Can TMS be Used to Treat Anxiety?

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What is Anxiety?

Anxiety is a sensation of worry, dread, and unease. You may start to perspire, become agitated, and experience a rapid heartbeat – a typical stress response. You might have anxiety, for instance, when confronted with a challenge at work, before taking a test, or before making a crucial decision.

Your concentration might improve, and you might even feel more motivated. Nonetheless, the panic might be intense and endure a long time for certain people with anxiety disorders.¹ In addition, a person’s ability to perform at work, learn, and maintain relationships can all be affected by anxiety disorders.

It’s common to have anxiety now and then. Yet, intense, excessive, and persistent worry and panic over ordinary circumstances are typically experienced by those with anxiety disorders. Anxiety disorders sometimes entail recurrent episodes of severe unease, fear, or terror that peak in minutes. This is known as a panic attack.

Insurance may be able to help cover the cost of therapy.

Athena Care is in-network with most major insurance plans. Find out more about your insurance coverage by calling your insurance company or by contacting us below. One of our care coordinators can help you navigate your insurance coverage to get the care you need.

Signs and Symptoms of Anxiety

Signs and symptoms of anxiety include:

• Feeling jittery, fidgety, or uptight
• Feeling a sense of impending danger, terror, or disaster
• Hyperventilation
• Feeling drained or exhausted
• Difficulty focusing on anything other than your worry
• Sleep problems
• Digestive system (GI) issues
• Desire to stay away from things that cause worry

Types of Anxiety

There are many kinds of anxiety disorders, including phobia; however, the five major types of anxiety disorders are as follows:²

• Generalized Anxiety Disorder (GAD): Chronic anxiety, excessive worry, and tension that persists without a trigger.
• Obsessive-Compulsive Disorder (OCD): Recurring, unpleasant thoughts (obsessions) and/or repetitive actions (compulsions), including hand washing and counting.
• Panic Disorder: Abrupt, frequent, intense fear accompanied by physical symptoms such as wooziness, heart palpitations, shortness of breath, or stomach aches
• Post-Traumatic Stress Disorder (PTSD): This type of anxiety disorder can appear after exposure to a terrible experience that directly happened to you or that you witnessed. Violent personal attacks, catastrophes caused by nature or people, accidents, and military conflict are examples of traumatic events that might set off PTSD.
• Social Anxiety Disorder (SAD): Often known as social phobia, SAD is characterized by intense self-consciousness and crippling anxiety during everyday social interactions.

It is unclear what exactly causes anxiety. However, life events like traumatic experiences seem to set off anxiety disorders in persons predisposed to it. Moreover, inherited qualities or an underlying medical condition may cause anxiety for some individuals.

Diagnosis & Treatment for Anxiety

To diagnose anxiety, a licensed medical professional will most likely conduct a psychological evaluation and other tests to rule out any underlying issues.³ There are several treatment options for anxiety, including the following:

• Cognitive Behavioral Therapy (CBT): CBT is a short-term treatment that targets current issues and symptoms, focuses on the connections between ideas, feelings, and behaviors, and aims to change thoughts, feelings, and behavior patterns that make it difficult to function.⁴
• Cognitive Processing Therapy (CPT): You’ll learn to change and dispel false beliefs about the trauma generating your anxiety.
• Prolonged Exposure Therapy: Prolonged exposure teaches you how to approach traumatic memories, feelings, and circumstances gradually. By facing what has been avoided, you’ll probably find that the painful memories and cues are safe and needless.
• Eye Movement Desensitization and Reprocessing (EMDR): This structured therapy that can last up to 90 minutes urges you to concentrate on the traumatic memory while undergoing bilateral stimulation (usually eye movements or tapping). This is linked to a decrease in the vividness and strong emotion attached to the traumatic memories.
• Support Group: Your experiences dealing with anxiety may be helpful to other group members. In contrast, you can learn and gain comfort from others via their experiences. In addition, your sense of self-worth and confidence in your capacity to manage your symptoms can increase due to being able to assist others.⁵
• Medications: You and your doctor may decide on the appropriate medication to manage your symptoms and condition with the fewest side effects. Tell your doctor if there are any negative side effects from your prescriptions. Before finding the right prescription, you might need to experiment with several medications or a combination, or your doctor might need to change the dosage or schedule.
• Transcranial Magnetic Stimulation (TMS):⁶ TMS therapy for anxiety is a non-invasive procedure that stimulates the cells in a particular brain region by delivering electromagnetic pulses using an electromagnetic coil. TMS for anxiety controls activity in other brain regions, possibly returning them to normal. Restoring the stability and balance in your brain helps reduce symptoms.
• Acceptance and Commitment Therapy (ACT): During ACT, you’ll study many techniques for determining your life values and apply these techniques in your daily routine. Researchers discovered that online ACT therapy is effective in treating several anxiety conditions.⁷
• Stress Inoculation Training (SIT):⁸ SIT is a form of CBT that may be carried out in an individual or group setting. It gives you the tools to quickly combat fear and anxiety when confronted with reminders or cues that trigger those feelings.
• Present-Centered Therapy (PCT):⁹ Instead of directly processing the trauma, this non-trauma-oriented therapy concentrates on present-day issues. PCT offers psychoeducation on trauma’s effects and teaches problem-solving techniques to deal with everyday stressors.
• Deep Brain Stimulation (DBS): Electrodes are implanted in various areas of the brain. Electrical pulses control unusual impulses, and these electrical pulses may have an impact on the molecules and cells of the brain.¹⁰

Statistics on Anxiety Disorders

• Anxiety disorders are the most prevalent mental illness in the United States. Forty million persons (19.1% of the population), 18 and older, are affected annually.
• An anxiety condition is identified in nearly half of those diagnosed with depression, demonstrating that anxiety and depression go hand-in-hand.
• 6.8 million adults in the U.S., or 3.1% of the population, have GAD, yet only 43.2% are receiving therapy.
• Women are twice as likely as males to be impacted by GAD, and major depression frequently co-occurs with this disorder.
• Specific phobias afflicting 19.3 million adults, or 9.1% of the U.S. population, are twice as likely to impact women as males.¹¹

TMS Treatment for Anxiety

Transcranial Magnetic Stimulation (TMS) is a non-invasive alternative therapy that uses electromagnetic fields to activate brain regions that aren’t functioning well. A small coil is positioned over your head throughout the treatment. Without obstructing the scalp and bone, the magnetic field produced by the coil’s electric current can influence the activity of the nerve cells in the prefrontal cortex. The magnetic pulses’ position, magnitude, and frequency all affect the magnetic stimulation.¹²

TMS is an effective treatment for obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Still, there is insufficient information on how well it works to treat other anxiety disorders, according to a 2019 study. Although more research is required, the findings indicate that TMS may be a valuable treatment for generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD). It appears to be effective by applying high-frequency stimulation to the right dorsolateral prefrontal cortex.¹³

The benefits of TMS for anxiety include its relative safety, non-invasive technique, lack of side effects, and the fact that it’s pain-free. In addition, it doesn’t require the use of medications, which is helpful, considering 75% of Americans struggle to take their medications as prescribed.¹⁴

Furthermore, a promising 2018 trial shows that TMS combined with Cognitive Processing Therapy (CPT) worked well in treating PTSD. Moreover, this combination’s positive effects persisted for six months.¹⁵

The initial TMS treatment for anxiety typically lasts sixty minutes. First, you’ll be led to a treatment area, instructed to sit in a recliner, and given earplugs to wear throughout the process. Next, your doctor must determine where to place the magnets on your head and how much magnetic energy is appropriate.

Your head will be pressed against an electromagnetic coil frequently turned on and off, creating stimulating pulses. This causes a tapping or clicking sound for a short period before pausing. The tapping feeling will also be felt on your forehead. This procedure is known as mapping.

Your doctor will gradually increase the magnetic dose until your fingers or hands begin twitching to calculate the necessary amount of magnetic energy. This is referred to as your motor threshold. It serves as a benchmark for choosing the appropriate dose. Depending on your symptoms and adverse effects, the stimulation level can be adjusted throughout the treatment.¹⁶

A typical treatment course usually takes place 3-5 times a week over several weeks.¹⁷

When Should TMS be Used to Treat Anxiety?

Alternative treatments, like TMS for anxiety, are usually used when patients do not respond to conventional therapies, such as psychotherapy and medication. TMS therapy for anxiety disorders is still considered “off-label” since it is not FDA-approved. However, it was given FDA approval in May 2022 as an additional treatment for people with OCD and anxious depression.¹⁸

TMS can be a safe, non-invasive, and successful treatment for other anxiety disorders. However, researchers must conduct more extensive, controlled studies to determine how well TMS treats anxiety.

If any of the following apply to you, you may be a good candidate for TMS therapy for anxiety:

• You are dissatisfied with the effects of your medication(s).
• You cannot handle the side effects of your medication(s).
• Your medical condition makes it difficult for you to take medication.
• Your anxiety symptoms disrupt your daily life.

How Will I Know TMS Treatment for Anxiety is Working?

When it comes to TMS for anxiety, treatment does require a time commitment. Some individuals won’t see any changes until many weeks following treatment. For example, you may notice that you are sleeping better, not worrying as much, and your overall quality of life has improved.

On the other hand, some patients might not see any changes at all. However, your loved ones may notice minor improvements, including reduced anxiety symptoms.

Are There any Side Effects or Risks of Using TMS for Anxiety?

According to research, most TMS side effects are mild to moderate, if they occur at all. However, they may consist of the following:¹⁹

• Headaches (most common)
• Lightheadedness
• Scalp pain
• Neck pain
• Tingling
• Face twitching
• Sleepiness
• Altered state of mind during treatment
• Seizures (most rare)²⁰

There is no evidence that TMS can worsen anxiety.²¹

Who Should Avoid TMS for Anxiety Treatment?

People with certain medical implants should avoid TMS therapy for anxiety. Metal implants or gadgets that interact with magnetic fields can cause complications. In addition, you may not be eligible for TMS if you have stents, implanted stimulators, a pacemaker, a medicine pump, cochlear implants, or gunshot fragments in your body. Generally, metal in areas that exceed 10cm from the head is usually acceptable.²²

Additionally, people with certain medical issues should avoid TMS for anxiety. For instance, people with a history of seizures, those with bipolar disorder, or those who are pregnant should avoid this therapy.

Finally, inform your TMS psychiatrist about any prescription or over-the-counter medications, supplements, or vitamins you’re taking, as certain drug combinations can cause serious complications. Discussing the above concerns with your doctor before anxiety TMS treatment is critical to avoid adverse effects.

Cost & Insurance Coverage for TMS for Anxiety

The following are average costs for TMS therapy for anxiety. These costs may vary by location and other factors. Therefore, they may not reflect the actual cost of treatment or what you may pay in Tennessee.

TMS treatment typically costs between $400 and $500 per session.²³ The overall price of TMS therapy may be around $15,000 because most patients require numerous sessions to reach desired results. In addition, because the general use of TMS for anxiety isn’t FDA-approved, some insurance carriers may not cover this type of treatment.

Athena Care has multiple TMS treatment centers in Tennessee. We are also in-network with most major insurance plans. Therefore, filling out our free, confidential, no-obligation online insurance verification form is the best way to obtain all the information needed to begin TMS treatment for anxiety.

Allow our highly experienced, knowledgeable care coordinators to handle the challenges of contacting your insurance carrier for more information about your coverage for TMS treatment. After you submit the form, a care coordinator will review your policy and clearly explain your options. Any information you provide or discuss will remain confidential.