Transcranial magnetic stimulation (TMS) therapy has recently been approved by the FDA as a treatment option for adolescents with depression. This treatment, which has been FDA-approved for adults since 2008, is now available to teens aged 15 and older.
TMS therapy is an alternative treatment for depression. It is non-invasive, non-systemic, and does not involve medication or anesthesia. The FDA approval was based on data by NeuroStar, which found that 78% of adolescents treated with TMS therapy reported significant improvements to their depression symptoms. This marks a significant advancement towards providing safer, effective treatments for young people with depression.
If you’re researching TMS therapy and want to know more about how this treatment can help your child, this article is for you. We will discuss what TMS therapy is, how it works, what a TMS treatment session looks like, and how you can start TMS treatment for your teen.
Adolescents and mental health
Mental health issues are common amongst children and adolescents, and are unfortunately continuing to increase. In the United States alone, depression affects around 2.7 million people under the age of 17 and can have severe consequences, such as substance abuse, teen pregnancy, and even suicide, which is tragically one of the leading cause of death amongst this age group.
In a 2021 CDC report that surveyed U.S. students:
- 42% felt persistently sad or hopeless
- 29% experienced poor mental health
- 22% have seriously considered attempting suicide
- 10% have attempted suicide.
According to this same research, certain groups, including LGBQ+ students, female students, and Black students, are more likely to be affected by mental health struggles than others.
Symptoms of adolescent major depressive disorder can include:
- Persistent low mood
- Low energy levels
- Lack of interest in activities
- Changes in eat and sleep habits
- Difficulty concentrating
- Lack of motivation
- Withdrawing from friends and social activities.
Only two antidepressant medications are currently FDA-approved for depression in teens: fluoxetine (Prozac) and escitalopram (Lexapro). Although evidence-based psychotherapy can be useful for adolescent depression, not all patients respond well to this form of treatment and more options are needed. In fact, one study found that 30-40% of youth undergoing behavioral therapy and SSRI medication will not respond positively to treatment.
The issue of adolescent depression is important as many mental health behaviors established in youth will carry on to adulthood. Research shows that major depression in young people is often connected to:
- Increased suicidality
- Prolonged illness
- Higher risk of not responding to treatment.
This makes early diagnosis, treatment, and intervention of adolescent depression essential to help young people maintain good mental wellbeing into the future.
See More: How Diet and Exercise Affect Your Mental Health
What is TMS therapy?
Transcranial magnetic stimulation, or TMS, therapy is an FDA-approved treatment for depression and other mental health conditions. It is a non-invasive and non-systemic treatment that has been shown to provide relief for those who haven’t responded to antidepressant medications or therapy (also known as treatment-resistant depression).
TMS therapy works by delivering targeted magnetic pulses to areas of the brain responsible for mood regulation. These pulses stimulate nerve cells thought to play a role in causing depressive symptoms. Over time, TMS treatment can rebalance brain activity to reduce symptoms of depression and improve mental wellbeing.
Each TMS treatment session lasts around 20 minutes and is completely safe and painless. Since no anesthesia is needed, patients are free to go home and continue their daily activities as normal. For adolescents, TMS therapy provides a safe and effective alternative to medication-based treatments and can be effective for those who experience side effects or haven’t responded to medications.
You’ll sometimes see TMS therapy referred to as rTMS (repetitive transcranial magnetic stimulation). This is due to the repetitive magnetic pulses used in the treatment.
Who is TMS therapy for?
TMS therapy has been FDA-approved for the treatment of major depressive disorder (MDD), especially for people who haven’t found relief from traditional treatments (known as treatment-resistant depression). It is also FDA-approved for adults suffering from obsessive-compulsive disorder (OCD).
TMS treatment is also being researched for its effectiveness in treating other psychiatric disorders such as generalized anxiety disorder (GAD), bipolar disorder, and post-traumatic stress disorder (PTSD), however research in these areas is ongoing and not as established as it is for depression.
Adults are usually recommended TMS therapy to treat major depressive disorder and treatment-resistant depressive disorders. It is especially useful for those who:
- Have not responded to antidepressant medication or other treatments
- Want to try an alternative to medication
- Cannot tolerate antidepressant medications due to side effects.
Keep Reading: Who Qualifies for TMS Therapy? (TMS Requirements)
Who is not eligible for TMS therapy?
There are certain cases where TMS treatment may not be a suitable option for your teen. Factors that can make TMS therapy unsuitable include:
- History of neurological conditions, such as seizure or epilepsy
- Pregnancy or nursing
- Brain illness, traumatic brain injury, brain tumor, or stroke
- Substance abuse
- Implanted medical devices or non-removal metal objects in the cranium (i.e. bullet fragments), not including metallic fillings
- Cochlear hearing implants
- Implanted medical devices, such as pacemakers, vagus nerve stimulators, aneurysm clips, or heart stents.
To better understand whether your teen is eligible for TMS therapy, don’t hesitate to reach out to our team for advice.
What happens in a TMS treatment session for teens?
Our adolescent TMS therapy sessions are not too different to our regular TMS treatment sessions. Here’s what your teen can expect from a typical TMS therapy session:
- Preparation: We start the session by seating the patient comfortably in a chair and answering any questions they may have. We’ll make sure they’re relaxed and ready before starting treatment.
- Placing the coil: The TMS technician will place an electromagnetic coil on the patient’s scalp, near the forehead. This coil targets specific areas of the brain which tend to be underactive in adolescent patients with depression. The target location is located above the left eye, near the hairline and is called the dorsolateral prefrontal cortex (DLPFC).
- Stimulation: The stimulation part of the session involves delivering repetitive magnetic pulses through the coil to the targeted region of the brain. This stimulates nerve cells and releases neurotransmitters that can help balance mood.
- Sensation: There may be some light tapping or clicking sensation on the scalp as the magnetic pulses are being delivered through the coil. Some patients might also feel a slight tingle or twitch in their facial muscles.
- Monitoring: We’ll continuously monitor the patient’s comfort level throughout the session and adjust the intensity of magnetic pulses as required.
- Post-session: There is no recovery period after the session and your teen will be free to resume activities as usual, whether that’s home, school, or work.
- Follow-ups: TMS treatment is administered over a number of sessions, usually around 36 in total over several weeks. The exact number of sessions your child needs will depend on factors such as depression severity and response to the therapy.
Can TMS therapy help adolescents with depression?
The short answer is yes. As of 2024, the US Food and Drug Administration (FDA) has approved the use of TMS therapy for adolescent patients as young as 15. For the long answer, let’s look into what research shows about the effectiveness of TMS treatment for adolescent depression.
Promising remission rates
One open-label study investigating TMS therapy in adolescents showed a promising 44% remission rate amongst participants aged 13 to 21 years old.
Minimal side effects
TMS therapy has minimal side effects compared to other depression treatments, including antidepressants. The most common side effects are mild headaches, fatigue, scalp discomfort, and slight tingling of facial muscles. These all subside an hour or two after treatment and tend to disappear after a few weeks once the body has adjusted to treatment.
For adolescents, the minimal risk of side effects is the same. This is backed by a thorough review of all published research on TMS therapy, from 1985 to 2016, which found that the risk of TMS treatment in children is the same as adults, i.e. little to no adverse side effects.
Safe treatment
TMS therapy has been shown to be safe and tolerable for children and adolescents. In one large-scale study of 384 children, aged 1 to 18 years, who received TMS therapy over the course of ten years found that there were no serious side effects.
This result is supported by another study by Cincinnati Children’s Hospital and the University of Cincinnati College of Medicine, which examined 165 young patients undertaking TMS therapy and found it to be as safe for children as it is for adults.
See More: What to Do When Antidepressants Don’t Work for You (and Why)
How effective is TMS therapy?
There have been numerous studies into the effectiveness of TMS therapy for both adults and adolescents. According to Harvard Medical School, more than half of people with depression who’ve tried medications with no results have responded well to TMS therapy. Nearly one third of these patients experience a full remission with symptoms disappearing completely.
Another study tracked patients who underwent TMS therapy for a year after treatment. Of these, 62.5% were still doing better a year later and 45.1% who achieved full remission were still symptom-free. From those who didn’t go into remission after the first round of treatment, 84.2% did so after the second round of TMS treatments.
While the above two studies were conducted on adults, there is just as much evidence into its effectiveness for children. Research into TMS therapy for children and adolescents dates back to 2001 and almost always points towards it being an effective treatment that is feasible and tolerable for adolescents.
Below, we summarize what research into TMS therapy for adolescents has shown over the years:
- TMS is ‘safe, feasible, and potentially effective’ for kids, Wall, et al. (2011)
- ‘Adolescents showed a substantial decrease in depression’, Wall, et al. (2013)
- ‘TMS mitigated suicidal ideation in adolescents’, Croarkin, et al. (2018)
- ‘rTMS is an effective and safe treatment for depression in youth’, Rosenich, et al. (2018)
- ‘TMS is a feasible, safe, and clinically effective treatment option’, Dhami, et al. (2019)
- ‘Safe and effective treatment for youth’, MacMaster, et al. (2019)
- TMS helped depression but not sleep for kids, Sonmez, et al. (2020)
- ‘Significant improvement in depression severity’, Shere, et al. (2021)
- ‘Adolescents with MDD benefited from rTMS’, Gordon, et al (2021)
- TMS is ‘an acceptable treatment for adolescent MDD’, Wallman, et al. (2022)
- ‘Depression symptom severity significantly improved’, Thai, et al. (2024).
How can I get TMS therapy for my child?
If you think TMS therapy may provide relief for your teen, the team at BestMind Behavioral Health is happy to help. We know that finding the right treatment for your teen can be complex and it’s important to explore your options thoroughly.
From our experience your teen might benefit from TMS therapy if they:
- Have been diagnosed with major depressive disorder (MDD)
- Have tried antidepressant medication with no results
- Prefer to avoid pharmacological or systemic treatments.
Determining whether TMS treatment is suitable for your child is a collaborative process. Below is an idea of what you can expect when pursuing TMS therapy for teens at BestMind Behavioral Health:
- Step 1: We start by collaborating with your teen’s clinical care team to assess and ensure continuity of care. This involves carefully considering their unique clinical profile and therapeutic needs.
- Step 2: Our experts will conduct a thorough psychiatric evaluation and build a personalized treatment plan for your child. Our aim is to manage symptoms and optimize outcomes through targeted interventions.
- Step 3: We’ll assess whether your teen is suitable for TMS therapy with the ultimate goal of identifying sustainable treatment options for lasting relief. During our consultation, we will suggest various treatment options, including the pros and cons of each. This can help you and your teen better understand the effects of each treatment.
To learn more about our process and explore the best treatment options for your teen’s mental health journey, schedule a consultation with our friendly and supportive team members.
TMS therapy for teens in Colorado & Oregon
If you’re interested in exploring TMS therapy for your teen, we at BestMind Behavioral Health are ready to provide support. With a team of experienced, compassionate adolescent psychiatrists, we understand the complexity of adolescent depression and are here to provide sustainable, effective options with wellbeing as our top priority.
We offer TMS treatments for adolescents at our clinics in Colorado & Oregon. You can learn more about this service by clicking here, or go ahead and book a consultation to start the process.
