Transcranial magnetic stimulation is being added to the Medicare Benefits Schedule. Here's how it works. Some say you can't put a price on peace of mind. Diagnosed with bipolar disorder six years ago "I was lucky to have a GP who identified the symptoms I was experiencing"she has run the gauntlet of the Australia's mental health system, changing medications to address her depression "every couple of months".
At an impasse, her psychologist suggested repetitive transcranial magnetic stimulation rTMS — a treatment often recommended for those who do not respond well to drug therapy. It's a quandary all too familiar for those left to navigate more complex treatment options — and now, it's about to change.
Think of the brain like a "sophisticated computer", says Professor Colleen Loo, a psychiatrist and clinical academic researcher at the University of New South Wales and the Black Dog Institute. In practical terms, an electromagnetic coil is placed against the patient's scalp.
It delivers a painless, magnetic pulse that stimulates nerve cells in the area of the brain involved in mood control and depression. But it is not a "once-in-a-lifetime fix", Professor Loo cautions "It's not as if you're kind of cured of the depression gene for life," she says.
While the treatment may have grown in prominence in recent years, it's hardly a new concept. It's like a whole new field in psychiatry. Though our understanding of the treatment and its potential benefits may have improved in the decades since, its uptake has been limited by availability.
Compared to other nations like Canada and the United States, says Paul Fitzgerald, a psychiatrist and founder of TMS Australia, we've found ourself in "a really weird situation". Professor Fitzgerald, who has been lobbying to have rTMS added to the Medicare Benefits Schedule MBS sincebelieves the funding will make the treatment more accessible to those without private health insurance, and those who simply don't have the time or the money for a stint in hospital.
Figures have shown about 50 to 60 per cent of people with depression who have tried and failed to vad är tms benefit from medications experience a clinically meaningful response with rTMS. Of those, about a third experience a full remission — meaning their symptoms go away completely.
So why are some people more likely to respond to it than others? Ultimately, it "comes down to the fact that the brain is so complex", says Martin Sale, a neurophysiologist, physiotherapist and associate professor at the University of Queensland's School of Health and Rehabilitation Science.
Setting it apart from some treatment options, Professor Sale adds, is that "it has very few side effects". Research, which included more than 5, people who had undergone rTMS, found that its "strong efficacy and the low side effect and medical risk profile" suggested that it be evaluated "as a first-line treatment" for major depressive disorder.
Though the addition of the treatment to the MBS Googletrender no doubt a coup for those struggling, it is by no means a silver bullet, Professor Loo cautions, nor should it be considered a first port of call. While depression is a "very common term, and something we all relate to kind of colloquially", she says, "it's actually a very complicated illness".
For Trish, who engaged in a number of treatment options before being referred to rTMS, the benefits have been "immeasurable". Above all, she says, it has given her an emotional "baseline" that helps her recognise when she's "getting into trouble".
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