When you suffer from a mental health condition and traditional forms of treatment haven’t provided relief, it’s time to seek out other evidence-based options. You may have heard of transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT).
Are either right for you? We’ll look at how these procedures differ and what conditions they can effectively treat.
TMS Therapy vs. ECT Treatment
TMS is a non-invasive procedure that stimulates neurotransmitters in the brain with magnetic pulses.
This helps them return to a normal level of activity and function. In depression, for example, the neurotransmitters are hypoactive.
If you have anxiety, your neurotransmitters are hyperactive.
ECT, which used to be known as electroshock therapy, is a procedure in which small electric currents are sent through the brain.
This is designed to trigger a brief seizure, which changes brain chemistry. Changed brain chemistry leads to improvements in the symptoms of mental illness.
Years ago, in very early treatments, high doses of electricity were used in ECT treatments.
As a result, there is still some stigma attached to the therapy today. ECT used to be administered without anesthesia, which led to severe memory loss, fractured bones, and other harmful side effects.
ECT treatment is carried out much differently today and is much safer. Electric currents are weaker and more controlled. This results in less risk and fewer side effects, with memory loss being one of the most common.
How Are TMS and ECT Delivered?
During TMS treatment, a technician places an electromagnetic coil gently against your scalp. This coil delivers magnetic stimulation to your brain, targeted at the regions associated with mood control. These magnetic pulses are the same type as those emitted by a magnetic resonance imaging (MRI) machine.
During an ECT session, a nurse puts electrode pads on your head.
There are two types of ECT treatments:
- Unilateral, which is when electric currents focus on only one side of the brain
- Bilateral, where electric currents are delivered to both sides of your brain
A doctor presses a button on the ECT machine to send a weak electric current through the electrodes.
You’ll be under a general anesthetic, so you’ll be asleep during the ECT treatment. A muscle relaxant is also administered. The use of both anesthesia and muscle relaxer means you’ll be unaware of the seizure that’s triggered by the electric current. This seizure lasts less than a minute.
What Do TMS and ECT Treat?
There is a growing body of evidence for the efficacy of TMS for a wide range of mental disorders. Results show TMS is long-lasting and effective for patients who haven’t responded well to other treatments, like anti-depressants.
TMS therapy can offer relief for:
- Depression, including treatment-resistant depression
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
Most studies in the clinical literature focus on depression, which is the most common mental health condition TMS therapy treats. Research shows promising results for anxiety, PTSD, and OCD as well. The Food and Drug Administration (FDA) approved the use of TMS for depression in 2008 and recently approved it for the treatment of OCD.
In various controlled studies with placebos, ECT has been shown to quickly and effectively relieve the symptoms of mental illness. It is used to treat:
- Severe depression – Especially when the individual also experiences detachment from reality (major depression with psychotic features), suicidality, and a refusal to eat
- Treatment-resistant depression – This is depression that has not improved with medication or various forms of psychotherapy.
- Severe mania – This is when an individual experiences intense agitation, euphoria, or hyperactivity as part of bipolar disorder. Severe mania can also be characterized by impulsive, reckless, and risky behavior; drug and alcohol abuse; and psychosis.
- Catatonia – This is a state characterized by lack of movement, fast or strange movements, lack of speech, and apparent unresponsiveness. It can result from a psychiatric illness, such as schizophrenia, or may be caused by a physical illness.
- Dementia with symptoms of agitation and aggression
- Eating disorders – Such as anorexia nervosa and bulimia nervosa
Side Effects: TMS vs. ECT
TMS therapy doesn’t rely on medication, sedation, or anesthesia.
During treatment sessions, you are awake and alert. Afterward, you can carry on with your day as normal and likely won’t experience any side effects.
TMS does not have the side effects associated with many antidepressant medications: headaches, nausea, weight gain, dry mouth, and sexual dysfunction.
The only adverse side effect that some patients report is a slight feeling of discomfort in the area being treated during a TMS session.
Your technician will ensure you are as comfortable as possible throughout the treatment.
While ECT is generally considered safe, there can be some side effects.
Side Effects to ECT:
- Confusion after treatment, lasting anywhere between a few minutes to a few hours. You may not recognize where you are or the reason for being there.
- Memory loss after ECT treatment; forgetting what happened right before— or sometimes weeks or months before—treatment. For most people, these memory issues improve within a couple of months.
- Physical side effects, such as nausea, headache, jaw pain, or muscle ache. Since general anesthesia is used, you may feel some side effects from this, including dizziness, dry mouth, sore throats, and chills.
Who Benefits from TMS and ECT?
TMS and ECT are usually considered as treatment options for mental disorders when other treatments, like psychiatric medications (antidepressants, benzodiazepines, and antipsychotics), lifestyle changes (exercise and improved diet), and talk therapy (cognitive behavioral therapy), have failed.
Many people with mental health conditions report that TMS and ECT offered them relief from their symptoms when all other options failed.
Success TMS offers effective TMS therapy in a warm and supportive environment.