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How TMS Therapy Can Heal Symptoms of PTSD

How TMS Therapy Can Heal Symptoms of PTSD

February 11, 2023 PTSD, TMS

“PTSD can lead to chronic, debilitating symptoms that don’t go away on their own.”

Introduction:

Are you suffering from flashbacks? Do you feel hyper-alert and anxious at times for seemingly no reason? Post-Traumatic Stress Disorder (PTSD) is a debilitating condition, and many people who get help won’t find relief.

Transcranial Magnetic Stimulation (TMS) works by creating electrical currents in brain tissue. It’s non-invasive and can relieve flashbacks and anxiety from PTSD faster than SSRIs and therapy.

Let’s talk about how TMS works for PTSD. PTSD can happen after you’re exposed to traumatic events or even after you learn about someone else’s trauma. When you think of PTSD, you might picture a veteran with traumatic memories of combat. Veterans are more at risk for PTSD, and it’s estimated that 12-13% of Iraq veterans qualify for a diagnosis. Among the general population, PTSD rates are about half that. A short-term trauma response may mean replaying a car accident in your mind for days or weeks afterward. But PTSD can lead to chronic, debilitating symptoms that don’t go away on their own.

Symptoms of PTSD include:

  • Re-experiencing a traumatic event
  • Intrusive thoughts
  • Flashbacks
  • Nightmares
  • Dissociation (feeling detached from reality or yourself)
  • Sadness or guilt surrounding the event
  • Physiologic reactions like racing heart rate, breathing quickly, and difficulty focusing
  • Problems with sleeping
  • Feeling hypervigilant
  • Irritability
  • Avoiding traumatic triggers
  • Depression often occurs in conjunction with PTSD

These symptoms can present themselves in different people in different ways, and make living a “normal” life a lot more difficult. Psychiatric medications and therapy are first-line treatments for PTSD, yet many patients find their symptoms don’t go away even after months of treatment. Only 20-30% of patients see their PTSD symptoms recede with medications.

TMS is an innovative treatment that offers hope for people who still struggle with PTSD after trying other options. At KarmaTMS, we treat people with PTSD, depression, anxiety, bipolar disorder, and more. We love seeing our clients get their lives back. But people usually have a lot of questions about TMS. You might not have heard about this treatment before, and that’s okay.

Let’s break down how TMS works for treating PTSD, and get clear on the data that supports this new medical intervention. How TMS Works for PTSD: What the Research Says Researchers have been studying TMS for PTSD for over 20 years. It’s safe, tolerable, and effective. And unlike SSRIs, its side effects are minimal and short-lasting. And unlike other medical treatments, you won’t have to go under sedation or stop eating before you have it done.

In 2008, the FDA approved TMS for treatment-resistant depression, and it’s since then been approved for Obsessive-Compulsive Disorder, migraine headaches, and more. TMS is not yet approved for PTSD, but two large meta-analyses have shown that it’s helpful in improving symptoms.

Here’s how TMS improves the symptoms of PTSD:

  • TMS helps relieve the distress and anxiety that people experience with PTSD.
  • TMS has relieved hyperarousal in people with PTSD.
  • TMS has helped with insomnia and sleep problems that are particularly distressing for people with traumatic memories.
  • TMS is effective for treating depression, even for people who have already tried other treatment methods.

Success Rate of TMS for PTSD

TMS helps with PTSD in these specific ways. But what can you expect from TMS therapy as far as success rates go? How Successful Is TMS for PTSD? In some of the latest research, half of the patients showed significant improvement or remission after TMS treatments.5 Some trials have shown that up to 80% of patients see an improvement in their symptoms. In comparison, SSRIs are helpful for 60% of patients with PTSD and lead to remission in 20-50% of cases.4

TMS has an impressive response rate, and it’s even more effective when it’s paired with supportive psychotherapy. You’ll give yourself a higher chance of full remission from PTSD if you put the time in for therapy along with treatment. That’s why we offer supportive psychotherapy alongside TMS to create an integrative treatment process.

Using supportive therapy and TMS, we help our patients recover from battle trauma, memories of sexual assault, and accidents. Sometimes people come to us with the symptoms of PTSD, along with others. This is sometimes called Complex PTSD or C-PTSD. Let’s talk about what this means and how TMS can help you.

TMS for Complex PTSD (C-PTSD) Complex PTSD can happen after a person has repeatedly experienced trauma. Rather than one event, their trauma may come from a period in their life. C-PTSD may have roots in childhood abuse or neglect, domestic violence, sexual abuse, or war. You may be more at risk for c-PTSD if your trauma began when you were very young, you felt trapped, or you were abused by someone you trusted.12

Just like every other mental illness, PTSD is a spectrum. C-PTSD falls on the more severe side of that spectrum. The symptoms of C-PTSD may be more intense than PTSD. People with C-PTSD will likely show a few core symptoms, along with one or more of these:

  • Feeling intense guilt, shame, or worthlessness
  • Mood swings that stem from a lack of emotional control
  • Feeling disconnected from other people
  • Struggling to maintain relationships with friends or partners

C-PTSD is characterized by more problems with connection and emotions. People with C-PTSD may go through personality changes, like becoming more closed-off when they used to be extroverted. Sometimes other diagnoses can contribute to or stem from C-PTSD. For example, borderline personality disorder leads to relationship problems, issues with self-image, and patterns of instability. Someone with C-PTSD may also show these symptoms because of their response to trauma. This is why it’s so important to get assessed by a thorough mental health provider so you can be sure you get the right diagnosis, then proper treatment. Treatment recommendations for C-PTSD are usually similar to PTSD, but patients may need additional support. Let’s talk about how TMS has been shown to help the more complicated symptoms of C-PTSD. TMS for C-PTSD The symptoms of C-PTSD have responded well to TMS in trials.

Here’s how TMS treats the symptoms of C-PTSD:

  • TMS has helped lessen feelings of abandonment, paranoia, and suicidal behavior.
  • TMS has been shown to help with regulating mood and impulses.
  • TMS has helped with the ability to manage anxiety and depression.

Even though C-PTSD is a severe and all-consuming illness, there’s still hope with TMS therapy. But you might have some reservations about this treatment. Can TMS worsen PTSD? Let’s talk about the current research. Can TMS for PTSD Make Symptoms Worse? There have been no instances where TMS therapy made PTSD worse in trials. But there are a few specific things to be aware of before you go into treatment:

The machine that we use to create TMS impulses makes a loud popping sound, which has been compared to firearms. This may be triggering to veterans and people with a history of firearm violence. We use ear protection with all of our patients, so this won’t be nearly as loud during your session, but it’s something to be aware of going into the treatment.

TMS has a risk of triggering mania in people with bipolar disorder. This risk is similar to that of SSRIs. We still treat people with bipolar disorder with TMS, but we may change the frequency of TMS sessions to mitigate this risk.

TMS has few risks, especially when compared to other treatments like SSRIs. But does the treatment hurt? Let’s get into how TMS feels. What Does TMS for PTSD Feel Like? Patients report that TMS feels like a tapping or poking sensation. These vibrations can feel especially strange during your first few visits, and it can even feel uncomfortable. Most of our patients get used to this after a few sessions. It can even be tempting to fall asleep during your later sessions (but we ask our patients to stay awake for treatment).

Now that you know how TMS works for PTSD, let’s talk about how to get started. TMS for PTSD: How to Get Started Your first priority in getting started with TMS is choosing a qualified and experienced provider. This is an important step because not all TMS providers are the same. You can read more about how to choose a TMS clinic using this guide.

If you’re ready to get started with TMS and you’re in the Palm Springs area, call our office to learn more about how TMS works and to schedule your first consult. Our compassionate staff are experts in integrative psychiatric care. We don’t just prescribe TMS and send you on your way. We’re partners on your journey to a better life with PTSD.

To get started, call the number on our homepage and one of our skilled clinicians will help you get started.

Resources: 1)Hoge CW, Castro CA, Messer SC, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004; 351: 13–22. https://pubmed.ncbi.nlm.nih.gov/15229303/ 2)Goldstein RB, Smith SM, Chou SP, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions–III. Soc Psychiatry Psychiatr Epidemiol 2016; 51: 1137–1148. https://pubmed.ncbi.nlm.nih.gov/27106853/ 3)Mann SK, Marwaha R. Posttraumatic Stress Disorder. [Updated 2022 Feb 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559129/ 4)Alexander W. Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. P T. 2012 Jan;37(1):32-8. PMID: 22346334; PMCID: PMC3278188. 5)Petrosino NJ, Cosmo C, Berlow YA, Zandvakili A, van ‘t Wout-Frank M, Philip NS. Transcranial magnetic stimulation for post-traumatic stress disorder. Ther Adv Psychopharmacol. 2021 Oct 28;11:20451253211049921. doi: 10.1177/20451253211049921. PMID: 34733479; PMCID: PMC8558793. 6)Cirillo P, Gold AK, Nardi AE, Ornelas AC, Nierenberg AA, Camprodon J, et al. Transcranial magnetic stimulation in anxiety and trauma-related disorders: a systematic review and meta-analysis. Brain Behav. (2019) 9:e01284. doi: 10.1002/brb3.1284 7)Wilkes PB, Mehndiratta RB, Mehndiratta YP, Wamer A, Rosse RB, Balish M. Repetitive transcranial magnetic stimulation treatment of comorbid posttraumatic stress disorder and major depression. J Neuropsychiatry Clin Neurosci. (2002) 14:270–6. 10.1176/jnp.14.3.270 8)Clark, C., Cole, J., Winter, C., & Grammer, G. (2016). Transcranial magnetic stimulation treatment of posttraumatic stress disorder. Oxford Medicine Online. https://doi.org/10.1093/med/9780190205959.003.0005 9)Adam P. Stern, M. D. (2020, October 27). Transcranial magnetic stimulation (TMS): Hope for stubborn depression. Harvard Health. Retrieved February 1, 2023, from https://www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335#:~:text=Does%20TMS%20work%3F,their%20symptoms%20go%20away%20completely. 10)Philip NS, Ridout SJ, Albright SE, Sanchez G, Carpenter LL. 5-Hz Transcranial Magnetic Stimulation for Comorbid Posttraumatic Stress Disorder and Major Depression. J Trauma Stress. 2016 Feb;29(1):93-6. doi: 10.1002/jts.22065. Epub 2016 Jan 7. PMID: 26748883; PMCID: PMC4849266. 11)Brewin CR, Cloitre M, Hyland P, Shevlin M, Maercker A, Bryant RA, Humayun A, Jones LM, Kagee A, Rousseau C, Somasundaram D, Suzuki Y, Wessely S, van Ommeren M, Reed GM. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD. Clin Psychol Rev. 2017 Dec;58:1-15. doi: 10.1016/j.cpr.2017.09.001. Epub 2017 Sep 6. PMID: 29029837. 12)NHS. (2022, May 13). Complex PTSD – Post-Traumatic Stress Disorder. NHS choices. Retrieved February 2, 2023, from https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/ 13)Calderón-Moctezuma AR, Reyes-López JV, Rodríguez-Valdés R, Barbosa-Luna M, Ricardo-Garcell J, Espino-Cortés M, Hernández-Chan N, García-Noguez L, Roque-Roque G, Trejo-Cruz G, Cañizares-Gómez S, Hernández-Montiel H. Improvement in borderline personality disorder symptomatology after repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex: preliminary results. Braz J Psychiatry. 2021 Feb 1;43(1):65-69. doi: 10.1590/1516-4446-2019-0591. PMID: 32876128; PMCID: PMC7861182. 14)Konstantinou, G. N., Trevizol, A. P., Downar, J., McMain, S. F., Vila-Rodriguez, F., Daskalakis, Z. J., & Blumberger, D. M. (2021). Repetitive transcranial magnetic stimulation in patients with borderline personality disorder: A systematic review. Psychiatry Research, 304, 114145. https://doi.org/10.1016/j.psychres.2021.114145 15)Sverak T, Linhartova P, Gajdos M, Kuhn M, Latalova A, Lamos M, Ustohal L, Kasparek T. Brain Connectivity and Symptom Changes After Transcranial Magnetic Stimulation in Patients With Borderline Personality Disorder. Front Psychiatry. 2022 Jan 18;12:770353. doi: 10.3389/fpsyt.2021.770353. PMID: 35115961; PMCID: PMC8804206. 16)Peterchev AV, Murphy DL, Goetz SM. Quiet transcranial magnetic stimulation: Status and future directions. Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:226-9. doi: 10.1109/EMBC.2015.7318341. PMID: 26736241.