression symptoms. With 80% of depressed individuals complaining of insomnia4 or general body fatigue, it’s no surprise that this accumulation of stress on the body contributes to chronic pain.

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TMS NeuroHealth Centers Opens More Locations

TMS therapy in Richmond, VATMS NeuroHealth Centers is pleased to announce the opening of TMS NeuroHealth Centers, Rockville, MD and Reston, VA as it continues to expand its coverage area for individuals seeking TMS Therapy for the treatment of depression. Since opening its flagship center in McLean, VA in 2011, TMS NeuroHealth Centers has administered more than 15,000 treatments to over 500 patients. Bill Leonard, CEO and founder of TMS NeuroHealth Centers explains, “Expanding our service reach throughout the DC METRO area only makes treatment even more accessible to those individuals suffering with depression when anti-depressant medication has been unsuccessful.”

TMS Neurohealth Centers is a network of centers offering TMS Therapy in Tysons Corner, Richmond, Charlottesville, and Reston, Virginia as well as in Kensington, Greenbelt and Rockville, Maryland. TMS NeuroHealth Centers’, with its team of leading medical experts in the fields of neurology and psychiatry, are deeply committed to providing patients with the latest in medical technology, individualized treatment and compassionate care.

Transcranial Magnetic Stimulation (TMS) therapy is a non-drug, non-invasive, FDA-cleared medical treatment for patients suffering with depression without any of the typical side effects experienced with antidepressant medications, such as weight gain, fatigue and sexual problems. This treatment uses highly focused magnetic pulses to gently stimulate areas of the brain known to control mood which have been scientifically identified as under-active in people who suffer with depression. Stimulation of the neurons, cells that transmit and process information, cause the release of chemical neurotransmitters in the brain, thus resulting in a reduction of depressive symptoms. Each treatment is a 30-40 session; typically administered 5 days a week for 4-6 weeks when depression is in its acute phase.

TMS therapy is a proven medical treatment for depression for patients suffering from side effects of antidepressant medications and/or who are treatment resistant. Dr. Geoffrey Grammer, Chief Scientific Advisor with TMS NeuroHealth Centers elaborates, “a former patient of ours could not have explained his results from TMS Therapy any better, ‘imagine living your whole life with one hand tied behind your back. After TMS Therapy, I now know what hope truly feels like. TMS gave me my life back’”.

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Antepartum Depression: Depression During Pregnancy

Antepartum DepressionPregnancy is one of life’s greatest journeys, and like any new quest, there brings change, unique challenge and discovery. The expecting mother and her partner will likely confront many additional commitments and unique challenges. From numerous doctor visits to added relationship strain and career stress, expecting couples learn to balance and adapt to these new demands. One of the more significant challenges during pregnancy is the physical and emotional impact of surging hormones which affects brain chemistry, sometimes causing a Major Depressive Disorder (MDD).1 There is growing awareness concerning Postpartum Depression- a period of about 6-weeks following the baby’s birth; however, there is practically no awareness and information being shared about the very real potential of suffering from depression during pregnancy- referred to as Antepartum Depression.

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You CAN cure Depression. Here’s the Proof.

Depressrace-winnerion is a very real condition that affects 1 in 10 Americans. Though some dealing with depression at various stages are able to treat and cure their symptoms using an Anti-Depressant medication and/or psychiatry, others are not as successful and end up dealing with Treatment-Resistant Depression (TRD). TRD occurs as a result of major depressive disorder which has occurred due to an unsuccessful attempt at treating depression through regular dosages of anti-depressant medication. A variation and/or combination of anti-depressants can be prescribed in this case to help counteract different symptoms in an attempt to treat the depression. Unfortunately, even these drastic measures can still show little to no success, leaving affected individuals feeling hopeless, defeated and even more anxious about their condition. The reality of the TRD can be quite hash, as those affect feel like there are no other options. In fact, one study suggests that anywhere from 29 to 46% of people (depending on the type of medication) fail to respond to treatment of an anti-depressant and 15% of these patients find no relief in multiple treatment trials[1].

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Robin Williams’ Death Reminds us Mental Illness can Affect Anyone

Robin WilliamsThe world is mourning the loss of one of the best actors, philanthropists and comedians today as Robin Williams was found deceased in his home yesterday at the age of 63. Williams died from an apparent suicide, when his struggle with depression and substance abuse came to an end. According to his publicists, Williams was likely to be suffering from bipolar disorder along with his severe depression symptoms. He even underwent rehab as recently as July to protect his sobriety.

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