Repetitive Transcranial Magnetic Stimulation - rTMS: New Treatment For Depression

Depression; the blues, sadness, feeling down, listless, tired and perhaps suicidal. Depression has been called the Common Cold of Emotional Illness. And yet, it is poorly understood in terms of why some get it and some don't; why some deal with tragedy after tragedy and rise above life's problems and why others become severely depressed for no apparant reason. As a mental health professional, I've worked with hundreds of patients who have been there. Some were mildly depressed, some so depressed and suicidal only emergency hospitalization could keep them safe until treatment had a chance to work. Suicide is too often an issue with depression. I've written about it here.

Depression has been around as long as mankind. The early Greeks attributed depression to an interplay of the "four humors;" Choleric, Sanguine, Phlegmatic and Melancholy with "black bile" being the primary cause of melancholia. They recognized depression as an illness, but were mystified as how to treat it other than via "blood letting" to remove the "excess."

In crowded European cities, the severely mentally ill became difficult to manage as their illness manifested in severe behavioral problems. These unfortunates were often taken "away" and locked up in lunatic asylums where they received little treatment and were often abused by their keepers. The first English mental hospital St. Mary's of Bethleham had it's name bastardized into "Bedlam" a word now used to indicate wildness and chaos.

In America, Dr. Benjamen Rush, the "Father of American Psychiatry" blood letting and other techniques in an attempt to cure disease. In Europe later in the next century Sigmund Freud used the "talking cure" or free association to help his patients resolve the conflicts of childhood and arrive at happiness.

By the 1950's the first real "medical" treatment for depression came about with the discovery of Imipramine. In the 60's seratonin became a focus of research into the causes of depression. Within a couple of decades newer treatments became available including the Seratonin Selective Reuptake Inhibitors (SSRI's) such as Prozac and others.

And now, comes rTMS or Repetitive Transcranial Magnetic Stimulation. rTMS, according to one health provider is a

"procedure in which electrical activity in the brain is influenced by a pulsed magnetic field. The magnetic field is generated by passing brief current pulses through a figure 8 coil of wire. This coil of wire is encased in plastic and held close to the scalp so that the magnetic field can be focused onto specific areas of the cortex, or surface, of the brain. The magnetic field that is generated in rTMS can penetrate the scalp and skull safely and painlessly to induce a current in specific neurons (brain cells). Because the magnetic stimulation is delivered at regular intervals, it is termed repetitive TMS, or rTMS."

Martha, a mother of two from Connecticut, has suffered from depression for the better part of two decades. She has been to psychiatrists and psychologists and tried dozens of medications, but nothing seemed to work very well or for very long. Then last June she heard about an experimental treatment being tested at the New York State Psychiatric Institute at Columbia University. It involved aiming a powerful magnet at a spot on the brain to reset the wayward neural circuits that keep Martha, and millions like her, stuck in the downward spiral of depression.

Figuring she had little to lose, Martha agreed to the treatment and soon found herself sitting in a chair under a squat, gray crescent that administered a series of magnetic pulses to the top of her head. The treatment lasted for one hour, five times a week, for six weeks. "I started to see signs of change by about the third week," she says. "By September, I was on top again. I could take pleasure in things like food and sunshine." Returning to the institute every once in a while for repeat sessions of what researchers call repetitive transcranial magnetic stimulation (rTMS), Martha has kept her symptoms at bay for the better part of six months."