South Florida Psychiatrist, Dr. Gregory Marsella at Chrysalis TMS Institute using Advanced TMS and rTMS Technology as an Alternative Treatment for many Psychiatric and Neurological Disorders

TMS Treatment for Anxiety Disorders

Call Us Today at 561-394-2532 to begin your transformation

Transcranial Magnetic Stimulation (TMS and rTMS) for Anxiety

Psychiatrist, Dr. Gregory Marsella's TMS treatment as an alternative treatment for Anxiety in South Florida

Anxiety Disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty. Unlike the relatively mild, brief anxiety caused by a stressful event (such as speaking in public or a first date), anxiety disorders last at least 6 months and can get worse if they are not treated. Anxiety disorders commonly occur along with other mental or physical illnesses, including alcohol or substance abuse, which may mask anxiety symptoms or make them worse. In some cases, these other illnesses need to be treated before a person will respond to treatment for the anxiety disorder.

Panic Disorder

Panic disorder is a type of anxiety disorder in which you have repeated attacks of intense fear that something bad will happen.

A panic attack begins suddenly, and most often peaks within 10 - 20 minutes. Some symptoms may continue for an hour or more. A panic attack may be mistaken for a heart attack. Panic attacks may include anxiety about being in a situation where an escape may be difficult (such as being in a crowd or traveling in a car or bus). A person with panic disorder often lives in fear of another attack, and may be afraid to be alone or far from medical help.

Social Anxiety Disorder

Social Anxiety is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as parties and other social events.

People with social phobia become very anxious and self-conscious in everyday social situations. They have an intense, persistent, and chronic fear of being watched and judged by others, and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.

Although many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them on their own.

Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others). Or, it may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost everyone other than family members.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is a pattern of constant worry and anxiety over many different activities and events.

The main symptom is the almost constant presence of worry or tension, even when there is little or no cause. Worries seem to float from one problem to another, such as family or relationship problems, work issues, money, health, and other problems.

Even when aware that their worries or fears are stronger than needed, a person with GAD still has difficulty controlling them.

Other symptoms include:

  • Difficulty concentrating

  • Fatigue

  • Irritability

  • Problems falling or staying asleep, and sleep that is often restless and unsatisfying

  • Restlessness, and often becoming startled very easily

Along with the worries and anxieties, a number of physical symptoms may also be present, including muscle tension (shakiness, headaches) and stomach problems, such as nausea or diarrhea.

TMS treatments for anxiety disorders are available, and research is uncovering new treatments that can help most people with anxiety disorders lead productive, fulfilling lives.

Many people afflicted with anxiety disorder do not find sufficient symptomatic relief from medication. Dr. Marsella is offering Transcranial Magnetic Stimulation (TMS and rTMS) treatments to select, off-label patients who suffer from anxiety disorders. These treatments use repetitive transcranial magnetic stimulation (rTMS) to ‘short circuit’ processes in the brain related to anxiety. rTMS is a safe, non-systemic treatment that carries none of the side-effect burden of anxiolytic medication.

 

Related Articles

Transcranial Magnetic Stimulation (TMS and rTMS) and OCD (Obsessive Compulsive Disorder)

South Florida Psychiatrist, Dr. Gregory Marsella's TMS treatment as an alternative for Tourette's and Obsessive Compulsive Disorder at the Chrysalis TMS Institute in Boca Raton

Obsessive-compulsive disorder is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions). Often the person carries out the behaviors to get rid of the obsessive thoughts, but this only provides temporary relief. Not performing the obsessive rituals can cause great anxiety.

Obsessive-compulsive disorder (OCD) is more common than was once thought. Most people who develop it show symptoms by age 30.

There are several theories about the cause of OCD, but none have been confirmed. Some reports have linked OCD to head injury and infections. Several studies have shown that there are brain abnormalities in patients with OCD, but more research is needed.

About 20% of people with OCD have tics, which suggests the condition may be related to Tourette syndrome. However, this link is not clear.

The symptomatology of patients with Obsessive-Compulsive Disorder and Tourette’s Syndrome is caused by a dysregulation of firing in specific brain circuits. rTMS (repetitive Transcranial Magnetic Stimulation) has been shown to improve these disorders by normalizing the firing of such circuits. Daily rTMS treatments for Obsessive-Compulsive Disorder and Tourette’s Syndrome may result in symptomatic improvements in as little as one week.

Related Articles

top

Transcranial Magnetic Stimulation (TMS and rTMS) and PTSD (Post Traumatic Stress Disorder)

South Florida Psychiatrist, Dr. Gregory Marsella's TMS treatment as an alternative treatment for Post Traumatic Stress Disorder

Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.

A cocktail of drugs is often used to control the symptoms of anxiety and depression associated with Post-Traumatic Stress Disorder. Select PTSD patients may benefit from off-label rTMS treatment.

PTSD can occur at any age. It can follow a natural disaster such as a flood or fire, or events such as:

  • Assault

  • Domestic abuse

  • Prison stay

  • Rape

  • Terrorism

  • War

For example, the terrorist attacks of September 11, 2001 may have caused PTSD in some people who were involved, in people who saw the disaster, and in people who lost relatives and friends.

Veterans returning home from a war often have PTSD.

The cause of PTSD is unknown. Psychological, genetic, physical, and social factors are involved. PTSD changes the body's response to stress. It affects the stress hormones and chemicals that carry information between the nerves (neurotransmitters).

It is not known why traumatic events cause PTSD in some people but not others. Having a history of trauma may increase your risk for getting PTSD after a recent traumatic event.

Symptoms of PTSD fall into three main categories:

1. "Reliving" the event, which disturbs day-to-day activity

  • Flashback episodes, where the event seems to be happening again and again

  • Repeated upsetting memories of the event

  • Repeated nightmares of the event

  • Strong, uncomfortable reactions to situations that remind you of the event

2. Avoidance

  • Emotional "numbing," or feeling as though you don't care about anything

  • Feeling detached

  • Being unable to remember important aspects of the trauma

  • Having a lack of interest in normal activities

  • Showing less of your moods

  • Avoiding places, people, or thoughts that remind you of the event

  • Feeling like you have no future

3. Arousal

  • Difficulty concentrating

  • Startling easily

  • Having an exaggerated response to things that startle you

  • Feeling more aware (hypervigilance)

  • Feeling irritable or having outbursts of anger

  • Having trouble falling or staying asleep

You might feel guilt about the event (including "survivor guilt"). You might also have some of the following symptoms, which are typical of anxiety, stress, and tension:

  • Agitation or excitability

  • Dizziness

  • Fainting

  • Feeling your heart beat in your chest

  • Headache

Related Articles

top

Transcranial Magnetic Stimulation (TMS and rTMS) and Anxiety

TMS and Anxiety

The potential of TMS in the research of anxiety disorders includes determining the pathophysiology, improving our understanding of physiological endophenotypes and comprehension of neuroanatomical networks. Increased understanding in these areas may lead to improved treatment options and, in turn, mediation of symptoms (George and Belmaker 2007).

Relatively few studies have investigated TMS in anxiety to date; however those so far have been encouraging. A study in 2008 (Bystritsky et al) used fMRI-guided rTMS in the treatment of generalised anxiety disorder (GAD) to evaluate whether it is effective in reducing symptoms. fMRI was first used to determine the most active location in the prefrontal cortex of ten participants with a DSM-IV diagnosis of Generalized Anxiety Disorder (GAD). Ten participants received rTMS over the course of 3 weeks, stereotactically directed to the previously determined prefrontal location. The primary efficacy measures were the Hamilton Rating Scale for Anxiety (HAM-A) and the Clinical Global Impressions-Improvement of Illness (CGI-I) scale. Overall, rTMS was associated with significant decreases in HAM-A scores, indicative of clinical improvement in Generalized Anxiety Disorder (GAD) symptoms. At endpoint, 60% of the participants showed reductions of 50% or more on the HAM-A, and a CGI-I score of 1 or 2; those subjects also had an endpoint HAM-A score < 8, therefore meeting criteria for remission.

Though this study had a small sample size, these results have been corroborated by the findings of a systematic review: Zwanzger et al (2009) confirm that . . .

There is evidence for anxiolytic action of rTMS both from preclinical trials and studies in humans.

Based on the idea of interhemispheric imbalance and/or deficits in cortico-limbic control as a model for human anxiety, inhibitory rTMS of the prefrontal cortex has been shown to exert beneficial effects in a number of studies.

top

Transcranial Magnetic Stimulation (TMS and rTMS) and OCD
(Obsessive Compulsive Disorder)

Mantovani A, Lisanby SH, Pieraccini F, Ulivelli M, Castrogiovanni P, Rossi S.

Source

Department of Neuroscience, Section of Psychiatry, Section of Neurophysiology, Postgraduate School in Applied Neurological Sciences, Siena University, Siena, Italy. [email protected]

Abstract

There is evidence that motor and premotor cortex are hyperexcitable in obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS).

We tested whether low-frequency repetitive transcranial magnetic stimulation (rTMS) could normalize overactive motor cortical regions and thereby improve symptoms.

Subjects with OCD or TS were treated with active rTMS to the supplementary motor area (SMA) for 10 daily sessions at 1 Hz, 100% of motor threshold, 1200 stimuli/day.

Suggestions of clinical improvement were apparent as early as the first week of rTMS. At the second week of treatment, statistically significant reductions were seen in the YBOCS, YGTSS, CGI, HARS, HdrS, SAD, BDI, SCL-90, and SASS. Symptoms improvement was correlated with a significant increase of the right resting motor threshold and was stable at 3 months follow-up. Slow rTMS to SMA resulted in a significant clinical improvement and a normalization of the right hemisphere hyperexcitability, thereby restoring hemispheric symmetry in motor threshold.

top

Transcranial Magnetic Stimulation (TMS and rTMS) and PTSD (Post Traumatic Stress Disorder)

Mantovani A, Lisanby SH, Pieraccini F, Ulivelli M, Castrogiovanni P, Rossi S.

Source

Department of Neuroscience, Section of Psychiatry, Section of Neurophysiology, Postgraduate School in Applied Neurological Sciences, Siena University, Siena, Italy. [email protected]

Abstract

There is evidence that motor and premotor cortex are hyperexcitable in obsessive-compulsive disorder (OCD) and Tourette's syndrome (TS).

We tested whether low-frequency repetitive transcranial magnetic stimulation (rTMS) could normalize overactive motor cortical regions and thereby improve symptoms.

Subjects with OCD or TS were treated with active rTMS to the supplementary motor area (SMA) for 10 daily sessions at 1 Hz, 100% of motor threshold, 1200 stimuli/day.

Suggestions of clinical improvement were apparent as early as the first week of rTMS. At the second week of treatment, statistically significant reductions were seen in the YBOCS, YGTSS, CGI, HARS, HdrS, SAD, BDI, SCL-90, and SASS. Symptoms improvement was correlated with a significant increase of the right resting motor threshold and was stable at 3 months follow-up. Slow rTMS to SMA resulted in a significant clinical improvement and a normalization of the right hemisphere hyperexcitability, thereby restoring hemispheric symmetry in motor threshold.

top