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Overcoming Treatment-Resistant Depression with Transcranial Magnetic Stimulation (TMS)

Treatment-Resistant Depression with Transcranial Magnetic Stimulation (TMS)

Kartiki Churi, M.D., Family Care Center Regional Lead for Transcranial Magnetic Stimulation

Major Depressive Disorder (MDD) is a debilitating illness that significantly impacts daily activities, quality of life, cognitive function, employment status, and work productivity. As of 2020, approximately 8.4% of adults in the U.S. had at least one major depressive episode, representing an estimated 21 million Americans. At its worst, MDD can be life-threatening due to the high suicide rates.

Treatment-resistant depression (TRD) is a subset of MDD that does not respond to traditional and first-line therapeutic options. Although there is no formal consensus on the definition of TRD, it is commonly considered an inadequate response to at least two trials of antidepressant pharmacotherapy.

9 Factors that Increase the Risk of Treatment-Resistant Depression (TRD)

There is no single reason for TRD, but several factors could increase the risk of TRD, either individually or in combination.

  1. Co-occurring medical or psychiatric illness
  2. Side effects or incorrect medications
  3. Difficulty with treatment compliance / skipping medications
  4. Incorrect diagnosis
  5. Failing to engage in therapy
  6. Alcohol, cannabis, or other substance use, drug interactions
  7. Lack of Access to mental health services
  8. Genetic / Familial components
  9. Multiple psychiatric inpatient admissions

Risks of Untreated Depression

Research shows that depression that does not respond to typical treatment interventions carries an even higher burden of decreased quality of life, functional impairment, higher risk of relapse, increased self-harming behaviors, and suicidality. An estimated 44% of patients do not respond to two consecutive antidepressant therapies, and 33% do not respond to four. Thirty percent of patients with TRD attempt suicide at least once during their lifetime, which is at least double the lifetime rate in non-resistant depression.

Various treatment tools can be offered and utilized for TRD, including psychotherapy, adjunct pharmacological treatments like lithium, and intensive outpatient treatment or hospitalization in severe cases. Electroconvulsive therapy (ECT) is also known to treat severe depression with acute suicidality. However, this invasive treatment may not be right for many individuals and poses more risks and potential side effects.

Transcranial Magnetic Stimulation (TMS) Treatment for Depression

There has been increasing research and data supporting Transcranial Magnetic Stimulation (TMS) as an effective and well-tolerated treatment option for TRD. TMS therapy uses painless, repetitive pulsed magnetic fields, similar technology to an MRI. These pulses are usually applied to the Dorsolateral Prefrontal Cortex (DLPFC), a focal region on the superficial cortex of the brain, over several weeks of treatment sessions. This treatment helps alleviate depression and anxiety and improves cognition, energy, and motivation. Clinical studies support several areas of the brain which could alleviate symptoms.

As TMS treatment progresses, energy levels and sleep patterns initially improve. Then feelings of hopelessness and worthlessness associated with depression start dissipating, and for a significant number of patients, they remain in substantial remission thereafter. A recent study has shown that about 1 in 4 people with treatment-resistant depression may achieve full remission with repetitive transcranial magnetic stimulation treatment. Due to our training and experience, FCC providers for TMS have routinely achieved higher response and remission rates.

At Family Care Center, we provide psychotherapy, medication management, and TMS treatment options provided by a top-notch team that collaborates and roots for your treatment and recovery from depression. If you or someone you love has struggled with treatment-resistant depression and would like to know more about TMS, we invite you to schedule a no-cost TMS consultation with our experts to learn about treatment, insurance, and scheduling options.

Reference:; published on Jan 30, 2023; updated January 2022

Four Important Steps to Improve Your Mental | Mental Health Awareness Month

Mental Health Awareness Month Family Care Center
Mental Health Awareness Month Family Care Center

Four Important Steps to Improve Your Mental Health 

May is Mental Health Awareness Month, and here at Family Care Center, our team wants to help you learn more about how you can improve your mental health.

While severe mental illness is a real issue, millions of people live each day with mild to moderate levels of mental health conditions or illnesses, such as anxiety, depression, relationship challenges, coping with traumatic experiences, and chronic pain or illnesses.

Here are four important steps you can take to improve your mental health:

  1. Be Aware of Your Stress Levels

Stress is a common response to stressors such as financial issues, work, family, and parenting. One of the first steps towards building your awareness of your own mental wellness is to look at your stress levels. Ask yourself:

  • Do you have time to relax and recharge each week?
  • How do you care for your physical body? Are you eating well and getting enough sleep?
  • Are there at least one or two areas of your life that are deeply meaningful and bring happiness to you?

If you answered ‘no’ to the above questions, it might be a good time to consider seeking extra support.

  1. Seek Professional Help

The Family Care Center has many talented behavioral health professionals ready to support your mental wellness. Depending on your needs, you may receive care from one or more of the following professionals:

  • Psychiatrist providers
  • Psychologists
  • Social workers
  • Counselors
  • Marriage and Family therapists
  • TMS care

Types of Professional Help for Mental Wellness

Talk therapy is provided by psychologists, social workers, counselors, and marriage and family therapists, while psychiatric providers handle medication needs. Other professional supporters and staff provide TMS services.

  1. Educate Yourself

Expanding your knowledge and increasing comfort in talking about mental health is a fantastic way to improve your mental health. Consider receiving training in Mental Health First Aid, which covers a range of topics and can be helpful to individuals and agencies in understanding mental health conditions and how to talk about mental health.

  1. Try One New Thing

If you're not ready to seek out extra support, you can still create change on your own. Here are some suggestions:

  • Start a daily gratitude practice by writing down three things you're grateful for now.
  • Incorporate meditation or prayer into your daily routine. This can be done each morning or at a time that works for you.
  • Start doing one activity a week that helps you relax and recharge, such as reading a book, taking a leisurely bath, playing with your children, or walking your dog.
  • Seek out nature on a weekly basis for at least 15 minutes. Take a walk, sit in a park, or do some cloud watching – whatever feels easiest to start, then increase to one or more days a week.

You can improve your mental health and overall well-being by taking these steps. Remember that seeking help is a sign of strength, and it's never too late to start.

Family Care Center's clinicians include psychiatrists, psychologists, and licensed therapists ready to support you. We offer both in-person and telehealth appointments, so you get the care you need in the format that serves you best. We also accept most insurance plans, allowing you to get the most from your personalized care plan.



Family Care Center is here to help. Learn more about our services and therapy options.

Erika McElroy is a licensed psychologist offering mental health services at Family Care Center. She is passionate about educating others about the myths and stigma of mental health conditions. She spends her free time reading, enjoying the beautiful Colorado weather, and being creative.