Inside Out Consult
03/23/2024
- JP Nagar 6th Phase Bangalore
- 090197 04252
A comfortable clinical setup for TMS therapy. Patients sit in a specialized chair while a magnetic coil positioned over the head delivers targeted pulses to stimulate brain regions affected by depression.
Transcranial Magnetic Stimulation (TMS) therapy is a groundbreaking non-invasive brain stimulation technique bringing hope to many people with depression in Bangalore and across India. TMS uses focused magnetic pulses to stimulate specific brain regions involved in mood regulation, without any surgery or medication. For individuals who haven’t found relief with antidepressants or talk therapy, TMS offers a new pathway to recovery by directly energizing the brain’s mood circuits.
TMS is an FDA-approved therapy for major depressive disorder that has now made its way to advanced mental health centers in India. It works by creating a magnetic field that induces tiny electrical currents in the brain’s cortex. These currents activate neural pathways in areas that are underactive in depression (typically the left dorsolateral prefrontal cortex). By boosting brain activity in these regions, TMS helps improve mood regulation and alleviates depressive symptoms.
Safe and Well-Tolerated: TMS doesn’t require any surgery or anesthesia – you sit awake in a chair during treatment. Aside from feeling a gentle tapping on your scalp, it’s painless. Because it’s a localized treatment (unlike medication), you can resume normal activities right after each session. The most common side effect is a mild headache during or after treatment, which usually passes quickly. Serious risks (like a seizure) are extremely rare and mitigated by thorough screening.
TMS is not like electroconvulsive therapy (ECT) – there is no induced seizure and no memory loss. You are fully awake and alert during the procedure, and you can return to your routine immediately afterward. Each session typically lasts around 20 minutes. At Arka Anugraha Hospital, we perform TMS on an outpatient basis in a comfortable setting, making the experience as convenient as possible.
What does this nerve have to do with depression and anxiety? Quite a lot, as it turns out. Depression and anxiety are not just “in the mind” – they have powerful physical components. One such component is the balance between the sympathetic nervous system (fight-or-flight) and the parasympathetic (rest-and-digest). The vagus nerve is the captain of the parasympathetic team.
In chronic anxiety or depression:
Now, what happens if we stimulate the vagus nerve intentionally? Research and clinical experience have shown:
Stimulating the vagus nerve sends a signal up to the brain to release calming neurotransmitters. It’s like manually activating the relaxation response. Patients often report an immediate sense of tranquility, reduced chest tightness, and slower breathing. Over time, repeated stimulation can “train” the body to not overreact to stress.
In people with treatment-resistant depression, vagus nerve stimulation (with devices) has led to significant improvements in moodmayoclinic.orgmayoclinic.org. The mechanism isn’t fully understood, but it likely involves altering neurotransmitter circuits (like boosting serotonin and norepinephrine release in the brain) and reducing inflammation. It might also stimulate neuroplasticity – helping the brain form new, healthier connections.
The vagus nerve is key to emotional regulation, a concept highlighted by the popular Polyvagal Theory by Dr. Stephen Porges. According to this theory, when your vagus nerve is engaged, you feel safe and socially connected; when it’s not, you feel defensive and withdrawn. Stimulating the vagus nerve can thus shift someone from a state of fear/withdrawal (common in trauma and anxiety) to a state of safety where they can engage and process emotions betterpositivepsychology.compositivepsychology.com.
Many with anxiety/depression have physical complaints like Irritable Bowel Syndrome, migraines, or palpitations. By calming organ systems (remember, the vagus runs to the gut and heart), stimulation can alleviate these symptoms too. E.g., vagus activation often improves gut motility and reduces irritable bowel flares – which can indirectly lift mood because the gut and brain are so intertwined.
It’s important to note that VNS isn’t a standalone cure-all. Think of it as a potent new tool in the toolkit. It seems especially helpful for those who have not responded to other treatments, suggesting that their conditions have a strong physiological component that VNS can tap into. Depression accompanied by markers of inflammation, or anxiety with a lot of physical symptoms, are scenarios where focusing on the vagus nerve makes sense.
TMS therapy is typically delivered as an outpatient procedure – you don’t need hospitalization at all. A standard treatment course involves daily sessions, five days a week, for about 4–6 weeks. Each session lasts around 20 to 40 minutes. Here’s what a typical TMS session at Arka Anugraha Hospital’s Integrative Psychiatry department in Bangalore looks like:
You’ll be seated comfortably in a reclining chair. A clinician positions a cushioned magnetic coil on your scalp and finds the correct spot and energy level for your brain (by initially stimulating the motor area and observing a finger twitch). This calibration, done only in the first session, ensures the subsequent treatment hits the target area linked to mood.
Once the coil is properly placed over the frontal region, the machine delivers rapid magnetic pulses. You’ll hear clicking and feel a gentle tapping on your head. It isn’t painful – just an unusual sensation that most people get used to quickly. You remain awake and alert. During the session, you simply relax; some patients meditate or listen to calm music. A technician stays with you and monitors you the entire time.
When the pulse sequence ends (after about 20–40 minutes), the session is complete. You can immediately resume normal activities – drive back to work or home, etc. There’s no post-anesthesia grogginess (since there’s no anesthesia) and no memory loss. Aside from possibly a mild headache or scalp tingling (for which we can provide a pain reliever if needed), there are typically no side effects to deal with. You’ll schedule your next session for the following day and carry on with your day.
Patients usually start noticing mood improvements after the second or third week of treatment, though this varies – some feel better sooner, and others closer to the end of the 4–6 week course. It’s a gradual, gentle process as the brain circuits adjust to repeated stimulation.
TMS is primarily indicated for adults with major depressive disorder, especially those who have not found relief with standard treatments (treatment-resistant depression). Psychiatrists may recommend TMS after multiple antidepressants have failed or if medications are not an option due to pregnancy or intolerable side effects. Being medication-free and non-systemic, TMS is a valuable alternative in such scenarios. It has also shown promise (in research or overseas approvals) for conditions like OCD and PTSD, though those applications are considered off-label.
As with any procedure, certain people cannot receive TMS – for example, individuals with metal implants in the head (pacemakers in the brain, cochlear implants, etc.) or a history of seizures. A thorough screening at Arka Anugraha Hospital ensures TMS is safe for each patient’s unique situation. Generally, TMS is very well tolerated, and even those worried about discomfort are reassured after the first session, finding it much easier than anticipated.
What makes the TMS program at Arka Anugraha Hospital unique is that it is embedded in a broader integrative psychiatry approach. We don’t just administer TMS and send you on your way; we combine it with complementary therapies and lifestyle interventions to enhance your overall mental well-being. Depression is a complex condition, influenced by brain chemistry, nutrition, hormones, stress levels, and more. By addressing multiple facets of your health in parallel with TMS, we aim for more robust and lasting relief.
Some of the supportive therapies and services we incorporate alongside TMS include:
By combining TMS with these diverse therapies – nutrition, detox, mind-body practices, technology, and advanced diagnostics – we treat you as a whole person, not just a set of symptoms. This holistic care increases the likelihood of a breakthrough, especially if depression has multiple contributing factors. Many patients find that while TMS lifts the heavy blanket of depression, the integrative therapies build a solid foundation for long-term mental wellness, making relapses less frequent or severe.
To illustrate how TMS can transform lives, let’s look at a fictional but realistic example:
Rahul’s Journey: Rahul is a 38-year-old software engineer in Bangalore who has battled depression for over 5 years. He tried three different antidepressant medications; while each gave some relief, the benefits never lasted and side effects like weight gain and drowsiness bothered him. Therapy helped to an extent, but he still felt an oppressive low mood and lack of motivation that made it hard to get through work and family responsibilities. After yet another medication trial failed, Rahul felt hopeless – until his psychiatrist referred him to Arka Anugraha Hospital’s Integrative Psychiatry department for TMS therapy.
Rahul was initially anxious about the idea of “magnetic pulses” to his brain, but the team answered all his questions in a free consultation (Arka offers a Discovery Call for new patients). Reassured that the treatment is safe and evidence-based, he decided to give it a try. Along with starting TMS sessions, Rahul met with an integrative nutritionist at Arka. To his surprise, testing showed he had low vitamin D and B12 levels, so he began supplements and weekly IV nutrient infusions. He also started attending a Saturday breathwork class to help with his stress.
Mid-Treatment: Around the middle of the 4th week, Rahul realized he had spontaneously gone for a morning walk – something he hadn’t had the energy to do in months. He was sleeping better and one evening found himself actually laughing at a TV show with his children. These small shifts signaled that the treatment was starting to work. The encouragement from the clinic staff boosted his confidence and hope.
Completion: By the end of six weeks, Rahul’s depression scores had drastically reduced. He described feeling “a weight off my chest.” Co-workers noticed his upbeat demeanor. In psychotherapy, he was able to engage more actively in working through his thought patterns now that the intense gloom had lifted. Importantly, Rahul also stuck with the lifestyle changes – he continued his healthier diet and breathwork practice, saying these helped him feel “in control” of his well-being.
Over the next months, Rahul maintained his improvements. With the depression at bay, he rekindled hobbies he once enjoyed, like playing cricket on weekends. Rahul’s story shows that even when depression seems resistant, a combination of cutting-edge treatments like TMS and holistic care can lead to profound improvement.
Depression can make life feel dim and hopeless, but therapies like TMS are shining a new light on recovery. If you or a loved one is struggling with depression and want to explore advanced, integrative treatments, our team at Arka Anugraha Hospital in JP Nagar, Bangalore, is here to help. We believe in treating the whole person and empowering our patients with every tool available – from magnetic stimulation to meditation – to achieve healing.
Book a Free Discovery Call with our Integrative Psychiatry specialists to learn if TMS therapy and our holistic mental health program are right for you. This free consultation is a chance to discuss your challenges and goals, and get professional guidance on the path forward. You don’t have to suffer in silence – hope and help are available. Take the first step towards a brighter, healthier mind by reaching out to us today.
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