When it comes to severe mental illness, Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS) are among the most effective therapeutic options – especially for those who have not had much success with traditional treatments such as medication or therapy.
But what is the difference between these two treatments, and which one might be right for you? In this blog, we discuss how these treatments compare in effectiveness, cost, and application as well as what makes an individual an ideal candidate.
What is TMS?
Transcranial Magnetic Stimulation (TMS) is an FDA approved non-invasive procedure that uses magnetic fields to stimulate the nerve cells of the brain. It is typically used for treating Major Depressive Disorder (MDD), especially in cases where other types of treatment, such as medication or psychotherapy, haven’t worked well enough.
How Does TMS Work?
TMS works by delivering magnetic pulses to neurons (the brain’s nerve cells). This stimulation changes their activation patterns and can result in improving mood and cognitive function.
The Procedure
TMS is typically performed five times a week for several weeks, depending on how well the patient responds. The TMS procedure is simple and generally involves the following:
- Assessment: Before starting treatment, you’ll go through some preparation involving a physical and psychological assessment to make sure you would be a good candidate to receive TMS treatment.
- Positioning: Once determined eligible, you would sit in a chair and the TMS device will be placed above your head, targeting the area of the brain that needs stimulation.
- Magnetic Pulses: The treatment itself lasts about 20 to 40 minutes. During this time, the TMS device delivers magnetic pulses to stimulate your brain.
Who is a Good Candidate for TMS?
TMS is a great treatment option for individuals who have:
- Treatment-resistant depression (with unsuccessful results using traditional medication or therapy)
- Aversion to medications (or difficulty tolerating medications)
- Anxiety disorders (occurring alongside depression)
- Bipolar disorder (particularly with depressive episodes)
Potential Side Effects of TMS
TMS is considered a safe treatment option with the possibility of some mild and temporary side effects including:
- Headache
- Scalp discomfort
- Brief tingling sensations
Although TMS is considered safe, caution is advised for those who have metal implants in or near the head or those with seizure history. Like any treatment, TMS and potential risks and side effects should be discussed with a healthcare professional.
What is ECT?
Electroconvulsive Therapy (ECT) is another FDA-approved treatment that, while technically non-invasive, requires general anesthesia, making it partially invasive. During ECT, small electrical currents are sent through the brain to deliberately induce a brief seizure under general anesthesia.
While this method may sound alarming, it’s actually an incredibly effective treatment for certain severe mental health conditions including Major Depressive Disorder (MDD), bipolar disorder, and certain forms of schizophrenia.
How Does ECT Work?
ECT works by sending electrical pulses to neurons (the brain’s nerve cells). This stimulation causes the neurons to fire together and trigger a seizure. The exact reason why this procedure is so effective for treating depression is not well understood.
However, it’s believed that the seizure causes a change in the brain’s neurotransmitters and helps regulate the stress hormone, which can result in better mood.
The Procedure
ECT is typically performed over the course of multiple sessions in a controlled environment, such as a hospital, and the length of the treatment course is determined by the individual’s clinical case. The treatment involves the following procedures:
- Assessment: Similar to TMS, you will undergo a thorough preparation involving a physical and psychological assessment to determine if ECT is right for you.
- Anesthesia: On the day of the treatment, you’ll receive a short-acting general anesthetic so that you’re comfortable during the procedure.
- Electrode Placement: Depending on your treatment needs, electrodes are placed on your scalp either one one side of your head (unilateral) or on both sides (bilateral).
- Induction of Seizure: A brief electrical current is passed through the brain and induces a controlled seizure, which lasts about 30 to 60 seconds.
- Recovery: Following the procedure, you’ll be monitored while you wake up from anesthesia. Temporary confusion and disorientation are possible side effects of the treatment.
Who’s a Good Candidate for ECT?
ECT is typically used as a last resort for severe mental disorders, especially when immediate results are needed and other treatments have failed. ECT may be considered for individuals who have:
- Severe treatment-resistant depression (with unsuccessful results using traditional medication or therapy)
- Suicidal ideation
- Bipolar disorder (particularly with depressive episodes)
- Schizophrenia (alongside severe depressive symptoms)
Potential Side Effects of ECT
While generally safe when performed by well-trained medical professionals, ECT does carry risks and should be discussed carefully with a healthcare professional. Possible adverse reactions include:
- Temporary amnesia, or memory loss, particularly around the time of treatment
- Confusion, or disorientation
- Physical side effects related to the seizure itself
Why is ECT used as a last resort?
ECT is often used to treat severe mental illness when other treatments have failed or when a person is in life-threatening condition. Because it requires anesthesia, induces seizures, and comes with more serious side effects, ECT is typically considered as a last resort option.
TMS vs. ECT: Which is Better?
Effectiveness
The effectiveness of either treatment depends on the individual and the severity of the mental disorder. ECT typically provides faster results, especially in urgent or severe cases of depression. However, it comes with more serious side effects, such as memory loss. TMS, on the other hand, is generally better tolerated, but it may take longer to see results.
Relapse Rate
TMS generally has a lower relapse rate and offers longer lasting relief compared to ECT, especially in the first year following treatment. Relapse rate for either treatment can be managed with follow-up therapy, medication, and/or additional treatments.
Cost
Cost can vary widely based on location of the treatment facility and whether treatment is covered by insurance. TMS is generally less expensive than ECT per session but the overall cost may be similar depending on the number of sessions required.
Key Differences
The main difference between TMS and ECT is how they stimulate the brain and their potential side effects. TMS uses magnetic pulses to stimulate the brain and does not induce seizures or require anesthesia. ECT, on the other hand, uses electrical stimulation to induce a controlled seizure and requires anesthesia with possible side effects including accidental physical harm when seizing or temporary amnesia. TMS is typically the first option to be considered before ECT in cases of moderate depression and ECT considered for more severe cases of depression.
Conclusion: Choosing Between TMS and ECT
Ultimately, the choice between TMS and ECT depends on the severity of the mental health condition, the individual’s response to previous treatments, and their preferences for different types of therapies. Both options are highly effective and can significantly improve quality of life for those struggling with severe depression and other mental health disorders. Always consult with a healthcare professional to discuss which treatment is best for you.
Get Treatment at Kaizen Brain Center
We understand how devastating depression can be, and we strive to empower our patients with knowledge and tools to regain control and improve overall health.
At Kaizen Brain Center, we are honored to be one of the few health facilities currently offering SAINT TMS for treatment of depression as well as Traditional TMS and Kaizen Accelerated TMS.
Our team of experts have developed comprehensive services and programs that can help you or your loved one find a remedy that works.
For resistant depression, consider these treatments at Kaizen Brain Center:
Kaizen Brain Center TMS Testimonials
At Kaizen Brain Center, we create new beginnings for our lovely patients . See what our patients have to say about their TMS treatment at Kaizen Brain Center.: