Anxiety is one of the major mental health problems around the globe. It can wreak havoc on the quality of life of a person and causes significant mental distress and dysfunction. It affects social life, increases the risks of various health problems, and may provoke extreme thoughts of suicide. However, many people take it for granted and do not seek medical help.
Various treatment options for anxiety treatment include several medications and behavioural or talk therapies. However, these treatments sometimes fail to cure anxiety disorders in patients.
Transcranial Magnetic Stimulation (TMS) has recently gained much popularity in the past couple of decades. It has emerged as a safe and highly effective treatment for mental health problems, like anxiety and depression.
TMS has long been tested for treating various mental and psychological problems. FDA has now officially recognized it as a potential and safe treatment for such disorders. Several countries, including Australia, are currently offering TMS therapy to patients with anxiety and depressive disorders.
Before going into a detailed discussion of TMS, how it works, and how effective it is in treating anxiety, let’s first understand more about anxiety disorders.
What are Anxiety and Anxiety Disorders?
According to the American Psychiatric Association, anxiety is the feeling or anticipation of a future concern resulting in the development of muscle tension and avoidance behaviour. It is a natural response of the body against stress. It alerts us and prepares our bodies for stressful conditions.
However, anxiety disorders are something different from the usual feelings of anxiousness. If your anxiety is extreme, lasting for more than six months, and interferes with your everyday life activities like your relationship, job performance, school work, etc., you may have an anxiety disorder.
Several different types of anxiety disorders are there, including;
- Generalized anxiety disorder
- Panic disorders – characterized by panic attacks of extreme anxiety
- Phobias – the fear of a specific object, situation, or an activity
- Agoraphobias – intense fear of being in a situation or place from where escape is difficult
- Social anxiety disorders – extreme fear of being judged in social interactions
- Separation anxiety disorder – the fear of going away from your home or loved ones
- Selective Mutism – the fear of speaking in front of others – etc
Besides, your anxiety can also be a symptom of some mental, psychological, or health conditions, like post-traumatic stress disorder (PTSD), major depressive disorders, chronic pain, chronic inflammatory diseases, drug abuse, etc.
What are the Symptoms of Anxiety?
Anxiety symptoms vary from person to person, depending on how the individual perceives it. It can be a feeling of butterflies in your stomach or can present in the form of extreme sweating or a racing heart.
Generally, the symptoms of anxiety include;
- Restlessness
- Irritability
- Troubling thoughts or beliefs that are hard to control
- Difficulty in concentration
- Sleeplessness or difficulty falling asleep
- Tiredness or fatigue
- Body aches and pains – etc
How Common is Anxiety – the Global Trends of Anxiety Disorders
The incidence of anxiety disorders has been increasing over the last three decades. According to a recent epidemiological study published in 2023, approximately 301 million people around the globe have anxiety disorders which make up 4.05% of the world population. These numbers have increased by more than 55% from 1990 till 2019. 1[]
It is more common among women.[2] Demographic analysis has shown that these anxiety disorders increase with socioeconomic development and urbanization.
Prevalence of Anxiety Disorders in Australia
According to the Australian Bureau of Statistics, anxiety is the most common type of mental health problem in Australia. Around 3.3 million Australians currently suffer from some kind of anxiety disorder, making up 17% of the total population. In other words, 1 out of every 6 persons living in Australia has anxiety issues. [3]
Anxiety Disorders are highly overlooked and undertreated
The results of the National Comorbidity Survey Replication revealed that nearly 75% of the individuals in America with social or generalized anxiety disorders do not get treatment for their mental health condition. [4]
The same is the situation in Australia. According to an estimate, only 39% of Australians with anxiety issues seek professional help for their mental illness while only 27% get an evidence-based treatment. 5]
Although there can be many reasons, social stigma and lack of awareness are two major causes of the under-treatment of anxiety.
What are the Different Treatment Options Available for Anxiety Treatment?
Anxiety disorders should not be neglected and appropriately treated like any other disease. Following are the treatment options for managing anxiety problems.
Ø Medications
Although medicines do not cure anxiety, they help alleviate the symptoms and allow you to perform daily activities. Some of the commonly used drugs are;
- Benzodiazepines – reduce the symptoms of panic and worry associated with anxiety
- Antidepressants – elevate the mood
- Beta-blockers – alleviates physical symptoms, like high blood pressure, fast heart rate, palpitations, shivering, etc
Ø Psychotherapy
Psychotherapy, or talk therapy, involves psychological counselling, where a psychologist helps you reduce anxiety symptoms.
One such example is Cognitive Behavioral Therapy (CBT). It is one of the most effective psychotherapy methods for treating anxiety disorders. It helps you identify the patterns and situations that trigger your anxiety and how to overcome it confidently.
Doctors usually treat anxiety with medicines, psychotherapy, or both. However, other methods, like transcranial magnetic stimulation therapy, have been introduced to reduce anxiety disorder symptoms.
What is Transcranial Magnetic Stimulation?
Transcranial Magnetic Stimulation, or TMS is a non-invasive brain stimulation technique in which powerful magnetic fields are used to stimulate the nerve cells in specific areas of the brain. It improves brain activity and is a safe and effective treatment for depression, anxiety, and several other mental and psychological disorders.
The U.S. Food and Drug Administration (FDA) approved TMS to treat major depressive disorders in 2008. In August 2021, the BrainsWay Deep TMS system received FDA clearance for relieving anxiety symptoms in patients who have depressive disorders and have failed to respond to conventional treatments, like talk therapy and anti-anxiety medications. [6]
How does TMS help in the Treatment of Anxiety?
The brain is an electrically active organ. The cells and neurons in our brain use minute amounts of electricity to send and receive information throughout the body and the brain.
Bringing a strong magnetic field close to the brain alters these electric currents and stimulates the electrical activity in the brain. TMS is believed to use the same principles of electric and magnetic fields to stimulate certain areas of the brain, which are responsible for controlling mood, emotions, thoughts, cognition and feelings of pleasure, etc. This, in turn, helps elevate the mood and reduces the symptoms of anxiety disorders.
Efficacy of TMS in Anxiety Disorders – What Does the Research Say?
Transcranial Magnetic Stimulation therapy has been tested in numerous randomized control and open-label studies regarding its efficacy in treating anxiety disorders.
For instance, in a study recently published in the Journal of Psychiatry Research in 2023, researchers observed that the stimulation of the insular-prefrontal cortex using TMS led to a reduction in the anxiety symptoms of patients with occupational stress and generalized anxiety disorder by 88.7% and 70.7%, respectively.[7]
Another multicentre, double-blind, randomized control clinical trial was conducted on 212 individuals with anxiety and depressive disorders. It was found that deep TMS significantly reduced anxiety symptoms by the 5th week of therapy, with a complete remission in 32.6% of the patients. It improved the Hamilton Depression Rating Scale (HDRS-21) by 6.39 points with an effect size of 0.76, significantly more than those in the control group. [8]
Similarly, data from three randomized control trials demonstrated significant improvement in the anxiety scores in patients with anxious depression. Compared to the sham and medication therapies, the effect sizes of deep TMS were 0.34 and 0.90, respectively, with an overall pooled effect size of 0.55. The results were sustained in the individuals for up to 16 weeks. [9]
While on the other hand, a meta-analysis of over 70 studies conducted on approximately 16,000 individuals has shown that the maximum effect size achieved with standard-of-care medications only ranges from 0.2 to 0.37. These stats depict the potential efficacy of TMS therapy for treating comorbid anxiety.
What to Expect During the TMS Therapy?
TMS is a safe, non-invasive, and painless treatment performed on an outpatient basis. No sedation or anesthesia is given, and the patient remains awake throughout the treatment.
The doctor will record measurements and determine the sites on the scalp where the magnetic coils of the TMS machine will be placed. This ensures that the specific targeted areas of the brain get stimulated.
Once the measurements have been taken, the electromagnetic coils will be placed over the scalp at predetermined sites. Transcranial magnetic stimulation will then be done. The session lasts for 20 to 50 minutes.
After the session, you are ready to perform your daily routine activities. You may feel a slight discomfort or headache around the treatment areas, but these side effects are common and temporary. They relieve on their own and improve with subsequent sessions.
Transcranial Magnetic Stimulation (TMS) Therapy in Australia
Transcranial Magnetic Stimulation (TMS) is an approved treatment for anxiety and depression in various countries, including Australia. Multiple centres offer this treatment for mental health disorders, including anxiety and major depression. Monarch Mental Health Group is one of them.
The total price depends upon the number of treatment sessions you require and where you get the treatment. TMS has also been added to the treatment procedures covered by Medicare health insurance policy in Australia. Medicare provides a rebate to those who meet the treatment eligibility criteria of TMS.
Bottom Line
Anxiety is a major mental health disorder globally, and its incidence is quite high in Australia. Despite the various treatment options available, anxiety disorders are highly overlooked and undertreated. Doctors usually treat anxiety with the help of talk therapy and medications.
However, Transcranial Magnetic Stimulation (TMS) is now emerging as a potential and effective treatment for anxiety and depression disorders, especially those resistant to conventional treatments. TMS therapy is also used in Australia to treat such mental health problems.
References
- Javaid SF, Hashim IJ, Hashim MJ, Stip E, Samad MA, Ahbabi AA. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Current Psychiatry. 2023 May 26;30(1):44.
- Xiong P, Liu M, Liu B, Hall BJ. Trends in the incidence and DALYs of anxiety disorders at the global, regional, and national levels: Estimates from the Global Burden of Disease Study 2019. Journal of Affective Disorders. 2022 Jan 15;297:83-93.
- Australian Bureau of Statistics. National Study of Mental Health and Wellbeing [Internet]. Canberra: ABS; 2020-21 [cited 2023 June 26]. Available from: https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release.
- Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Archives of general psychiatry. 2005 Jun 1;62(6):629-40.
- Harris MG, Hobbs MJ, Burgess PM, Pirkis JE, Diminic S, Siskind DJ, Andrews G, Whiteford HA. Frequency and quality of mental health treatment for affective and anxiety disorders among Australian adults. Medical Journal of Australia. 2015 Mar;202(4):185-9.
- Brainsway Deep TMSTM treating anxiety in depressed patients [Internet]. 2022 [cited 2023 Jul 1]. Available from: https://www.brainsway.com/news_events/fda-clears-brainsway-deep-tms-system-for-decreasing-anxiety-symptoms-in-depressed-patients/
- Moraga-Amaro R, Muñoz P, Villalobos T, Linsambarth S, Maldonado F, Meirone V, Femopase B, Stehberg J. Real-world data of non-invasive stimulation of the human insula-prefrontal cortices using deep TMS to treat anxiety for occupational stress and generalized anxiety disorder. Psychiatry Research. 2023 Feb 1;320:115036.
- Levkovitz Y, Isserles M, Padberg F, Lisanby SH, Bystritsky A, Xia G, Tendler A, Daskalakis ZJ, Winston JL, Dannon P, Hafez HM. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry. 2015 Feb;14(1):64-73.
- Pell GS, Harmelech T, Zibman S, Roth Y, Tendler A, Zangen A. Efficacy of deep TMS with the H1 coil for anxious depression. Journal of clinical medicine. 2022 Feb 15;11(4):1015.