Post-traumatic stress disorder (PTSD) is a common mental health disorder caused by traumatic events. It can give way to disturbing thoughts and images, often interfering with daily life and leading to major depressive disorder and anxiety.
According to research, one in eleven people are diagnosed with PTSD in their lifetime. Despite this, there's still no set treatment. Antidepressant medication and cognitive processing therapy are often used to control PTSD symptoms, but they can sometimes exacerbate the condition.
However, brain stimulation therapies have started to gain traction in the medical field to treat mood and psychiatric disorders. Food and Drug Administration (FDA) approved and non-invasive, transcranial magnetic stimulation (TMS) can also help treat and control PTSD.
What Is Post-Traumatic Stress Disorder?
PTSD is a psychiatric condition often caused by a traumatic event. Once thought to have been a condition primarily experienced by military veterans because of battle fatigue and shell shock, PTSD can affect anyone.
PTSD symptoms are often characterized by intense, disturbing thoughts or nightmares that reoccur regularly and can include:
- Intrusive thoughts and feelings
- Avoiding people or places associated with the traumatic event
- Repressed memories
- Negative beliefs
- Low self-worth and self-esteem
- Feeling guilty, angry, or shameful about what has happened
- Losing interest in hobbies and activities once enjoyed
- Withdrawing from loved ones
- Socially withdrawing
- Reactivity problems
- Intense outbursts of anger and sadness
- Insomnia and sleeping problems
In addition to the above symptoms, those with PTSD often have co-occurring conditions like major depressive disorder, anxiety, or obsessive-compulsive disorder (OCD) due to the trauma they've suffered.
Read more: TMS for OCD
What Causes PTSD?
Post-traumatic stress disorder is usually always triggered by a traumatic event. This traumatic event can be anything from sexual assault and child abuse to a serious injury.
Combat veterans, for example, often return from war with PTSD because of the traumatic events they experience on the battlefield.
However, the actual cause of PTSD happens due to the changes that take place in the brain after experiencing a traumatic event. After experiencing trauma, three parts of the brain - the amygdala, ventromedial prefrontal cortex, and hippocampus - undergo significant changes.
Made up of the limbic system, the amygdala manages survival instincts like the fight or flight response. This brain region also determines how people process and regulate emotions such as fear and anger. After experiencing trauma, the amygdala becomes hyperactive. In other words, it struggles to regulate and control emotions.
A more complex part of the brain, the ventromedial prefrontal cortex (vmPFC), helps us process and deal with emotions. After experiencing a traumatic event, people often experience lower activity levels in the vmPFC and brain. In turn, this affects the amygdala, making it more difficult to regulate emotions.
This change, in particular, leads to a condition known as a comorbid post-traumatic stress disorder. Those with this condition simultaneously live with PTSD and other psychiatric disorders, such as major depressive disorder.
Similarly, the hippocampus is a core part of the brain responsible for regulating and processing memories. However, after experiencing trauma, the hippocampus often represses harmful memories and shrinks, making it challenging to distinguish memories from the present.
After a traumatic event, the functional connectivity of all three parts of the brain becomes affected, causing PTSD to develop.
What Is Transcranial Magnetic Stimulation for PTSD?
Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation therapy that uses electromagnetic waves and magnetic stimulation to target the prefrontal cortex.
These magnetic waves help stimulate nerve cells, triggering activity in the brain. You might have also heard of the term repetitive transcranial magnetic stimulation. The only difference between the two is that repetitive refers to multiple treatment sessions over a set period.
TMS treatment is used to alleviate several mental disorders and mood conditions, including:
- OCD
- Major depressive disorder
- Treatment-resistant depression
- Anxiety
- PTSD
TMS for PTSD stimulates nerve cells in the vmPFC via electromagnetic waves. Depending on which disorder a person is suffering from, TMS will target slightly different areas of the brain.
Another popular brain stimulation therapy similar to TMS is theta-burst stimulation (TBS).
What Is Theta-Burst Stimulation?
Theta-burst stimulation is essentially a subset of TMS therapy. The only difference between the two treatments is the frequency of electromagnetic waves used.
Unlike TMS, TBS uses much shorter bursts of magnetic stimulation at higher frequencies. Since it uses shorter bursts, it's a quicker treatment option than TMS and can last as little as thirty minutes in total.
How Does Repetitive Transcranial Magnetic Stimulation Work?
Transcranial magnetic stimulation works by targeting nerve cells in the dorsolateral prefrontal cortex - an area of the brain that houses the vmPFC.
TMS for PTSD works similarly to TMS treatment for other psychiatric disorders. During treatment, an electromagnetic coil is placed on a client's head. This coil delivers magnetic stimulation to the prefrontal cortex and stimulates cells in the three parts of the brain responsible for PTSD (the amygdala, vmPFC, and hippocampus).
This brain stimulation helps regulate cells in these areas without affecting brain function, relieving symptoms of PTSD and co-occurring disorders like major depressive disorder and anxiety. Stimulation can also help regulate emotions and restore stability.
If, for example, someone suffers from treatment-resistant depression, repetitive transcranial magnetic stimulation might be used to target different areas of the brain to relieve depressive symptoms and PTSD.
How Can TMS Help PTSD?
Though there's no set cure for post-traumatic stress disorder, repetitive transcranial magnetic stimulation can help make PTSD symptoms more manageable.
It's also vital to note that TMS helps treat comorbid post-traumatic stress disorder, which approximately 80% of those with PTSD experience, by reducing symptoms of multiple conditions.
For example, if someone is suffering from PTSD and depression, transcranial magnetic stimulation can trigger magnetic stimulation in both brain parts affected. TMS can then deliver magnetic stimulation waves to the dorsolateral prefrontal cortex, triggering active stimulation in similar ways for both disorders.
Furthermore, TMS for PTSD works because the brain operates similarly to someone with a mood disorder; both conditions cause the brain to function irregularly.
While transcranial magnetic stimulation can help stabilize functional connectivity between the amygdala, hippocampus, vmPFC, and various neural networks in the brain, it should still be complemented with other treatments for maximum success.
When combined with other treatments, the root cause of PTSD can be addressed from all corners. Some of the most popular complementary TMS treatments include talk therapy, exposure therapy, and cognitive-behavioral therapy (CBT).
Gino's Story of Post-Traumatic Disorder
“In 2003, I was struggling a lot with my mental health. My dad had just died, and I wasn't doing as well as I'd hoped at college. I'd been experiencing depressive symptoms for a while but never thought to get it checked out. It was just normal for me at that point. It went on like this for a couple of years, but I still felt the same. I also never really got any therapy to help me deal with my dad's loss. It was only once I had a serious injury at work that I started to take a closer look at mental health.
I worked in construction and remember being hit by an operating machine. It knocked me clean out, and I was left with broken bones for months. Even though I couldn't remember much about the accident, I started having PTSD symptoms. I kept getting disturbing flashbacks and regular nightmares, and I was too scared to leave the house. I finally went to a clinic, and as well as having my PTSD diagnosed, it was confirmed I had major depression.
My doctor recommended I try TMS treatment before any kind of drug, so I took his word on it. Treatment sessions were about thirty minutes, and I felt nothing. I did it on and off for a few weeks and started to see a significant improvement in symptoms. I didn't need to take drugs, and I've been doing it ever since. In combination with exposure therapy, it's been a real game-changer."
What To Expect at a TMS Appointment
Transcranial magnetic stimulation is virtually painless. As a non-invasive procedure, it can also be completed in as little as 30 minutes. If repetitive transcranial magnetic stimulation is administered regularly, treatment sessions can last as little or as long as a client wishes. There's no set number of sessions, though it's best to take the advice of a medical health provider.
Here's what to expect at the first TMS appointment:
- An electromagnetic coil is fitted around the head and placed directly above the scalp.
- The TMS technician will determine a client's motor threshold (how much magnetic energy is needed to make their fingers twitch). This will ensure they deliver enough magnetic stimulation to achieve the desired results.
- The coil will then deliver electromagnetic waves and pulses to nerve cells in the brain, triggering magnetic stimulation and brain activity.
It is customary to hear a tapping or clicking sound during a TMS session - this is simply the sound of the coil delivering magnetic pulses to the brain.
How To Prepare for a TMS Appointment
Since transcranial magnetic stimulation is non-invasive, it doesn't require much preparation. There are a few things clients need to do before an appointment, though, including taking a psychiatric test and physical examination. This is because the TMS technician needs to understand whether any other mental health disorders are present and if TMS has been provided before.
Not only does conducting an examination help the technician determine whether TMS is right for each client, but it gives them a better idea of each person's motor threshold and how much magnetic stimulation they need to see improvements.
Before completing TMS, doctors need to be aware of:
- Whether a client is pregnant
- If a client has any metal devices in their body (cochlear hearing implants, stents, aneurysms, and coils)
- Whether the client takes any medication
- Any previous brain damage or brain injuries
- Genetic history of seizures and epilepsy
- Regular headaches and migraines
- Previous TMS treatment
Though transcranial magnetic stimulation can be used to treat a wide variety of mood disorders, it's not recommended for everyone. As a result, we recommend making an appointment with a TMS technician or doctor at GIA Miami to discuss whether TMS is suitable.
Related: TMS Therapy for Autism
Common FAQs about TMS for OCD
How Long Are TMS Sessions?
Transcranial magnetic stimulation can last anywhere between 30 to 45 minutes, and sessions can span up to four months. However, it's important to remember that the length of TMS depends on the individual.
If those with PTSD, for example, have been exposed to particularly traumatic events, additional TMS sessions may be needed to alleviate symptoms. This also applies to those who have comorbid post-traumatic stress disorder.
How Much Does TMS Cost?
The cost of TMS varies depending on how many sessions a client requires and the clinic carrying out the treatment.
At GIA Miami, we accept many insurance providers. We also offer payment plans and strive to make our treatment and recovery services accessible to anyone who may need them.
To find out more about the costs of TMS treatments, contact us today.
Is TMS Safe?
TMS is extremely safe, and it's also virtually painless and similar to an MRI scan. Magnetic stimulation produces little to no side effects, and a TMS technician will always adjust the frequency of pulses if a client feels uncomfortable.
What Conditions Can TMS Help Treat?
TMS therapy can treat a wide variety of mental health disorders, including treatment-resistant depression, OCD, anxiety, and PTSD.
As there's no set cure for any of these disorders, most medical professionals advise combining TMS with other complementary treatments like exposure therapy, talk therapy, and medication.
Begin Your Journey to Wellness With GIA Miami
At GIA Miami, we're dedicated to helping each of our clients find the treatment they need to live a fulfilling life. Mental illness doesn't have to hold anyone back - it's why we've created a pool of resources and treatments to help people overcome past traumatic events and better manage their post-traumatic stress disorder.
Alongside TMS for PTSD, we offer a range of complementary therapies, including exposure therapy and cognitive-behavioral therapy. We also use transcranial magnetic stimulation to treat other mental health conditions, such as major depressive order and anxiety, so we are well equipped to deal with any comorbid conditions a client may have.
To find out more about TMS therapy, please contact us today.
