Can TMS be Used to Treat Postpartum Depression?

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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.

What is Postpartum Depression?

Postpartum depression (PPD) is a mood disorder that can affect women after childbirth. PPD can cause depression and anxiety, making it difficult for women to care for themselves and their babies. PPD affects up to 1 in 7 women, and the symptoms can appear any time during the first year after childbirth.¹

The symptoms of postpartum depression can differ from person to person, but some of the common symptoms include the following:

• Sadness, tearfulness, or feelings of hopelessness
• Loss of interest or pleasure in activities
• Changes in appetite or sleep patterns
• Fatigue or loss of energy
• Feelings of guilt, worthlessness, or inadequacy
• Difficulty concentrating or making decisions
• Irritability or agitation
• Thoughts of self-harm or suicide

New mothers may experience “baby blues” in the first few days after giving birth, which can cause mood swings, anxiety, and difficulty sleeping. However, these symptoms typically resolve on their own within a few weeks. PPD, on the other hand, can last much longer and significantly impact a woman’s life. Additionally, women with postpartum depression after one pregnancy are at increased risk for developing it again with subsequent pregnancies.²

It’s also important to note that postpartum depression differs from peripartum depression. Peripartum depression is similar, but it refers specifically to depression that occurs during the peripartum period, which is late pregnancy and the first few weeks after giving birth.

The causes of postpartum depression are not entirely clear, but there are a number of factors that may contribute to its development. Some of the most commonly cited causes of PPD include:

• Hormonal changes: After giving birth, a woman’s body experiences significant hormonal changes, including a drop in levels of estrogen and progesterone. These changes can affect mood, contributing to the development of PPD.
• Genetics: A family history of depression or other mental health disorders can increase a woman’s risk of developing PPD.
• Stress and life changes: The birth of a baby can be a stressful and overwhelming experience, and significant life changes, such as a new baby, disrupted sleep, and changes in roles and responsibilities, can all contribute to developing PPD.
• Lack of support: Women who lack social support, including emotional support from a partner or family members, may be at higher risk of developing PPD.
• Medical complications: Women who experience medical complications during pregnancy or childbirth or who have a history of mental health issues may be at higher risk.

A healthcare provider, such as a doctor or mental health professional, typically diagnoses postpartum depression. To diagnose PPD, a healthcare provider will ask about your symptoms, medical history, and any risk factors for PPD. They may also perform a physical exam and order blood tests to rule out any medical conditions that could be causing or contributing to the symptoms.

Your healthcare provider may use a screening tool, like the Edinburgh Postnatal Depression Scale (EPDS). Screening tools help assess your symptoms and determine whether you may have PPD.

There are several treatment options available for PPD, including:

• Therapy: Counseling or evidence-based therapy approaches, like cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), can effectively treat PPD. Therapy can help identify negative thoughts and behaviors and develop coping mechanisms to deal with symptoms.
• Medications: Antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs), can be prescribed to treat PPD. However, talking to a doctor before starting any medication is important, especially if breastfeeding.
• Hormone therapy: Hormone therapy, such as estrogen replacement therapy, is sometimes effective. However, hormone therapy for PPD is still being studied and is not currently a first-line treatment.
• Support groups: Joining a support group can be very helpful. Talking to other women who have experienced similar feelings can be very comforting and help reduce feelings of isolation and shame.
• Self-care: Engaging in self-care activities, such as exercise, healthy eating, and getting enough sleep, can also effectively treat PPD. Taking care of yourself and prioritizing your needs during this time is essential.

TMS Treatment for Postpartum Depression

Transcranial magnetic stimulation (TMS) is a non-invasive brain stimulation technique that uses magnetic fields to stimulate nerve cells in the brain. A small coil is positioned over your head throughout treatment. Without obstructing the scalp and bone, the magnetic field produced can influence the activity of the nerve cells in specific, designated brain regions.³

TMS is a promising treatment for depression, including postpartum depression. TMS for postpartum depression is typically used to stimulate the dorsolateral prefrontal cortex (DLPFC), a brain region regulating mood and emotion. Studies have shown that people with depression, including PPD, often have reduced activity in the DLPFC. By stimulating this area of the brain, it is thought that the activity in the DLPFC can be increased, leading to improvements in mood and other depressive symptoms.

TMS may also stimulate the release of certain neurotransmitters, such as serotonin and dopamine, which are also known to regulate mood and emotion. By increasing the activity of these neurotransmitters, TMS therapy for postpartum depression may help to alleviate symptoms.

TMS is typically administered as a series of daily sessions over several weeks of treatment.⁴ The initial TMS treatment for postpartum depression 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 treatment. Next, your TMS psychologist must determine where to place the magnets on your head and how much magnetic energy is appropriate.

Your head will be placed against a coil of electromagnetic energy regularly switched on and off, sending off energizing pulses. This produces a quick tapping or clicking noise before pausing. Your forehead will experience the tapping sensation as well. Mapping is the term for this process.

Your doctor will gradually increase the magnetic dose until your fingers or hands begin to twitch. This calculates the necessary amount of magnetic energy and is called your motor threshold. The stimulation intensity can be adjusted according to your symptoms and side effects throughout therapy.⁵

TMS postpartum depression treatment has several potential benefits, including the following:

• Non-invasive: TMS does not require surgery or anesthesia, making it a safe and relatively comfortable treatment option.
• Effective: Several studies have shown that TMS can effectively treat PPD, significantly improving mood and other symptoms. For example, a randomized controlled trial in 2010 found that women who received repetitive TMS for postpartum depression significantly improved symptoms compared to those who received a placebo.⁶
• Fast-acting: TMS can relieve symptoms of PPD relatively quickly, with many women experiencing improvements within a few weeks of beginning treatment.
• Minimal side effects: TMS is safe and well-tolerated, with minimal side effects. The most common side effects of TMS include mild headaches or scalp discomfort during the procedure.
• No medication required: TMS is a medication-free treatment option for PPD. This is particularly appealing if you are breastfeeding or have concerns about the potential side effects of antidepressant medications.
• Improved quality of life: By reducing symptoms of PPD, TMS can improve your overall quality of life and ability to care for yourself and your child.

The exact mechanisms by which TMS for postpartum depression works are still being studied and understood. However, evidence suggests that TMS can be an effective treatment for PPD by targeting the specific areas of the brain involved in regulating mood and emotion.

When Should TMS be Used to Treat Postpartum Depression?

TMS can treat PPD when other treatments, such as psychotherapy or medication, are ineffective or cause intolerable side effects. TMS for postpartum depression is generally considered a second-line treatment after traditional treatments have been tried but have not provided adequate relief.

TMS may also be a good option if you prefer non-pharmacological treatments or have concerns about the potential risks of antidepressant medications while breastfeeding. Additionally, TMS can be a good option if you’ve experienced intolerable side effects from antidepressant medications or have not responded well to other treatments.

How Will I Know TMS Treatment for Postpartum Depression is Working?

If you are receiving TMS therapy for postpartum depression, below are several signs that may indicate that treatment is working:

• Improvements in mood: One of the primary goals of TMS therapy for postpartum depression is to improve mood.
• Reduction in symptoms: TMS for postpartum depression can help to reduce symptoms such as sadness, anxiety, irritability, and fatigue. If you notice a reduction in these symptoms during treatment, this may be a sign that TMS is working.
• Increased energy and motivation: PPD can cause exhaustion and apathy, but TMS treatment can help increase energy levels and motivation.
• Improved sleep: PPD can cause disruptions in sleep patterns, but TMS treatment may help enhance sleep quality and quantity.
• Positive feedback from loved ones: Sometimes, assessing your own progress during treatment can be difficult. However, if your loved ones notice improvements in your mood, behavior, or overall functioning, this could be a sign that TMS is working for you.

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

Transcranial magnetic stimulation is considered a safe and well-tolerated treatment for postpartum depression. However, as with any medical treatment, there are some potential risks and side effects to consider. According to research, if side effects occur at all, most are mild to moderate.⁷

The most common side effect of postpartum depression TMS treatment is mild to moderate scalp discomfort or pain at the stimulation site. This discomfort typically occurs during the actual TMS session and subsides shortly after the session ends.

Some people may also experience mild headaches, dizziness, tingling, sleepiness, and neck pain. In rare cases, more severe side effects may occur, including seizures.⁸ However, the risk of this is extremely low. Furthermore, there have been isolated reports of hearing loss or tinnitus (ringing in the ears) associated with TMS treatment, but these side effects are also very rare.⁹

No evidence suggests that TMS can worsen postpartum depression. In fact, TMS for postpartum depression is considered to be a safe and well-tolerated treatment. However, it is essential to note that it may not be effective for everyone, and in some cases, it may not be the best treatment option.

Who Should Avoid TMS for Postpartum Depression Treatment?

People with certain medical implants should avoid TMS therapy for postpartum depression, as 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.¹⁰

Furthermore, people with certain medical issues should avoid TMS therapy for postpartum depression. For instance, people with a history of seizures, bipolar disorder, and those who are pregnant should speak with a healthcare provider before TMS.

Finally, be sure to inform your doctor about any prescription or over-the-counter drugs, vitamins, or supplements you’re taking. Some drug combinations might have severe complications. Discussing the above concerns with your doctor before TMS treatment for postpartum depression is essential to avoid potentially harmful effects.

Cost & Insurance Coverage for TMS for Postpartum Depression

The cost of TMS for postpartum depression in Tennessee can vary depending on a variety of factors, including your specific location, the type of equipment used, and the number of treatment sessions required. Generally, an entire course of TMS therapy for postpartum depression can cost several thousand dollars.¹¹

Insurance coverage for TMS for postpartum depression also varies depending on the individual insurance plan and the specific circumstances of the treatment. For example, some insurance plans may cover the cost of TMS therapy for postpartum depression if it is deemed medically necessary and if other treatments have been unsuccessful. However, not all insurance plans cover TMS for PPD, and some may require prior authorization or other documentation.

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

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