TMS for PTSD

PTSD can happen to anyone, but that doesn’t mean you need to suffer. Here’s what you need to know about TMS for PTSD

TMS for PTSD

Article Contents

What is Trauma?

Transcranial magnetic stimulation (TMS) Therapy is effective when it comes to reducing depressive symptoms related to PTSD due to trauma. Trauma is defined as an emotional response to a distressing event or experience that affects an individual’s power to function and cope. These types of events result in psychological, physical, and emotional trauma. 

At some point, many of us will experience some kind of trauma. Death of loved ones, job loss, abandonment, childhood trauma, illness, natural disasters, psychological trauma, and violence are just a few of the events many experience in their lives that can make a lasting negative impact.

Types of Trauma 

Trauma usually falls into three categories: 

  • One-time traumas are limited in extent. Accidents or natural disasters, for example, are one-time events that are not ongoing. 
  • Trauma that is chronic and ongoing, such as illness or multiple episodes of abuse. 
  • Overlooked traumas that occur in everyday life, such as surgery or childbirth. 

What is PTSD? 

There is no one way to respond to trauma. Everybody reacts differently and what is “normal” or “abnormal” is relatively individual. Some normal responses to trauma include

  • Hypervigilance 
  • Hyperarousal 
  • Intrusive thoughts and memories 
  • Feeling unsafe 

While there are common reactions to trauma, there are times when a person’s response to trauma overcomes their ability to function in everyday life. Posttraumatic Stress Disorder, or PTSD, is a mental health condition that arises after a terrifying or life-threatening event. It can happen after either experiencing or witnessing the event.

While it was originally diagnosed in combat veterans, today, we know that it can occur to anyone. According to the American Psychiatric Association, PTSD affects one in eleven people in their lifetime.1

To be diagnosed with PTSD, a doctor needs to identify the exposure to an upsetting, traumatic event.  

Signs and Symptoms of PTSD

While experiencing symptoms after trauma is normal, even expected, there are times where coping is difficult long after the event has passed. Symptoms of PTSD may develop up to three months after the event and last for more than a month. It also significantly disrupts the individual’s life. 

While certain symptoms vary in severity, they typically fall into four categories: 

Intrusion 

Some intrusive events include flashbacks of the traumatic event, recurrent, involuntary memories, and distressing dreams. Flashbacks can be so realistic that people feel as though they are seeing the event again before their eyes. 

Avoidance 

People go out of their way to avoid thinking about or reminders of the event. This avoidance includes shunning people, places, objects, situations, and activities that could trigger memories. They could avoid talking about the event or their feelings about it. 

Changes in Reactivity and Arousal 

People experiencing PTSD may have reactive symptoms even long after the event has passed. This reaction may include angry outbursts, being irritable, and self-destructive behavior. It can also manifest in being overly suspicious or startled, or issues with concentration or sleep.

Changes in Mood and Cognition 

PTSD can cause negative beliefs about oneself or others, such as “I can’t trust anyone” or “I am a bad person.” These distorted thoughts can lead to one blaming themselves wrongly for the traumatic event.  

These negative thoughts and feelings can lead to ongoing horror, fear, guilt, anger, or shame. It can also lead to a sense of detachment or estrangement from others. Moreover, mood changes can lead to an inability to remember traumatic events or important details from them. 

Memory issues, substance use, chronic pain, and depression are often conditions related to PTSD. 

Treatments for PTSD

While PTSD can be debilitating, there is hope. Since it was first diagnosed back in World War I as “shell shock,” there have been many treatment modalities to help people recover from PTSD. Some forms of trauma therapy include: 

EMDR 

Eye movement desensitization and reprocessing, or EMDR, is a therapy model that seeks to engage the natural healing processes of the brain. It entails the client focusing on external stimulus, usually lateral eye movement, while briefly attending to emotionally disturbing material.

One study found that after six 50-minute sessions 100% of single-trauma victims and 77% of chronic trauma victims were no longer diagnosed with PTSD.

Trauma-Informed Care 

Trauma-Informed care seeks to bring a holistic, complete picture of a patient’s life to provide the most effective health care. There are four core principles of trauma-informed care 

  • Safety so that patients and staff feel psychologically and physically safe throughout the organization. 
  • Empowerment where strengths are acknowledged, encouragedand validated.
  • Transparency to help build and maintain trust. 
  • Collaboration where any power difference 

Trauma-informed care goes beyond the psychologist’s office and is applied to all medical care.

CBT 

Cognitive-behavioral therapy, or CBT, concentrates on changing the relationship between thoughts, feelings, and behaviors. Specifically, emotional processing theory and social cognitive theory can help reduce symptoms of PTSD. 

Exposure Therapy 

Exposure therapy focuses on the unhelpful learned behaviors that people use to respond to thoughts, memories, or situations that may provoke fear. For example, someone who survives a car crash may avoid driving for fear of it happening again. However, avoidance often makes PTSD symptoms last longer. Exposure therapy helps reduce this anxiety by actively confronting their fear. 

What is TMS?

While all of these treatments can be effective for some people, others are not adequately helped by traditional therapies. Transcranial magnetic stimulation, also called TMS or rTMS (for repetitive TMS), can be another option. It uses electromagnetic impulses to regulate cells in the brain and help with healing. This treatment can become valuable in helping those who experience PTSD. 

How can TMS help in PTSD treatment? 

Brain scans have identified specific areas of the brain that are affected in the case of PTSD. Specifically, three areas transform following traumatic events:
  • The hippocampus, which stores long-term memories, 
  • The ventromedial prefrontal cortex (vmPFC), which helps process complex emotions, and
  • The amygdala, which is where more primal emotions take place, especially fear. 
Researchers have found that in the case of PTSD, the vmPFC slows down while the amygdala takes over and leads to intense anxiety. The hippocampus also decreases, making it difficult to tell the difference between a memory and the present. TMS for PTSD uses electromagnetic impulses to help restore balance to the brain and ease symptoms. While more research needs to be done, an initial review of the science found that it can be effective for PTSD.3

What to Expect in TMS Therapy

For those who have not benefitted from traditional PTSD treatments, it is understandable to be skeptical of something new. However, TMS for PTSD is a critical tool to use towards healing.

How Long is the Therapy? 

TMS therapy typically requires five sessions a week for up to six weeks to treat PTSD. After this,  there are then less frequent sessions for three weeks. Each session typically takes anywhere  from 30-40 minutes 

Depending on how severe the PTSD is, many people start to see results after a couple of weeks. 

How to Prepare for TMS Therapy?

To make sure that rTMS is a safe and effective option, you may need a physical exam and  other lab tests, as well as a psychiatric evaluation to discuss symptoms. 

Who Administers TMS? 

TMS for PTSD is typically performed at a doctor’s office under a qualified physician or TMS technician. 

Benefits of TMS for PTSD

Transcranial Magnetic Stimulation has exciting implications as a brain stimulation therapy. Some of the benefits of TMS for PTSD include:4

High-success rate.

Most studies report success in about 60% of patients, with 30-40% in remission. For those who struggle with other more traditional therapy, TMS for PTSD could be  

Non-invasive.

While electroconvulsive therapy is effective, it is no longer used because of how invasive the procedure is. However, rTMS harnesses the effectiveness of neurostimulation without invasiveness.

Minimal side effects.

The most reported side effect is a mild headache, although it is not common and can be easily treated with pain relievers such as Tylenol.

Who Cannot Receive TMS Therapy? 

While rTMS can be an effective option for many, certain people should not have the treatment, including those:5

  • Those with metal or implanted medical devices 
  • Those who are pregnant 
  • Those with a history of seizures or a family history of epilepsy 
  • Individuals with brain damage from illness or injury, such as a stroke.
  • Those who have frequent or severe headaches 
  • Individuals with certain other medical conditions

Your doctor should perform a thorough history to ensure you have nothing that might conflict with TMS therapy. Also, be sure to speak with your doctor about any other medication or supplements you are taking before starting TMS for PTSD.

TMS for PTSD can help those who may not respond to traditional treatments. Ask your doctor if it is right for you. 

  1. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6576151/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047114/
  5. https://www.nami.org/About-Mental-Illness/Treatments/ECT,-TMS-and-Other-Brain-Stimulation-Therapies

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