Mental health and suicidal ideation

Thoughts of suicide, also called suicidal ideation, are often linked to severe mental health conditions such as depression, anxiety and post-traumatic stress disorder (PTSD).  It has also been linked to personality disorders, psychoses, and certain life factors, including:

• Ongoing chronic pain, physical health problems and disability
• Loneliness and isolation
• Grief and loss
• Adverse life events like abuse, job loss, financial crisis and divorce
• Alcohol and drug abuse
• Exposure to suicidal behavior, for example, a family member or friend
• Previous attempts to end one’s life

Understanding suicidal ideation

In depressive illness, transient thoughts of suicide are common.  These transient thoughts are a passive form of the condition, where someone may feel depressed and feel that life is no longer worth living.  However, in these cases, there is rarely a plan to harm themselves physically.

Suicidal ideation is different.  Unlike passive suicidal ideation, the thoughts become consuming, and the individual becomes more and more preoccupied with ending their own life.   This preoccupation may lead to planning and eventual suicide attempts.  It is a frightening and overwhelming condition for both sufferers and their families.

Certain mental health conditions carry more risk of suicidal thoughts than others:

Transcranial Magnetic Stimulation and Traditional Therapies

It is important to remember that not everyone who experiences suicidal ideation will go on to attempt to end their own life.  However, the risk is more significant when someone starts actively making plans to do so.  It is, therefore, critical to address these thoughts earlier rather than later.

Traditional therapies often include a combination of psychotherapy and medication.  The most commonly used medicines are SSRIs (Selective Serotonin Reuptake Inhibitors) for depressive illness, which may be combined with anti-anxiety medication.  In severe cases, hospitalization has been needed to keep the person safe.

Research has shown that a combination of both medication and talking therapy is often more effective than either used alone.  However, for some people, this still does not provide relief from these thoughts, and Transcranial Magnetic Stimulation (TMS) is providing new hope in these cases.  Unlike traditional forms of treatment, TMS is non-invasive and does not produce the body-wide side effects associated with medication that some people find unpleasant.  It can also be used alongside conventional therapies to increase their effectiveness, improving quality of life and making hospitalization less likely.

In the next section, we will look at how TMS works, how it can help with suicidal thoughts and what a patient can expect if they decide to include TMS  in their treatment plan.

What is TMS?

Transcranial Magnetic Stimulation is a technique that works to stimulate the brain’s nerve cells by passing a magnetic pulse through the skull.  It is licensed by the FDA to treat major depressive disorder, which is often found in people with suicidal ideation.  It is helpful as a standalone therapy, which makes it useful for those who have not responded to traditional medications.  It works locally, so combining TMS,  medication and talking therapies is perfectly safe.

How does TMS work to help reduce suicidal ideation?

TMS is effective in reducing the symptoms of depression, which are often the driving factor for suicidal thoughts.  There have been several studies that have shown TMS to mitigate suicidal thoughts in people with depressive illness.  It has also been found to be effective for the reduction of suicidal thoughts caused by other issues such as alcohol and drug dependency.

The science behind TMS

TMS targets the pre-frontal cortex, the area at the front of the brain that controls decision-making.  It also helps us regulate our moods and control our emotions.  In depressive illness, there is often reduced activity in this area.  This lack of activity is frequently seen in the left dorsolateral pre-frontal cortex (DLPFC), the area concerned with motivation and hope.  TMS therapy specifically stimulates the brain in this area, encouraging the release of certain chemicals (neurotransmitters), such as serotonin, which are directly related to mood.  It further fosters activity within these areas, increasing connectivity through the brain’s natural ability to produce new neural pathways.

What happens at my TMS appointment?

TMS appointments involve outpatient visits each weekday for several weeks.  The session will last around 30-60 minutes and is entirely non-invasive.  You will be seated comfortably during the session, and a qualified practitioner will place an electromagnetic coil against your scale.  This coil will generate the magnetic pulses that will stimulate the brain cells in this area.  TMS treatment is tailored to the individual; therefore, the exact location of the coil and the length and duration of your sessions will be determined in discussion with our medical team, following a detailed assessment of your individual needs.

Are there side effects?

Most people find TMS completely painless.  For others, there may be some scalp tingling as the magnetic pulses are delivered, or they may experience a mild headache which resolves quickly.  Unlike other treatments, there is no need to be admitted to the hospital, and there are no body-wide side effects from TMS.

How rapidly will it work?

Again, this depends on the individual and the severity of the problem.  However, there are recent studies which have shown a significant reduction in thoughts of suicide within just two or three sessions for some people.  Many people report experiencing less suicidal thinking within a week or two.  Since TMS is individualized, we monitor your responses and can adjust the treatment to fit your needs.

Once treatment has ended, many people find that the positive effects can last for many weeks or months.  Some people need occasional maintenance treatments, yet others report significant long-term reductions in depression, anxiety and suicidal ideation.

Why TMS Is Different from Other Treatments

• Non-invasive
• Rapid effects
• On-going, long-lasting benefits
• No body-wide and minimal local side effects

Taking the first step

Your first step is to book an initial consultation by calling one of our trained healthcare professionals, who will take a complete medical history, including your mental health condition and any existing treatments.  If you are suitable for the treatment and decide to proceed with TMS, you can book your first sessions.  We will discuss the best course of treatment – usually around 4-6 weeks of weekday sessions.  You will be monitored throughout the treatments so any minor adjustments can be made, and a follow-up appointment will be made to discuss any maintenance sessions you may require.

If you have treatment-resistant depression, anxiety and suicidal thoughts, TMS may be the breakthrough you are looking for.  Call the Southern Colorado TMS Center today at 719.625.8114 to discuss your options.