Major Depressive Disorder

Major Depressive Disorder (MDD) consists of recurrent (usually) depressive episodes characterized by low mood, poor concentration and energy, disturbance of sleep and appetite, loss of interest in previously pleasurable activities, and feelings of guilt or shame. Depression may result in suicide or suicide attempts for many people. Over 17 million Americans suffer from depression each year (CDC). About 15% of the population will have a depressive episode at some point in their life. After puberty, women are twice as likely as men to experience a depressive episode, which means that 20% of women (one in five) and 10% of men will be affected.

At these rates, it is likely that you or someone you know will struggle with MDD at some point, which is why it is important to know some of the most common symptoms of depression.

Click here for video describing Depression, “The Black Dog” (4 mins)

Many women choose to avoid antidepressant medications during pregnancy, but Depression itself has been shown to cause complications. Based on a number of studies, TMS appears to be a promising treatment option for pregnant women who do not wish to take antidepressant medications. Many protocols have used exclusively right sided treatment with slow frequency stimulation to minimize the number of pulses needed to treat an episode. Thus far there have been no untoward effects to the developing baby

Click here for 2015 Medscape article

Key indicators of Major Depressive Disorder (MDD)

For some individuals, the feelings they have and the behavior they exhibit may be so severe that it’s obvious what they’re going through is beyond a temporary mood swing. For others, however, they may just feel generally miserable or unhappy without really knowing why. For all of these reasons, it is important to know some of the more common symptoms of depression, which are:

  1. Feelings of sadness or melancholy. This may be represented by a sustained and pervasive sense of unhappiness. It may also include an unusual irritability or frustration, even over small problems.
  2. Lack of pleasure or interest in activities previously enjoyed. Little to no interest in former hobbies, pastimes, social activities or sex are common symptoms of depression.
  3. Changes in appetite.  Both weight gain or weight loss may occur with MDD.  Some people experience a lack of appetite, while others may crave carbohydrates.
  4. Self-loathing and feelings of worthlessness. It is common for a person with MDD to regularly self-criticize for perceived faults and dwell on mistakes. This may present itself in the form of fixating on past failures or blaming oneself when things are not going well.
  5. Physical and/or mental exhaustion. This is often demonstrated by unusual fatigue, tiredness and a loss of energy. The person’s whole body may feel heavy, and even small tasks may seem exhausting or take longer to complete.
  6. Restlessness or periods of agitation.  Some people find themselves unable to sit still and relax.  They may pace, fidget, or rock in place 
  7. Physical manifestations of depression may show themselves in the form of increased incidence of headaches, back pain, aching muscles and stomach pain.
  8. Changes in sleep. Sleeping too little or too much are both common symptoms of depression. Early morning awakening with inability to fall back asleep is characteristic of MDD. 
  9. Concentration and focus. Declining school or job performance may be related to MDD. Impaired concentration may make it difficult ro complete even simple taks. Anxiety and ruminative thoughts may be so intrusive as to interfere with planning your day or reading.
  10. Thoughts of not going on, or even death. This is one of the most serious symptoms of depression at any age. Suicidal thinking is a sign of serious depression that should never be taken lightly. Of all people with depression, older adult men are at the highest risk of committing suicide. If you are seriously considering suicide, it is important to seek emergency psychiatric care, call 911 or go to your nearest emergency room to get help, because depression symptoms are treatable. The National Suicide Prevention Lifeline can also be reached by calling 1-800-273-8255.

It is important to remember that depression is a medical illness that affects all aspects of a person’s life. Like other major illnesses, it usually requires professional treatment.  TMS is a proven treatment for MDD, and may be the right one for you. Please see our FAQs for detailed information about TMS.

Numerous scientific studies have confirmed TMS as a successful treatment for MDD.  Selected references are included below.  As TMS becomes more widely used, our understanding of how best to use it for each person will grow.

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Selected References

  • O’Reardon JP, Solvason HB, Janicak PG, Sampson S, Isenberg KE, Nahas Z, McDonald WM, Avery D, Fitzgerald PB, Loo C, Demitrack MA, George MS, Sackeim HA. “Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial.” Biol Psychiatry. 2007 Dec 1; 62(11):1208-16. [abstract]
  • Avery DH, Isenberg KE, Sampson SM, Janicak PG, Lisanby SH, Maixner DF, Loo C, Thase ME, Demitrack MA, George MS. “Transcranial magnetic stimulation in the acute treatment of major depressive disorder: clinical response in an open-label extension trial.” J Clin Psychiatry. 2008 Mar; 69(3):441-51. [abstract]
  • Janicak PG, Nahas Z, Lisanby SH, Solvason HB, Sampson SM, McDonald WM, Marangell LB, Rosenquist P, McCall WV, Kimball J, O’Reardon JP, Loo C, Husain MH, Krystal A, Gilmer W, Dowd SM, Demitrack MA, Schatzberg AF. “Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study.” Brain Stimul. 2010 Oct; 3(4):187-99. [abstract]

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