Depression has fast become one of the most common diseases on the planet — and by ruining your relationships and destroying every aspect of your health, it is also one of the most devastating.
As a result, over the last few years, there has been a huge amount of time and effort spent finding new depression treatments that actually work.
That is exactly where ECT and TMS enter the discussion.
Let’s start with the basics.
What is ECT?
Electroconvulsive therapy (ECT for short) is a mental health treatment that has been around for decades. However, in historical settings, it was used to treat those psychiatric disorders that sit on the more serious end of the spectrum (think schizophrenia and psychosis).
However, not so long ago some researchers started applying it as a method of treating resistant treatment depression — and with great success, I might add.
How Does ECT Work?
ECT is one of the more serious depression treatments we have available.
See, ECT is performed in an operating theatre while you are under general anesthesia.
This is because you need to be completely unconscious during treatment. Then, while you are knocked out, a qualified doctor will impart an electrical stimulus into your brain.
While this shock only lasts for about five seconds, it induces a seizure that lasts around a minute. As bad as this may sound, it’s actually very important.
This seizure acts to reset your brain, turning its functional capacity back to ‘normal’.
ECT has been shown time and time again to cause lasting improvements in mental health, while also acting as a potent treatment for depression.
What is TMS?
Now, let’s shift gears and dive into transcranial magnetic stimulation (or TMS for short).
Transcranial magnetic stimulation is a unique depression treatment that shares some similar principles to ECT, but applies them in a different manner.
“Unlike ETC, TMS does not use electricity at all but uses magnetic pulses targeted at a specific location in the brain, and no seizure is induced, and therefore, there are no memory issues associated with TMS. The patient is fully awake and alert during TMS, and there is no recovery or monitoring time needed.” explains Dr. Lindsay Israel, the Chief Medical Officer at Success TMS, one of America’s largest TMS providers.
How Does TMS Work?
During a TMS session, a special electromagnetic pad is placed on your forehead. When turned on, this pad sends magnetic pulses into your skull, which activate many of the nerve cells found in your brain.
Importantly, the nerve cells it stimulates are those responsible for controlling your mood and emotional responses. As a result, TMS can enhance your mood, increase your feelings of general wellbeing, and have a significant impact on depression.
What are the Key Differences Between ECT and TMS?
I have outlined the fact that ECT uses electric shocks to stimulate your brain, while TMS uses magnetic fields. I have also stated that ECT needs to be performed under general anesthesia, whereas TMS does not.
But these are not their only differences.
You know what a single session of both ECT and TMS looks like — now let’s talk about a whole treatment protocol?
During a bout of ECT, a single session of treatment (lasting about 60 minutes) is normally given 2-3 times per week, and for around 10 to 12 sessions. As a result, ECT normally lasts 6 weeks in duration.
Similarly, when it comes to TMS, most people also receive a 6-week treatment plan. However, this will include anywhere between 20 and 30 single sessions of treatment (lasting 30 minutes each). This means that over the 6 weeks, you could have up to five sessions per week.
Cost of Treatment
I should note that costs can differ between states and clinics.
However, TMS is consistently around half the price of ECT
Considering this, a 6 bout of TMS can cost anywhere between 5,000 and 12,000 dollars. Conversely, a 6 week treatment of ECT may cost anywhere up to 20,000 dollars.
While this difference is indeed large, there is a good reason for it. Remember, ECT requires an operating theatre, a nurse, and general anesthetic, whereas TMS can be done at your local doctor’s office.
Side Effects of ECT and TMS
While generally considered extremely safe (especially when applied by a professional), both treatments do have some side effects that deserve mention.
Side effects of ECT can include:
- Feeling confused after the treatment
- Short term memory loss
- Jaw aches
- Muscle aches
Side effects of TMS can include:
- Mild headache
- Skin discomfort (where the pad was placed)
- Twitching of your facial muscles
- Feeling light-headed and dizzy
Effectiveness of Treatment
Now for the big one — is one of the treatments more effective than the other.
Before I go any further, I do want to highlight the fact that both treatments are effective at helping cure depression.
Moreover, both TMS and ECT have been used successfully to help people suffering from treatment-resistant depression — which suggests that they are both more effective than many other more common treatment methods on the market.
But, within this, research does suggest that ECT may have some better outcomes. In this manner, it is generally more effective and causes longer improvements in both your mental state and emotional well being.
While ECT is generally seen to be the more effective of the two, both ECT and TMS offer an effective treatment for depression. As a result, you might want to make your decision based on cost and ease of application.
With this in mind, TMS is less invasive, has fewer side effects, and tends to cost much less than ECT — as such, it might make for a better starting point.