Discover how to Treat OCD and Anxiety with TMS

OCD Anxiety Treatment In Colorado

TMS has been cleared by the FDA for the treatment of OCD as an adjunct to medication treatments since 2018. OCD can be a devastating illness that takes over almost all aspects of life. Many treatment options are needed.

Why use TMS to treat OCD?

Transcranial magnetic stimulation (TMS) does not use medication. No new substances are added to your body. TMS has very few side effects, just mild headache and slight tiredness. Some forms of TMS are approved by the FDA to treat OCD. 

OCD Anxiety Treatment In Colorado

Symptoms

Obsessive Compulsive Disorder (OCD) is characterized by the presence of obsessions, compulsions, or both. Obsessions are recurring and persistent thoughts that are unwanted or intrusive and cause anxiety. Compulsions are repeated actions (e.g., handwashing, re-arranging) or thoughts (e.g., counting, repeating words, or praying). OCD can be diagnosed if these symptoms last more than one hour a day, cause distress, and interfere with daily functioning.

Compulsive Behavior

Performing an action over and over again, without it leading to a reward.

Hypervigilance

Being in a state of increased monitoring constantly. Always alert to hidden dangers.

Panic Attacks

Being overwhelmed by anxiety or fears for brief periods of time.

Food Aversion

Avoiding food and being sensitive around eating certain types of food.

Impulsivity

Inability to control your thoughts, behaviors, or actions.

How we are treating
depression with TMS?

Step 1

Contact us and provide your history of OCD and any other coexisting illnesses, including your treatment history. We will interview you at no cost to see if health insurance will cover you. Although the treatment is FDA approved, some health insurance decline to cover TMS for OCD. We will work with you to try to get health insurance approval.

Step 2

Come to our clinic for about 40 minutes, five times per week, for about five weeks. The treatment itself only takes up about 20 minutes of your visit, and when it’s finished, you can return immediately to work or family life. No medication is used.

Step 3

Participate in our life skills classes, acupuncture or acupressure, and our biofeedback program sessions at no added cost. TMS works best as part of a comprehensive care package. Weekly psychotherapy with your own therapist is also strongly encouraged and typically results in better outcomes.

Our experts

John L Fleming
Doctor Profile
John l Fleming, MD. DLFAPA.

Medical Director of SCTMSC, LLC, John is a Board Certified Psychiatrist and a Distinguished Life Fellow of the American Psychiatric Association. He has over 40 years’ experience treating depression and related conditions and is recognized as a leader in the psychiatric profession. Since 2011 he has been a certified Provider Trainer and TMS provider for three different TMS treatment systems. His experience base includes psychopharmacology of complex conditions. psychotherapy of individuals and couples and the medical aspects of psychiatric illness. He has annually been selected by his peers as one of America’s Best Doctors since 2005.

About Melissa Hammock
Melissa Hammock, M.A., M.Ed., LMFT

Services Director of SCTMSC, LLC, Melissa received her master’s degree in Marriage and Family Therapy from Azusa Pacific University and her master’s in special education from California State University, Los Angeles. Melissa is a Certified Life Coach and a member of the International Positive Psychology Association. Melissa is also a Certified TMS Provider.

Melissa has been in private practice in Colorado Springs since 1981, working with adults, adolescents, and couples. Melissa specializes in the treatment of depression, anxiety, ADHD, and trauma-based disorders. She has received training in EMDR, Cognitive Therapy, Family Systems Therapy, Energy Therapies, Interpersonal Therapy and Accudetox. Melissa is a Licensed Marriage and Family Therapist. She has been involved with TMS treatment since 2011.

About Joe Hammock
Joe Hammock, M.A., PhD, Licensed Clinical Psychologist

Clinical Director of SCTMSC, LLC and Certified TMS Provider since 2011, Joe is a licensed psychologist and member of the American Psychological Association. He is a graduate of Fuller Graduate School of Psychology, and additionally holds an MA from Fuller Theological Seminary. He is certified by the International EMDR Association and is a Certified TMS Provider.In his thirty years of practice in Colorado, he has specialized in the treatment of trauma-based disorders, depression, anxiety disorders, and dissociative disorders. He also has extensive experience in psychological evaluations, CBT, EMDR, forensic psychology, and is frequently consulted as an expert witness.

FAQ

Many people have some obsessive or compulsive traits. As an example, librarians and accountants are often very conscientious, some might say obsessive, about keeping track of things. This is essential to the good performance of their job. Many people also have compulsions, such as never playing a game of football without a lucky charm. None of these are signs of illnesses. 

By contrast, if obsessions or compulsions become uncontrollable, time-consuming, unpleasant, and disruptive to an individual’s relationships, work, or other activities of life, then OCD may be diagnosed.  

Obsessions usually have a theme, such as fear of germs or contamination, wanting things symmetrically arranged or in a perfect order, thoughts of harming others or oneself, or taboo thoughts involving sex, religion, or harm. Compulsive rituals then develop as attempts at containing or responding to the obsessive thoughts. Cleaning, handwashing, rearranging, checking and re-checking if things have been done, or counting repeatedly a fixed number of times are common examples. Often, if the ritual is interrupted, it cannot be resumed where it was left off, but the affected individual must start back at the beginning. Usually, the individual is aware that they are thinking or doing things that are not necessary, but they cannot stop.

As with many other illnesses, we do not know the causes of OCD in most cases. However, the following factors may be relevant:

Family history and genetics may play a role, as OCD can run in families. However, the majority of OCD patients do not have a positive family history of OCD.
Certain brain circuits involving memory and inhibition are modified in OCD patients, so that the brain lacks the capacity to shut down a reoccurring circuit of thought and behavior. While this difference can be demonstrated on functional MRIs, its cause is unclear.
In some cases, OCD appears to be a form of “learned avoidance” of something that scares the individual. In these cases, the emergence of both the obsessions and compulsions is a form of PTSD.
In other patients, obsessions and compulsions appear to emerge as a result of thinking errors (cognitive distortions), in which the individual has an inflated sense of responsibility for what happens in life. They believe that things happen because of something they did or failed to do. This sort of thinking is entirely normal for children ages three to seven. It is not known what may cause it to persist abnormally into adult life. For these patients, OCD symptoms emerge as an attempt to control intense feelings of guilt and responsibility.
OCD can emerge in childhood within several weeks of a strep infection (often strep throat). This is what is called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection). In these cases, it is believed that the antibody to the strep infection begins to attack regions of the brain called the basal ganglia. Fortunately, many children with PANDAS outgrow the illness as they get older.

Most OCD is treated by using a combination of several treatments. Psychotherapy, especially cognitive behavioral therapy (CBT). is a mainstay treatment. A particular form of CBT called exposure response prevention (ERP) can be most helpful. In this type of CBT, the patient and therapist, after establishing a sufficient rapport and ability to work together, slowly expose the patient to the troubling mental images or thoughts that are connected with the obsessions and work on alternative ways to cope with these thoughts. 

 

Treatment with medication, particularly with SSRI antidepressant medications, is often helpful as well. SSRIs increase serotonin levels in synapses in the brain. This helps reduce the thoughts and triggers for OCD rituals. Atypical antipsychotic agents/mood stabilizers may be added to further reduce repetitious thoughts and behaviors. 

 

The above mainstay treatments help about 70% of those with OCD to reduce their symptom intensity by half. However, if a patient falls into the 30% who do not experience relief, or if reducing symptoms by half still leaves the patient in significant distress, other treatments become necessary. 

 

TMS is FDA approved for treating OCD in these cases and will be discussed below. It uses no medication, is not invasive, has few side effects, and is administered on an outpatient basis. 

 

Other treatments for non-responsive OCD include Ketamine IV infusion therapy, a six-session outpatient treatment using low dose anesthesia. This treatment can be quite effective and carries few risks. A more aggressive option would be deep brain stimulation, in which electrodes are surgically implanted in the brain to administer electrical stimulation, or gamma knife treatment, in which affected regions of the brain are deactivated or removed. This range of options is presented only because the most severe forms of OCD can interfere with a patient’s quality of life to such an extreme that any chance at all of improvement may be worth pursuing if all other options have failed. 

TMS protocols for treating OCD vary by study, and TMS is never the primary or sole treatment administered. 

However, evidence shows that application of “active” TMS in the treatment of OCD has three times the impact of “sham” TMS treatment — in other words, real TMS is three times more effective than a placebo treatment. This indicates a significant number of patients can be helped by TMS. The average improvement associated with TMS is about 30 to 35% reduction in overall severity of OCD. Since TMS is an add-on or adjunct to medication and psychotherapy, ithe three treatment forms together can make a significant impact. 

The most effective TMS treatments for OCD utilize those TMS machines and coils that can provide magnetic stimulation to deeper brain structures. The two machines approved by the FDA are the MagVenture TMS Machine and the Brainsway TMS machine.

The FDA approved “on-label treatment” of OCD differs in several ways from standard TMS treatment for depression: 

  1. The amount of magnetic energy used for treatment is calibrated according to how much it takes to make the patient’s leg wiggle, rather than their thumb.
  2. The locations treated are the anterior cingulate gyrus and the dorsomedial prefrontal cortex (DMPFC), as opposed to the dorsolateral prefrontal cortex (DLPFC). The DMPFC is about half an inch closer to the ear than the DLPFC. In order to stimulate these areas, special coils are needed to project magnetic energy deeper into the brain than standard TMS coils.
  3. The magnetic pulses are given more frequently (20 times per second rather than 10 times per second) than in rTMS or TBS treatments. 

Standard rTMS is not approved for treating OCD. Such use is considered “off-label.” However, a number of studies suggest that an rTMS coil using an inhibitory rate (i.e., one pulse per second applied to the right DLPFC) has a similar outcome to the “on-label protocol” discussed above.

While FDA clearance for OCD treatment dates back to 2018, health insurance companies have been slow to offer approval for OCD treatment. Progress is being made, and approvals are becoming more common with each passing year, at least for the “on-label” DMPFC cortex treatments discussed above. The “off-label” TMS treatment, also discussed above, is rarely covered by health insurance plans.

We currently offer “off-label” TMS treatments for OCD and plan to introduce “on label” treatment soon. We do offer both insurance-covered and non-insurance-covered treatments and will work with you to obtain approval if possible or make arrangements for self-pay. We’re also constantly following the latest research and will keep you up to date on any new medical findings relevant to your OCD treatment options.

Depression Assessment

Do you believe that you suffer from depression or anxiety? Check out our online assessments for a quick online self-assessment to see if you suffer from a mental health related issue and to see if you qualify for treatment with TMS.

What the Patients Think

Cindy Testimonial
Cindy – 22

The Southern Colorado TMS Center is truly the most caring, compassionate mental health facility I have ever known. You always hear stories about why people have gone into the mental health field, but these folks truly live it. Everyone who works for SCTMSC (and I mean everyone), exudes warmth and empathy. They walk the walk. One of my family members utilized several of their services, and I got to witness firsthand how they deal with patients. I would highly recommend them to anyone suffering from depression, because they not only offer treatments but expect patients to participate fully in their recovery.

Patients Review
Pam – 25

Dear TMS staff, I want to express my thanks for all your sincere help while I went through a very difficult time. Every time I went to the center the staff was so kind and understanding. The educational classes in the evening were wonderful and I have learned so much about depression. I still look at the handouts you provided. I have gotten into meditation and continue to educate myself about depression and anxiety. If I watch “Friends” on the TV, I will always think of my experience at the Southern Colorado TMS Center!! Thank you for doing your job so well.

Patients Review 4
Barb – 46

All the staff at SCTMSC are very caring during all of the components of the TMS treatment. From dealing with insurance companies to adjusting one’s treatment time due to conflicts with your schedule; they are all wonderful. I would recommend TMS treatments to any person suffering MDD, as I have for many years. From my experience, TMS helped me far more than an anti-depression medication or CBT.

Patients Review 2
FB – 35

Dear TMS Team, I just wanted to say that 6 months after treatment, I am doing well. I have a new life and I am living it up. It is like being young again as I am finding my way again. I am so grateful to Dr. Fleming, Camice, Dawn and all the folks who helped me to get here! But especially to Dr Fleming.

Patients Review 3
Michelle – 37

Dear Dr. Hammock, I am so incredibly grateful and appreciative for all the time and attention you gave to my husband and me. Thank you, thank you for caring so much abut the individual person. I am also grateful that you took the time to help us separate out how we view ourselves in relation to our understanding of God’s love for us verses our symptoms of major depression; neither of us had realized or thought about that. That was incredibly insightful of you and so thoughtful of you to help us get to the root of it. Thank you for helping so many people. I can tell, that you and your team do a lot of good with very sincere hearts. It shines through unmistakably.

Drug free solutions for optimized brain function

We focus on delivering real solutions for our patients. We know that patients can have real life-changing results through applying TMS.

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