Is the Future of TMS Depression Treatment In-Home Use?

Many people who suffer from depression are able to recover with conventional treatments, like talk therapy and medication. However, a smaller group of people experience treatment-resistant depression, which does not improve with traditional therapies. For many years, transcranial magnetic stimulation (TMS) has been used to successfully treat people with resistant forms of depression.

Until this point, TMS has only been available in clinics, where the treatment is administered by a trained technician. But today, a handful of companies are selling brain stimulation devices that are designed to be used at-home—no technician required. This new development begs the question, is at-home TMS treatment ethical, and how safe is it compared to clinical treatments?

The Rise of At-Home TMS Treatment

Traditional TMS treatment is incredibly effective, but it’s not accessible for everyone. While Los Angeles has a relatively high concentration of TMS clinics, more rural parts of the country have no clinics. The same goes for cost. At Pulse, we accept most major insurance providers, but for someone who doesn’t have insurance, clinical TMS might not be an option. 

To remove those barriers to entry, some companies have started designing and selling at-home TMS equipment. These companies claim that at-home TMS therapy has the same benefits of clinical therapy, like reduced depressive symptoms, better sleep, and improved mood. The equipment uses similar electromagnetic waves to stimulate the brain but in a much smaller package.

With at-home TMS, there’s no need to travel to a clinic or interrupt your day to make an appointment. The device can be used whenever and wherever you need relief.  Another major selling point of at-home TMS equipment is the price. Most devices sell for $100-$200, which is more affordable than paying for individual TMS sessions over the course of several months. But as we all know, decrease in cost doesn’t always provide the same quality and benefits.

The Difference Between TMS and tDCS

At-home TMS devices aren’t the same devices you’ll find in a clinical setting. In fact, they’re extremely different. The companies creating at-home TMS equipment are actually selling tDCS devices, which stands for transcranial direct current stimulation. Not only is the tDCS electromagnetic mechanism different, but the device itself also works differently than a TMS device.

First, a tDCS device is much smaller than a TMS device. If a TMS device is the size of a mini-fridge, then a tDCS is about the size of a cell phone. A tDCS device is typically lightweight and compact, which allows it to be easily transported. Unlike a TMS device, which is wall-powered, a tDCS is battery operated. 

When you’re receiving TMS therapy in a clinic, the technician places an electromagnetic coil across the forehead. With tDCS, the person treating themselves will wear headgear with attached electrodes that transmit the current.

On that topic, the current that a TMS device transmits is also very different from the current a tDCS device transmits. TMS uses short, high-power electrical waves to stimulate and activate specific areas of the brain. tDCS applies a sustained, lower power electromagnetic wave that aims to change the brain’s plasticity. 

While TMS and tDCS treatment both aim to reduce depressive symptoms, the mechanisms are not the same. It’s possible to have success with an at-home tDCS device, but it’s not as powerful as traditional TMS therapy at a clinic. Because of that, people who are suffering from serious and long term treatment-resistant depression might be better off investing in in-person TMS treatment.

The Debate Around At-Home tDCS Treatment

Like all new medical advancements, at-home tDCS treatment isn’t without controversy. One of the biggest points of debate around tDCS treatment is its efficacy. Currently, at-home treatment is considered experimental and is not FDA-approved. TMS, on the other hand, is FDA-approved and multiple studies have proven that the treatment can reduce depressive symptoms.

Another point of contention is that tDCS treatment only changes the brain’s plasticity. Because the at-home devices are less powerful than clinical TMS devices, they can’t actually activate parts of the brain. Cellular activation is one of the keys to improving brain health and function. Changing plasticity can improve depressive symptoms, but to a much lesser extent compared to TMS.

Because at-home tDCS treatment is still relatively new, it’s difficult to determine how useful it really is. The lack of research and absence of FDA-approval suggest that mental health professionals won’t know how effective it is until more studies have been done.

Even then, the research may be skewed. With any at-home treatment, there is room for human error. On top of that, the severity of people’s depression will vary greatly. If there’s no professional overseeing the treatment, measuring successful outcomes is challenging.

On a more positive note, there is no evidence to suggest that tDCS treatment does any harm to the brain. In fact, at-home tDCS treatment is likely more comfortable than TMS treatment at a clinic. That’s because the machinery is significantly less powerful, and the electromagnetic waves that get transmitted through the electrodes are less intense. 

Getting Professional TMS Therapy

Although at-home tDCS therapy is appealing, it shouldn’t be viewed as a quick cure or a reason to avoid other professional treatments, including talk therapy. Like TMS, tDCS should be used as part of a more comprehensive treatment program that involves both clinical and at-home approaches.

If you live near a TMS clinic, the best option is to get professional treatment. Because TMS is clinically proven to reduce depressive symptoms, you can trust that you’ll get relief with regular treatment sessions. If you choose at-home tDCS therapy, there’s no guarantee that you’ll feel better, no matter how long you use the device.

At Pulse TMS, we offer professional TMS services to people in the Los Angeles area. Our Brainsway™ Deep TMS Technology has been tested and approved by the FDA to treat people with treatment-resistant depression. It’s a non-invasive therapy with no downtime, so you can easily fit treatments into your weekly schedule. 

If you’re interested in learning more about TMS at Pulse, contact our team today. We’ll determine if you’re a good candidate for TMS, and explain what to expect during a TMS session. 

Article By: Chris Howard
Director of Community Outreach & Education Chris Howard has been working in the mental health field since 2010 after seeing the long-term effects of mental illness within his own family. He is a graduate of UCLA where he received his B.A. in Psychology. Having worked closely with those struggling with addiction, Chris considers the concept of community to be an essential part of treatment and advocates for wellness approaches that integrate both leading conventional therapies, as well as holistic practices like yoga and meditation.