Transcranial magnetic stimulation (TMS) is a procedure that uses an electromagnetic coil close to the skull to deliver magnetic pulses into the brain. These pulses can alter nerve cell activity in areas of the brain involved in mood regulation, which may help treat anxiety.
It is typical to experience occasional anxiety, but if someone feels frequently or constantly anxious, this may be a sign that they have an anxiety disorder.
Psychotherapy and medications may help treat anxiety, but if first-line treatments are not effective, people may try TMS.
TMS uses a magnetic field to create an electric current that stimulates certain areas of the brain to treat mental health conditions.
In this article, we look at what TMS involves and how it may treat anxiety.
What is TMS?
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TMS is a procedure that uses magnetic fields to alter activity in areas of the brain involved in regulating mood.
A doctor will place an electromagnetic coil close to the scalp to pass a magnetic pulse through the skull to the brain.
This pulse stimulates nerve cells to help activate regions of the brain involved in controlling mood.
Types of TMS
Different types of TMS may target different areas of the brain.
Repetitive transcranial magnetic stimulation (rTMS)
According to the National Institute of Mental Health (NIMH), a session of rTMS may usually last for 30–60 minutes.
It is a non-invasive procedure where anesthesia is unnecessary. An rTMS procedure may involve the following:
- A doctor will hold an electromagnetic coil against the forehead next to a specific area of the brain.
- The electromagnetic coil will deliver pulses through the skull to the brain, creating small electrical currents.
- These currents stimulate nerve cells in the appropriate area of the brain.
According to the NIMH, the pulses from rTMS usually reach up to 2 inches into the brain. The technique uses a magnetic field that has a similar strength to an MRI. Someone may feel a mild tapping or knocking sensation on their head during rTMS.
Theta burst stimulation is a form of rTMS that uses short bursts of high-frequency stimulation to mimic the usual rhythm of brain activity.
Deep transcranial magnetic stimulation (dTMS)
According to the Anxiety & Depression Association of America, deep transcranial magnetic stimulation (dTMS) targets larger regions, deeper within the brain.
During a dTMS procedure, specialized coils, called H coils, deliver pulses that reach around 4 centimeters below the skull. These coils stimulate different areas of the brain.
In a dTMS session, people will wear a special helmet, which produces magnetic fields. Individuals may have a 20-minute session each day for 4–6 weeks.
People will be able to resume their everyday activities after a dTMS session.
Does TMS work for anxiety?
According to a 2019 review, TMS is an effective treatment for major depressive disorder and obsessive-compulsive disorder, but there is little research on its effectiveness in treating anxiety disorders.
The review looked at research relating to TMS and anxiety or trauma-related conditions.
The research suggests that TMS may be an effective treatment method for both generalized anxiety disorder and post-traumatic stress disorder, although further research is necessary.
How TMS treatment works
TMS works by using a coil close to the skull to deliver electric currents to nerve cells in the cortex, which is the outer layer of the brain.
The electrical currents create changes in nerve cell activity in specific areas of the brain, such as the prefrontal cortex, which can help control mood. Doctors may refer to these alterations as neuroplasticity.
How long for it to take effect
There is little research on the effects of TMS on treating anxiety and how long it will take to start experiencing results.
A 2019 review suggests that a minimum of five sessions of TMS are necessary to induce neuroplasticity and improve anxiety symptoms in the long term.
Research on TMS for treating depression suggests that the number of sessions, for example, two sessions per day rather than one session daily, may increase improvement rates more than total pulses per session.
Can TMS worsen anxiety?
There is no evidence suggesting TMS can worsen anxiety, but people may experience the following side effects:
- headache
- neck pain
- scalp pain
- tingling
- sleepiness
- facial twitch
- cognitive impairment during treatment
Research suggests that most side effects of TMS are mild to moderate, but it may pose a risk of seizure.
Outlook
TMS may be a safe, noninvasive, and effective treatment for anxiety disorders such as generalized anxiety disorder.
However, researchers still need further, large-scale controlled trials to find out how effective TMS is in treating anxiety.
Summary
TMS is a noninvasive procedure that delivers magnetic pulses through the skull to the brain. These pulses alter nerve cell activity in specific areas of the brain that help regulate mood.
These changes in brain activity may help reduce symptoms of mental health conditions such as anxiety.
Healthcare professionals may try TMS as a treatment method for anxiety if psychotherapy and medications are ineffective.
TMS is a safe and effective treatment for depression and OCD. The technique may also be effective for treating anxiety when other methods have not worked.
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