NOTE: This article on TMS Austin is based on an exclusive talk given by Dr. Kevin Murphy, MD, developer of PrTMS therapy and professor at the University of California, San Diego. In June 2019 Dr. Murphy spoke in person at Dr. Vinay’s Conscious Mind Clinic in Austin, Texas. Together, doctors Murphy and Vinay have transformed the lives of thousands of Americans struggling with depression.
We all know somebody who has symptoms of depression. And these symptoms can be very dark. They can feel like a lack of appetite or increased appetite, weight loss or weight gain, fatigue and lack of motivation, off-moods, and even stopping taking care of yourself.
Not to mention the relentless feelings of guilt, sadness, anger, and frustration that can go on for decades for a lot of people. And this depression holds you with a vice-like grip and drags you down.
Up until 2009, the standard treatment for depression was psychiatry, medication, and more medication (when the first one doesn’t work). And then, even more medications to counter the side effects of the other medications.
It’s like a medication roller coaster.
How amazing would it be to overcome the medication roller coaster and emerge from depression?
Depression and your brain
Depression is a mental and physical illness.
Your brain is packed with nerve cells called neurons. These neurons send electrical impulses between each other and around your body. Neurons talk (or transmit messages) to each other naturally using chemical messengers called neurotransmitters. When one neuron releases a neurotransmitter, it “fires” an electrical signal. Then, the neighboring neuron senses it and “fires” as well. As the message moves to the next neuron and the next, it can go throughout several different parts of your brain.
These chemicals that cause electrical impulses also cause magnetic fields. This means that you have chemical, electrical, and magnetic events happening in your nervous system all at once.
Your brain’s neurons can fire at all different speeds. If many of them tend toward being too slow you might have depression and be unable to focus or pay attention. You feel too slow, sleepy, and not very social.
As Dr. Kevin Murphy describes it, “You physically have a brainwave that is going too slow.” He describes those slow neurons as though they’re sleeping and not useful. But, you’re awake, doing something important, and asking them to function normally. So you’re trying to force them to be active and do work when they’re simply not able to.
On the other hand, when you have some neurons going way too fast, they’re acting “angry.” They act as though they’re mad, causing the opposite symptoms like anxiety, stress, worry, frustration, and fear. You may feel like you have disordered perception like obsessive-compulsive disorder (OCD), tics, and habit-forming problems.
Sometimes the brain gets in these patterns where it’s too slow in some areas or too fast in others. And, if you have a mix, it can look like a combination of both depression and anxiety, like in post-traumatic stress disorder (PTSD).
Imagine what it’s like to have 50 percent of your neurons “off line” and the ones that are still online aren’t perfectly tuned?
The problems with antidepressants
Right now, the way to manage these problems is to get medication. Medications are useful and they’re not bad. And they’re necessary in some patients. The medications try to flood your system with neurotransmitters, like serotonin.
Oftentimes, they’re overdone and we don’t know what to do, so you get more and eventually even more medications.
But, what if you’re not deficient in serotonin or another neurotransmitter?
That’s not the only problem with antidepressants.
Many people become tolerant of medications. This happens because your neurons have serotonin receptors, like specialized catcher’s mitts, to catch the serotonin outside the cell and bring it inside. At some point you neurons realize that there is always too much serotonin and they stop making so many receptors in order to save energy.
This results in a smaller number of receptors.
That’s the problem with tolerance. Patients feel their medications aren’t working, but when they go off them, they feel even worse. This is because their brain has been trained to make fewer receptors.
That’s a negative effect of long-term high-dose use of medications—they can down regulate your system and you get stuck on them.
There is yet another problem with antidepressants.
Medications act on all neurons the same way: some medications speed up all neurons, while others slow them all down. But, as we learned earlier, not all of your neurons are too slow or too fast. Perhaps another reason why medications sometimes don’t work is that you have a mixed number of neurons going slow and fast.
If your medication tries to speed up all neurons, what effect do you think that has on the neurons that are already working well? What about the ones that are already too fast?
These are all reasons why you get side effects from antidepressants. And also why 30-40 percent of depressed patients don’t respond to antidepressants.
But what if the problem that medication is trying to solve isn’t really the problem? What if it’s not really those neurotransmitters at all? What if someone has good levels of neurotransmitters and the problem is simply that they’re not firing in sync with each other?
Maybe depression and other mental and brain illnesses aren’t always a chemical problem. What if they’re an electrical problem, instead?
These are the reasons why a new approach was desperately needed.
TMS for depression
TMS stands for Transcranial Magnetic Stimulation. It’s a modern technology that has been researched for about 20 years.
The fact that the brain’s neurons aren’t all firing in sync is a previously missed opportunity when it comes to treating mental and brain illnesses.
In 2009, the FDA approved TMS for the treatment of depression. It has since been approved because studies show it helps even more and more conditions.
TMS works by placing gentle magnetic fields over the specific areas of the brain. By doing this we try to repetitively pulse it back to its optimal state.
Ideally, brain waves, be they fast or slow, should all be synchronized with each other, like an orchestra. Because when they’re out of sync they get “noisy.” It’s as though the band members are playing different songs at different intervals. Some may even be walking off the sidelines at different times.
This is what’s happening with your brain waves.
Every time we bring more band numbers back in sync and the more repetitions they do, the more it sticks. We can restore someone’s really high mental performance because they were there in the first place. TMS helps to fix what was broken.
Dr. Murphy says, “the goal [of TMS] is to take the noise away. When we do, patients feel better.”
TMS uses a weak magnetic field that’s hard to feel. In most cases it’s a very light stimulus. But the field exists and it helps the neurons to fire. Being exposed to the repetitive nature of the magnetic field helps them begin to fire in sync with the field. After a short while, they learn to continue to fire together.
They get back in sync.
But, what if you’re already taking medications?
When someone comes in for treatment, we don’t restart them or take them off their medications. This is because we want their psychiatrist or neurologist or primary care doctor to manage that.
Instead, we tell them, “I’d like to talk to your doctor and see if they’ll take you off some of your sedatives.” This is because we can’t really move your brain over and wake up your neurons if you’re you’re knocking yourself out every night. And certain medications fight us. So we try to work with the prescribing doctor to get them off those one at a time.
TMS has been around for a while, but it gets even better than this. Here at Conscious Mind Austin we take a new and better approach by personalizing it.
Personalized TMS (PrTMS)
This clinic here in Austin, TX, has been using TMS since 2016. Multiple strategies have been brought together to create a very unique concept called personalized TMS, or PrTMS. This personalization has helped three times as many people, when nothing else had helped them!
By personalize, we tailor the treatment for each individual client. This helps to take away the “noise” in a way that’s unique to you.
As you can imagine, we all naturally are a different wavelength—we’re generally in the same range of 9, 10, 11, maybe 12 Hz—but, we’re all slightly different. That difference can be as small as one-tenth of a Hz. Just like our hearts are beating at slightly different rates, our brains are beating at different rates that are unique. Each of us has an intrinsic frequency that’s our signature.
Not everyone wears size 10 shoes, so why should we try to force everyone to get treatment at 10 Hz?
A lot of the science that went into this research was figuring out how to pick each person’s intrinsic wave.
This is where electroencephalograms (EEGs) come in. EEGs measure how fast 19 different parts of your brain are firing. Over a few minutes we can see your brain waves.
There are a few different kinds of waves and the ones we’re most interested in are your alpha waves. These are the ones in your peaceful state, like when you’re meditating or in the “zone.” It’s when you lose track of time and do something without even thinking about it. That’s a very ideal state to be in.
We want your brain to stop going too fast or too slow. We want you just right and calm. That’s what you’re doing when you get PrTMS.
PrTMS helps you get back to your meditative state. It teaches your neurons to go to a nice, restful place.
We all know that meditation takes effort and time. You don’t always have two hours a day to meditate, so with TMS we help you get there quicker. This doesn’t mean you shouldn’t be mindful or meditate, it just means that there is more than one way to get there.
An interesting thing happens when clients are tested and we say, “You like to meditate don’t you?” They always wonder how we know that! It’s because of the brain waves.
One goal of overcoming many mental and brain illnesses is to have different parts of your brain all working at the exact same wavelength. There is no more noise. All of your neurons are in sync—like a well-tuned orchestra. And this is the preferred state to be in. It’s a little hard to maintain this state all day long, but we naturally get here during parts of our day. The more you’re in that state the better you feel.
PrTMS teaches your neurons to go to a restful place so they’re ready to do what you need them to do.
How and why PrTMS is better
To personalize TMS we first measure your brain waves with an EEG when you’re feeling calm and collected. Then we modify the magnetic waves to match your naturally calm brain waves that are unique to you.
The wrong wavelengths can cause destruction interference of waveform. If you get the wrong wave, it creates trouble, so you get really sensitive to it.
That’s the point of the personalization.
TMS can restore synchonicity by just teaching the neurons to “fire” in place. And we do that by gently stimulating them at a frequency that matches their ideal alpha frequency.
We’re not giving you a generic frequency. PrTMS gives you your best frequency when you’re at rest.
During treatment we take an EEG every week. We use that objective information, plus how you’re feeling, and we make a good decision on how to continue.
In fact, we’ve created a computerized software program that can automate this so doctors like Vinay can take this and treat their patients.
The software uses data to make the machine even smarter. Because we’ve already analyzed 50,000 EEGs, it’s really getting to be a very “smart” computer.
How you feel, along with these regular EEGs and computer algorithm work together to update your progress. And as you progress, we’re sure that you get the right frequency for your brain, right now.
The best part is watching brainwaves realign and the symptoms go away.
While TMS is now known for how well it treats depression, the benefits can go way beyond that. That’s because a lot of things that are troubling you might just be the fact that your neurons aren’t necessarily “tuned.”
The TMS devices were first approved by the FDA for depression. But new research shows successful treatment of other issues. The devices are now also approved for OCD and migraines, with more to come.
In our research, some clients notice improvements with thinking speed, focus, and memory. Ongoing research is showing success with sleep disorders, brain injuries (e.g., concussions), tremors, ringing in the ears, PTSD, pre-dementia, etc.
PrTMS treats tens of thousands of brains, based on the unique frequency, but the treatment process is the same. Even though all these patients have different problems and different symptoms, TMS treatment can help.
The common fact is that everyone has a brain that creates brainwaves. So, we’re treating a vast array of problems, where the rhythm of the brain is out of sync in all of them.
Dr Murphy says, “I can tell you I tried just about every phenotype you could think of. And we see benefit really across the board.”
PrTMS treats what’s common amongst all these patients, not what’s different.
There are currently millions of dollars in research funding that we are using for several studies with thousands of patients.
Dr. Murphy says,
“I’ll tell you that we still have a lot to learn. This isn’t entirely figured out but I can tell you that we’ve treated a lot of patients—160,000 treatments so far. And we have a lot of data and it all tells a story.”
When people come to us for help they’re finally fed up. They’ve already tried the standard of care. They’ve gone to the psychiatrist or the neurologist. They’ve tried medications, in some cases they’ve been on them for years.
They realize that medications and behavioral therapy aren’t working and they want to try this “far out” thing to stimulate their brains. That’s where we’re at right now. We’re getting all the hardest cases where people are not responding to anything.
“And if we get responses in those hardest cases, it speaks more towards the benefits of how this really works,” says Dr. Murphy.
“After years of suffering with depression, anxiety, and bipolar symptoms without much relief from medications. I decided it was time to try something different. When I first started PrTMS treatment at Dr. Vinay’s Clinic I was very skeptical. After just 3 weeks, my symptoms where almost absent. My family and friends began commenting on the difference too. As I was beginning to feel better I was taking steps to improve my life that I’d been avoiding for years. Thank you Dr. Vinay and your team – I’ve finally emerged from depression.” – CM