Treating OCD with Deep TMS

OCD is a mental health disorder characterized by obsessive thoughts and significant anxiety. Discover how Deep TMS can help effectively treat symptoms of OCD. Obsessive-Compulsive Disorder is a mental health condition that causes a repetitive pattern of intrusive thoughts, including self-doubt and anxiety. Approximately 1-2% of the population struggles with this condition. Standard treatments for OCD include a combination of antidepressants and cognitive behavioral therapy, but these aren’t always effective for everyone. Deep Transcranial Magnetic Stimulation (Deep TMS) provides an alternative form of treatment that works by reaching deep into the brain to quiet the neural nodes causing symptoms. This article explores the science behind OCD and why some treatments work for some but not others. It also explores Deep TMS and the evidence behind its effectiveness.

The OCD Loop: What’s Actually Happening in the Brain

While the exact cause of OCD remains unknown, there are several factors that stand out in those with the illness. First, those with OCD often show differences in the cerebrum, which is the area of the brain that controls thinking and behavior. Imagine you’re leaving your house and suddenly can’t remember if you turned off your oven. You experience a sudden spike in anxiety, causing you to go back into the kitchen to check. After checking, anxiety returns to normal. In someone with OCD, anxiety doesn’t drop. You may have to check multiple times before anxiety subsides.

Why SSRIs and ERP Help Some People but Not Others

Selective Serotonin Reuptake Inhibitors or SSRIs are a class of antidepressant medications used to treat depression, anxiety and other mental health conditions. They work by increasing levels of serotonin in the brain, which helps regulate mood and anxiety. Exposure and Response Prevention (ERP) helps individuals face fears and intrusive thoughts through a type of talk therapy. It involves triggering obsessive thoughts and working to resist the urge to respond. Psychiatrists and therapists often recommend a combination of the two for those with OCD. However, only 30 to 40% of individuals respond to treatment. Sometimes the two treatments aren’t strong enough to break the cycle because some individuals don’t have the necessary cellular receptors needed for SSRIs to work.

How Deep TMS Interrupts the Loop — The mPFC and ACC Explained

Deep TMS uses magnetic fields to stimulate specific nerve cells in the brain. To further explain how it works, we need to look at the anatomy of the OCD loop. OCD occurs due to overactivity between the Anterior Cingulate Cortex (ACC) and the Medial Prefrontal Cortex (mPFC). The ACC is the brain’s error detector. It notices when something’s out of place or wrong. The mPFC is part of the brain that makes decisions. In an OCD brain, the ACC and mPFC get stuck in a feedback loop. The ACC detects errors, and the mPFC constantly identifies these errors as emergencies. Deep TMS uses a magnetic coil to send pulses to these areas of the brain to reboot the signals. Over time, Deep TMS helps quiet the hyperactive areas to break the cycle of the loop.

The FDA Clearance for OCD and What the Clinical Data Shows

The FDA first cleared BrainsWay’s Deep TMS for major depressive disorder in 2013, and cleared it specifically for OCD in 2018 — the first time a non-invasive device was cleared to treat the condition. Clearance followed rigorous testing in controlled environments with patients who had not found relief from traditional therapies and medications. Data showed approximately 49% of patients showed improvement in Y-BOCS scores (the Yale-Brown Obsessive Compulsive Scale) after a month of treatment, especially when combined with SSRI medications. Most individuals undergo 30 treatments over a course of 6 weeks.

What a Deep TMS Session Feels Like

When your healthcare provider schedules your first session, they will likely go over the treatment process. You may receive instructions on the importance of self-care, which includes getting enough sleep, regular exercise and keeping track of any changes in OCD symptoms. Unlike Electroconvulsive Therapy (ECT), Deep TMS doesn’t require anesthesia and doesn’t cause any systemic side effects. During a session, you’ll sit comfortably in a chair while the technician places a cushioned helmet on your head. Once they turn the helmet on, you’ll initially hear a rapid clicking that sounds like a traditional MRI machine. You may also feel a tapping sensation on your scalp. Each session lasts approximately 20 minutes. Because treatment doesn’t cause side effects, you can drive yourself home or go back to work afterward.

Combining Deep TMS With Therapy for Better Long-Term Results

While Deep TMS is shown to be effective for many people at reducing the effects of OCD, it works better when it’s viewed as a partner to therapy and not a replacement. This form of treatment supports neuroplasticity, which is the brain’s ability to heal, adapt and form new connections. By quieting the alarm center and making the brain more adaptable, Deep TMS makes treatment more effective. Before the magnetic pulse starts, the provider will trigger a mild obsession, such as having you touch a contaminated object. This activates the neural circuit driving your OCD. By activating the ACC and mPFC right as the magnetic pulses are applied, Deep TMS targets the specific pathway while it’s actively firing to maximize the effect of treatment.

FAQ

Is Deep TMS covered by insurance?

Most insurance companies cover Deep TMS. However, exact coverage amounts depend on your insurance policy. Check your policy or contact your insurance company to see whether it’s covered.

How effective is Deep TMS?

Studies have shown that approximately 82% of patients respond well to Deep TMS treatments. Many individuals who respond to Deep TMS have already tried multiple medications without success.

Who is a candidate for Deep TMS?

The best candidates for Deep TMS include individuals struggling with major depressive disorder and other mental health conditions, who’ve failed to respond to other treatment methods. Women who are pregnant or nursing or those struggling with substance abuse should not take part in Deep TMS.

Seeking Deep TMS at Sun Health Center

If you feel you’re running out of treatment options for OCD, contact the Sun Health Center to explore Deep TMS. Our caring counselors can get you started so you can regain control of your life.