Understanding TMS Therapy

What Is TMS Therapy?

Transcranial magnetic stimulation (TMS) therapy is a type of brain stimulation therapy that uses magnetic fields to address specific areas of the brain involved in mood regulation, impulse control, and other cognitive functions. 

In TMS therapy treatment sessions, a magnetic field is generated through a non-invasive magnetic coil that is placed on an individual’s scalp. This electromagnetic coil induces an electrical current and associated magnetic pulses through an individual’s skull and into their brain to stimulate nerve cells and neuronal activity.

While TMS refers to the technology, repetitive TMS (rTMS) refers to the use of repetitive magnetic pulses to stimulate the brain.

Overall, TMS therapy is an innovative treatment option that is used to treat a variety of mental health conditions and symptoms.

How Does TMS Therapy Work?

TMS therapy works by promoting neuroplasticity of the human brain – its innate ability to adapt and rewire its internal structure and functioning through the formation of new connections with every new experience. 

Untreated mental health conditions can hinder neuroplasticity in a self-reinforcing cycle. A combination of stress-induced neurochemical changes, chronic stress, and other factors common in mental health disorders can inhibit the brain’s ability to adapt. Such impairments in cognitive functioning can worsen psychological symptoms, such as emotional dysregulation, and reinforce maladaptive neural patterns even further.

With TMS, however, clinicians can target underactive or dormant areas of the brain affected by mental health conditions to restore healthy neuronal activity and balance neurotransmitter levels. The process of stimulating and altering neurons in different brain areas not only strengthens positive neuronal connections but also encourages the formation of new ones to, ultimately, improve brain functioning, motivate healing, and enhance overall quality of life.

With time, this unique approach to promoting neuroplasticity can disrupt existing cycles of problematic behavior while making the brain more resilient in the face of future challenges.

How Does TMS Differ From Other Brain Stimulation Therapies?

TMS therapy differs from other brain stimulation therapies like electroconvulsive therapy (ECT) and deep brain stimulation (DBS) specifically because it does not induce seizures or require a surgical procedure. 

Instead, this type of TMS is a noninvasive treatment that can be provided in both inpatient and outpatient treatment settings, as clients can resume normal daily activities following a standard treatment session. This makes TMS therapy more widely available, accessible, and cost-effective compared to other brain stimulation therapies.

Does It Have FDA Approval?

Yes, TMS therapy is an FDA-approved treatment for adolescents aged 13+ as well as adults.  

It was first approved by the FDA back in 2008 for the treatment of major depressive disorder (MDD) in adults, after rigorous and randomized clinical trials demonstrated its effectiveness. Since these initial trials, the FDA has expanded approval of TMS to include obsessive-compulsive disorder (OCD), chronic pain associated with migraine headaches, adolescent depression, bipolar disorder, post-traumatic stress disorder (PTSD), and more.

TMS therapy may be especially beneficial for individuals with treatment-resistant depression, a condition where depressive symptoms continue to impair functioning despite adequate treatment using antidepressant medications, psychotherapy, or a combination thereof. It is considered a safe and effective intervention for those with severe depression, with many participants noting improvements in symptoms in just a few short weeks.

TMS Therapy and Addiction Treatment

Can TMS Help People in Recovery?

Yes, TMS therapy can help people in recovery from substance abuse, addiction, and dual diagnosis. It is most effective when used in tandem with other evidence-based treatment approaches such as cognitive-behavioral therapy (CBT), medication-assisted treatment (MAT), and relapse prevention techniques. 

While TMS therapy does not have FDA approval to treat addiction at this time, it does have approval to address the mental health challenges that may be informing addictive behavior patterns.

Research shows that this treatment may be beneficial for addressing an array of addiction symptoms throughout treatment and recovery. For instance, a meta-analysis published by the Journal of Clinical Medicine highlights the potential for TMS therapy to reduce drug cravings.

Meanwhile, it is true that many people with substance abuse or addiction present to treatment with co-occurring mental health conditions like OCD or major depression. Additionally, these symptoms can become exacerbated during detox and withdrawal.

Thus, TMS therapy may be effective in improving mood and mental function in those with dual diagnosis by addressing core mental health problems that would otherwise be contributing to substance abuse. In this way, TMS therapy has the potential to reduce the risk of relapse and foster more sustainable sobriety.

How Does TMS Complement Other Addiction Treatments?

TMS complements other addiction treatments by providing a neurological stimulus that can enhance the overall effectiveness of other treatment approaches, including both medication and psychotherapy. 

By directly stimulating brain areas like the prefrontal cortex, the part of the brain responsible for regulating mood, impulse, attention, and other important cognitive functions, TMS promotes neuroplasticity and, thus, improves overall treatment outcomes.

For example, alongside medication-assisted treatment (MAT), TMS therapy can help an individual’s brain and body acclimate more quickly to the medication’s effects. This is because TMS therapy makes an individual’s brain more flexible and open to positive change.

Similarly, alongside other psychotherapeutic approaches, TMS therapy can make an individual’s brain more receptive to mental, emotional, and cognitive adjustments targeted in treatment sessions. In this way, TMS therapy offers a comprehensive approach to mental health care that addresses both biological and psychological factors contributing to substance abuse and addiction.

What Types of Addictions Benefit From TMS?

In general, TMS therapy can be a valuable modality to include in treatment for all types of substance use disorder (SUD), addictions, and co-occurring mental health conditions. 

Some examples of specific addictions that may benefit from TMS therapy include, but are not limited to:

• Alcohol abuse and alcohol use disorder (AUD)
• Nicotine dependence
• Cocaine addiction and other forms of stimulant abuse
• Opioid use disorder (OUD)

Preparing for a TMS Treatment Session

What Is the Step-by-Step TMS Session Process?

Typical TMS sessions are interactive, and you will be seated in a comfortable chair and remain awake and alert. Clients are encouraged to relax, watch videos, or engage in normal conversations with their provider during the treatment session.

Once a client is deemed appropriate for TMS therapy via a thorough consultation, the TMS therapy process will begin with an initial brain mapping procedure. Here, a technician will work with a new client to identify the precise location where the TMS coil will deliver magnetic impulses on the client’s scalp and into their brain.

You will have the scalp placed on your head while your technician delivers magnetic pulses to find the area of your brain that is responsible for controlling movement. Once this is detected, your hand will twitch.

This first session also involves motor threshold testing, which will determine the correct intensity to deliver magnetic impulses. In other words, this testing addresses the intensity needed to cause the twitch in your hand.

This personalized process is critical to ensure that future sessions will address brain areas associated with cognitive functioning, learning, memory, and mood regulation appropriately. It also ensures that treatment is safe and effective as you move into subsequent sessions.

Subsequent sessions will build off of each other and involve repetitive transcranial magnetic stimulation (rTMS). With an electromagnetic coil placed on your scalp, pulses will be delivered to you in short bursts. You can expect to hear a clicking sound while experiencing a tapping sensation on your scalp. Earplugs will be provided to you to ensure your comfort throughout the session.

How Many Sessions Are Needed?

TMS therapy is considered a short-term treatment that often requires daily participation four to five days a week for a total of four to six weeks. 

That said, it is important to recognize that the length of TMS treatment is individualized to meet each client’s unique needs and goals for recovery.

Individuals enrolled in a residential addiction treatment program, like ours at Crystal Cove Recovery, can expect TMS sessions to span the length of the treatment program. Meanwhile, for those enrolled in any outpatient mental health or substance abuse treatment program, the length of TMS treatment may vary on a case-by-case basis.

How Should You Prepare for Your First Appointment?

Effective preparation for TMS therapy can first include reading more about what to expect from TMS therapy sessions (just as you are doing now!), attending a consultation with a technician or provider to determine candidacy, and creating a treatment schedule. 

It can also be important to understand your health insurance coverage and prepare for any potential out-of-pocket costs before beginning TMS therapy treatment.

Once approved and scheduled for sessions, you can prepare for your sessions by:

• Wearing comfortable clothing
• Staying hydrated by drinking plenty of water and eating a light meal
• Getting sound sleep to ensure that you are alert during treatment 
• Continuing prescription medications as necessary
• Packing headphones, a book, or other interactive materials to remain engaged during the session
• Bringing someone you trust who can be there to support you during the process

How Long Do Sessions Typically Last?

TMS therapy sessions can last anywhere between 20 minutes and a full hour. 

It is important to reemphasize that the duration of sessions will vary on a case-by-case basis, depending on factors such as a client’s unique needs and recovery goals.

Does TMS Rewire the Brain?

Yes, TMS therapy helps to rewire the brain by promoting neuroplasticity, making it more susceptible to positive changes. 

Such magnetic stimulation helps to correct existing imbalances in brain areas that are responsible for life-sustaining functions. TMS therapy is also helpful in breaking harmful patterns of thought and emotion that could otherwise increase the risk of relapse throughout long-term recovery.

Does TMS Help With OCD?

Yes, TMS has been approved by the FDA as a safe and effective treatment for obsessive-compulsive disorder (OCD). 

More specifically, clinical studies have shown that TMS can offer significant relief from OCD-related symptoms, including intrusive thoughts (obsessions) and repetitive habits and behaviors (compulsions), while improving overall quality of life.

Side Effects and Safety of TMS Therapy

What Are the Common Side Effects?

Like any therapeutic modality, there can be side effects of TMS therapy. 

Some of the most common side effects of TMS therapy treatment include:

• Scalp discomfort
• Headaches
• Facial twitching
• Lightheadedness
• Fatigue
• Anxiety
• Insomnia

What Is the Most Serious Side Effect of TMS?

There are also rare but extremely serious side effects that can result from TMS therapy treatment. Understanding these side effects is critical to ensuring that each person is well-educated about the risks. 

These potential, serious side effects can include:

• An increased risk of seizures
• Tinnitus
• Burns
• Hypomania
• Hearing loss

All in all, TMS is considered to be a safe and well-tolerated treatment. Technicians, providers, and collaborative care professionals will also work to minimize these risks and reduce any potential for harm during treatment sessions.

How Long Do Side Effects Last?

The potential side effects of TMS therapy can vary in frequency and severity. Fortunately, common side effects tend to subside within minutes or up to a day or two following a session.

Typical timelines for common side effects are noted below:

• Scalp discomfort: Often subsides once the session is complete
• Headaches: Often mild, subsiding within a day or two
• Facial twitching: Often subsides once the session is complete
• Lightheadedness: Usually brief and resolves quickly once the session is complete
• Fatigue: Mild tiredness may span throughout the treatment program, especially if TMS sessions occur in the morning
• Anxiety: Mood changes can be common at the start of treatment, but tend to subside with therapeutic support 
• Insomnia: May last a few days up to a couple of weeks, as treatment progresses

Who Should Avoid TMS Therapy?

Not everyone may be a good fit for TMS therapy, especially those who are in active crisis or have magnetic-sensitive metal implants or other electronics placed in or near their head. 

Other groups of individuals who may not be a good fit for TMS therapy include:

• Children
• Those experiencing severe symptoms of mental health conditions, including those with bipolar disorder
• Individuals with a history of seizures or epilepsy
• Those who have cochlear implants, deep-brain stimulators, or pacemakers

Moving Forward With TMS Therapy

Is TMS Right For Me?

Before knowing if TMS therapy is right for you, it is important to identify a facility that offers TMS treatment and undergo a professional consultation. 

A professional consultation with a provider can gather a comprehensive view of the factors that are leading you to addiction or mental health treatment while providing you with a safe space to answer any lingering questions you may have about the treatment process.

At Crystal Cove Recovery, our admissions team is available to answer any questions you may have while helping you prepare to enter our detox and residential rehabilitation program.

What Should I Look For in a Provider That Offers TMS?

When choosing a TMS provider, it can be valuable to look for a board-certified professional who offers transparency regarding their clinical experience and application of TMS therapy treatment. 

Some specific examples of factors to consider may include:

• Use of personalized, integrative, and comprehensive treatment plans
• Clear insurance and cost information
• Commitment to providing a supportive and nurturing treatment environment
• Patient testimonials
• Success rates from previous clients

Does TMS Work Long-Term?

TMS often facilitates long-term benefits, with many patients reporting sustained improvement for months and years following TMS sessions. 

As stated previously, TMS should be used in tandem with other therapeutic approaches during treatment. Continuing care services can also assist in prolonging positive outcomes. 

Frequently Asked Questions

Can TMS therapy help with cravings?

Yes, TMS therapy can help with alcohol and drug cravings by targeting brain regions associated with impulse control and emotional regulation.

By regulating this neuronal activity, TMS can quiet urges and cravings to re-engage with substances.

How soon will I notice results?

You may notice improvements in your symptoms as little as one to two weeks after beginning TMS treatment, although these benefits will continue to grow over the course of your 4-6 week treatment program. 

Is TMS covered by insurance for addiction?

While some major insurance plans may cover the costs of TMS treatment, each health insurance plan has its own requirements and conditions. 

Oftentimes, TMS can be billed as an intervention used for a secondary, co-occurring condition, such as depression or OCD.

At Crystal Cove Recovery, we accept all PPO health care insurance plans and offer a cash pay program for those without insurance. Fortunately, we can also handle the verification process for you. Call our admissions team to learn more.

Does TMS really help depression?

Yes, TMS therapy can be an effective treatment for depression, especially for those with treatment-resistant depression. 

If you have not found relief from antidepressants, psychotherapy, or other treatments, TMS therapy may offer you an opportunity to obtain lasting transformation in your recovery journey.

Transcranial magnetic stimulation (TMS) therapy is a type of brain stimulation therapy that works to address dormant or underactive brain regions to reduce symptoms of mental health disorders while improving quality of life. TMS therapy promotes brain neuroplasticity, making it more susceptible to positive change, which can enhance the effectiveness of medication-assisted treatment (MAT) and psychotherapy while facilitating more successful treatment outcomes overall. While it has been approved by the FDA to treat depression and obsessive-compulsive disorder (OCD), it can be valuable for addiction treatment by addressing root mental health issues that may be contributing to substance abuse. At Crystal Cove Recovery, we offer TMS therapy in our residential rehabilitation program for addiction. Learn more by calling (949) 227-4306 today.