A primer on TMS with a focus on its use in treatment‐resistant depression

Abstract

I recently met Ms. B — a woman in her forties with a history of multiple episodes of severe depression since her teenage years. She attempted suicide multiple times in the past and had multiple psychiatric admissions. She had trialed multiple anti‐depressants (and augmentation agents) and was referred for TMS treatment by her outpatient psychiatrist after another bout of depression leading to hopelessness and poor functioning at home. After doing treatment for 3 weeks, her affect started to change, her hygiene improved, she became hopeful, and wanted to do things such as sit by the lake, dip her toes in the water, and enjoy the sunshine. After completing treatment for 6 weeks, she was in remission. She told me “TMS is my lifesaver.” This was her second round of treatment in the last 3 years, and she was one of the 40%–60% of treatment‐resistant patients with depression who respond well to TMS.