Treating PTSD with Transcranial Magnetic Stimulation

Treating PTSD with TMS

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. Profound depressive symptoms and significant anxiety symptoms are part of PTSD. TMS can help with these symptoms. TMS also reduces PTSD symptoms that are not related to depression.

Treating PTSD with TMS

Symptoms

Post-Traumatic Stress Disorder (PTSD) is the name we give to a complex set of reactions that can follow a severely threatening event. Both military and non-military traumas can trigger PTSD. Symptoms include flashbacks that may occur spontaneously or be triggered by an event similar to the original trauma(s). Nightmares, hypervigilance, self-isolation, emotional numbness, and depression are common. These symptoms range from mild to life-altering or life-threatening intensity. While many PTSD patients achieve some relief through conventional treatments, up to 40% do not. For those patients, life can be very difficult and the search for relief continues.

Aggression

Excessive behavior such as; agitation, irritability, hostility, and more.

Flashbacks

Feeling as if you are reliving traumatic events over and over again.

Insomia

Issues falling asleep or staying asleep for a long-period of time.

Anxiety

Inability to stop worrying or experiencing panic-attacks.

Emotional Detachment

Inability to connect with people on an emotional level.

How we are treating
depression with TMS?

Step 1

Contact us and provide your history of PTSD and any other coexisting illnesses, including your treatment history. We will interview you at no cost to see if health insurance will cover you.

Step 2

Come to our clinic for about 15 minutes, five times per week, for six weeks. The treatment itself will only take about three minutes of each 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 leads to 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

Some people find PTSD puzzling. They think [people who have experienced a trauma should “just get over it.”]Indeed, many people with PTSD believe this too and wish they could just move on without symptoms but cannot do so. The question of why some people can move on relatively unscathed after traumatic events while others develop extreme and lasting symptoms is still being researched. PTSD typically emerges after an event or events that are extremely frightening, in which the patient was either a victim or another party who had no choice but to deal with the situation or its aftermath. Traumatic events strongly trigger the fight or flight response, and a sudden, excessive release of neurotransmitters can sometimes destroy certain circuits of the brain. This may be a component of why PTSD happens. All mammals appear to have PTSD responses to these types of experiences and will, for example, shy away from any location where they have experienced an attack in the past. This is not simple learning, as the reaction includes nearly all of the symptoms of PTSD as far as observers can determine. 


Another component of a trauma that triggers PTSD is what is called moral injury. As defined by moralinjuryproject.syu.edu,Moral injury is the damage done to one’s conscience or moral compass when that person perpetrates, witnesses, or fails to prevent acts that transgress one’s own moral beliefs, values, or ethical codes of conduct.” There is some evidence that those who have experienced this specific sort of trauma, particularly but not necessarily in childhood, are more vulnerable to developing PTSD later in life. It is clear that this is not required for PTSD to develop.

PTSD affects about 3.5% of the U.S population. In Canada, the rate is about three times higher. Whether this is due to differences in diagnosis or other factors is not currently known. About 15-20% of veterans who have experienced combat develop PTSD. About the same percentage of people who experience civilian trauma also develop PTSD. Rates of PTDS following childhood sexual abuse approach 50%, and this form of trauma is particularly likely to lead to “Complex PTSD.”

For PTSD to be diagnosed, there must have been a severe trauma, and there must be relevant symptoms present. Symptoms fall into four groups. The text below is taken from the American Psychiatric Association:

  1. Intrusive symptoms: Intrusive thoughts such as repeated, involuntary memories; distressing dreams; or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes.
  2. Avoidant symptoms: Avoiding reminders of the traumatic event may include avoiding people, places, activities, objects and situations that may trigger distressing memories. People may try to avoid remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
  3. Alterations in cognition and mood: Inability to remember important aspects of the traumatic event, negative thoughts and feelings leading to ongoing and distorted beliefs about oneself or others (e.g., “I am bad,” “No one can be trusted”); distorted thoughts about the cause or consequences of the event leading to wrongly blaming self or other; ongoing fear, horror, anger, guilt or shame; much less interest in activities previously enjoyed; feeling detached or estranged from others; or being unable to experience positive emotions (a void of happiness or satisfaction).
  4. Alterations in arousal and reactivity: Arousal and reactive symptoms may include being irritable and having angry outbursts; behaving recklessly or in a self-destructive way; being overly watchful of one’s surroundings in a suspecting way; being easily startled; or having problems concentrating or sleeping.

The symptoms must be present for at least one month to qualify as PTSD. You need one from the intrusive list, one from the avoidance list, two from the cognition and mood group, and two from the arousal and reactivity group to be diagnosed. Subtypes of PTSD include acute, chronic, delayed onset, and complex (i.e., as the result of multiple ongoing traumas such as domestic violence or childhood trauma and abuse).

Dissociation is the ability to disconnect thoughts, memories, sensory experiences, and feelings from each other. At an appropriate level, dissociation is a necessary ego skill that allows us to cope in life. Common examples include daydreaming while driving down the highway, or calmly taking care of a child’s serious injury despite your worry about your child’s feelings. Most people have at least some ability to set aside their feelings and focus on a problem that needs to be solved. This is healthy and normal. Dissociation can also come in the form of losing touch with exactly who you are (called de-personalization) or with your sense that reality exists and applies to you (called derealization). 

Since we all have the ability to dissociate, it is no wonder that dissociation becomes part of how we adapt to severe traumas. Most often, trauma survivors use their dissociation skills to separate thoughts and memories from feelings. When this happens, facts of the trauma may be forgotten while the feelings of fear or anger persist. This leads to a sense of being “unmoored” or having feelings that are too intense or free of context to explain. In the reverse situation, the feelings are gone but the memory persists. People exhibiting this form of dissociation may seem eerily out of touch. When they report on their inner experience, it might sound something like, “it was just a fire in which my family died” or, “we saw a lot of action, but I was just doing my job.” The more intense dissociative experiences of depersonalization and derealization may also be present. 

It’s important to remember that dissociation is an adaptive coping mechanism, and is likely the best way the patient had available of dealing with overwhelming trauma. However, persistent dissociation will become an obstacle to living a full life, so it is necessary to address this troubling condition as part of the recovery process. 

While many centers are researching the use of TMS in PTSD treatment, military medical centers and the VA are among the most active. Walter Reed National Military Medical Center, the Naval Medical Center in San Diego, and Trippler Army Medical Center in Hawaii are leaders in the use of TMS for both active duty and retired members of the armed forces suffering from PTSD.

TMS appears to be effective for treating all aspects of PTSD.

It is no surprise that TMS can significantly help with the emotional symptoms of PTSD, particularly depression and anxiety, as TMS has already proven effective at treating these symptoms of many other psychological conditions.

There is also good evidence that TMS can help with the other three groups of PTSD symptoms — the intrusive experiences group, the avoidant symptoms group, and the arousal and reactivity group — as well as with the cognitive symptoms.

Large scale studies are ongoing. Current literature reviewing over 520 published studies reflects a high average success rate, with PTSD patients who receive TMS treatment showing about 79% more improvement on core (non-emotion-based) symptoms than those who do not receive treatment. The depressive symptoms, if present, show significant improvement in 70% of cases treated with TMS, equivalent to TMS’s success rate across all forms of depression.

For those with military health insurance or programs (Tricare and VA-treated patients), TMS treatment is becoming standard for both depression in the presence of PTSD and PTSD without depression.

For those with commercial health insurance, coverage is typically available only for FDA approved indications. This includes depression or OCD but not PTSD. However, PTSD is not an exclusion in most plans. Thus, a diagnosis of depression would qualify as “on-label” for TMS treatment, but PTSD itself is “off-label.”

We offer both “on-label” and “off-label” TMS treatments, as well as insurance-covered and non-insurance-covered treatments. We will work with you to see if we can help you obtain insurance coverage or self-pay TMS treatment. We’re also constantly following the latest research and will keep you up to date on any new medical findings relevant to your PTSD treatment options.

Mental Health 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.

Other Conditions

Depression in Adults

TMS treats depression without medication or medication side effects.

Depression in Adults

Many people suffer from depression. However, through the application of TMS they may find relief.

Post Partum
depression

Many mothers can suffer depression as a result of hormonal changes during or after pregnancy. TMS can help treat this type of depression effectively.

Post Partum
depression

TMS effectively treats depression during and after pregnancy, without the use of medication.

Depression in
Adolescents

TMS can effectively treat depression in teens.

Depression in
Adolescents

As a teen goes through difficult changes in their adolescent years, they can experience serious depression. TMS can help teens who suffer from depression.