Brain stimulation for depressionBrain stimulation for depression
All In The Mind
Clinical depression is sometimes not helped by medication. One promising alternative treatment is TMS: a magnetic pulse passed through the skin to a focussed part of the brain.
28:52•17 Dec 2017
Magnetic Brain Pulses: A New Option for Tough Depression
Episode Overview
- TMS uses focused magnetic pulses to stimulate specific brain areas, aiming to adjust activity in networks linked to depression.
- Research discussed in the episode suggests around half of patients with long-standing, treatment-resistant depression gain substantial benefit from a TMS course.
- TMS is generally recommended after at least two antidepressants have failed, and may be more likely to help than trying yet another medication.
- Side effects are usually limited to local discomfort and headaches, with very low seizure risk and no clear evidence of long-term harmful effects.
- Access and cost remain major barriers, with limited public funding and many people needing private hospital care or personal funds to undertake a full course.
“If you fail two antidepressants, you’re actually four times more likely to respond to transcranial magnetic stimulation than you are to a third antidepressant.”
How do people find hope in the darkest times? This episode of *All In The Mind* looks at transcranial magnetic stimulation (TMS) as an option for people whose depression hasn’t improved with standard medication. Clinical psychiatrist Dr Ted Cassidy calmly walks through what TMS actually is: a focused magnetic pulse aimed at a small area of the brain, about the size of a 50 cent piece.
Professor Paul Fitzgerald adds the research perspective, explaining that “at least 50% of patients can expect a really good response to treatment” after a full course, even when several antidepressants have failed. The emotional core comes from Lachlan O’Brien, who describes years of severe depression and bipolar II disorder, trying “everything under the sun” in terms of medication.
His account is raw: “I was profoundly sad, miserable, despairing, lots of tears, panic attacks… immense desperation.” He talks frankly about suicidal thoughts, late-night calls to crisis support, and the guilt that makes asking for help feel impossible. You’ll also hear what TMS sessions are actually like.
Patient Owen describes the sensation as “a slight tapping on the forehead”, while Lachlan compares early sessions to “really bad brain freeze”, painful but short-lived and, for him, worth the trade-off compared with medication side effects. The episode outlines how many sessions are usually needed, the typical side effects, and why safety guidelines are strict.
Cost and access are tackled head-on, including the lack of Medicare funding and the reality that many people rely on private hospitals or family support to pay for treatment. There’s also early discussion of combining TMS with psychotherapy, using the brain’s increased “mouldability” after stimulation to strengthen talking therapies. Anyone curious about non-drug options for hard-to-treat depression, or supporting someone stuck after multiple medications, will find this a grounded, honest look at what TMS can and can’t do.
Could this be the kind of extra option that changes what “treatment resistant” really means?
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