Depression Options That Work

Greg Thorkelson, MD with Ryan Reagan, PhD(c), LPC

Speaking of brains. The Nexus Group is also pleased to be one of the foremost providers offering Transcranial Magnetic Stimulation (TMS) in the Pittsburgh region. TMS is a non-invasive procedure that has been approved for the treatment of chronic depression. This procedure is delivered in an outpatient setting on a daily schedule.  TMS sessions are approximately20 minutes in length. Many patients complete them before or after work, and even on lunch breaks. This is not the same thing as ECT (electroconvulsive therapy) that is delivered in hospital settings.

The TMS procedure is relatively painless. A mild electromagnetic current is targeted to a region of the brain that is shown to be under stimulated during episodes of depression. You may be familiar with the now dispelled notion that depression was nothing more than a “chemical imbalance” in the brain. It is not that the case that neurochemistry does not matter, it is just the case that it is not the only thing. The newer thinking is that depression is like circuitry, a deeply entrenched network that has built over time and now pulls an inordinate amount of attention and energy away from the patient. It comes as no surprise that fatigue and difficulty focusing are common complaints during depression.

TMS is one of the new tools that can help to alleviate suffering for depressed patients who have tried medications and therapy and still have not achieved remission. Many patients undergoing TMS also continue outpatient therapy. CBT and other modalities of treatment can continue during TMS and may even enhance the efficacy of both procedures. Depression tends to overlap with other anxiety disorders and the difficulty focusing and concentrating may limit the efficacy of cognitive therapies. TMS may help get the gears turning.

At Nexus we learned to adapt to the pandemic by offering services that could be delivered and modified to fit patient needs. In the past three years we have learned quite a lot about how to effectively deliver new services like telepsychiatry and continue TMS and medication management for our patients. This care is compassionate, integrated, and transformative with you at the center.

             

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