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Depression affects about 6% of the Dutch population. This comes down to 750.000 Dutch people suffering that suffer from Depression!
There are many methods that can be used for treatment of depression, such as medication (such as Seroxat, Prozac or Efexor), psychotherapy, cognitive behaviour therapy and rTMS or TMS. rTMS is a new evidence-based treatment method with proven efficacy for the treatment of Depression, even for patients that do not respond well to medication (so called treatment resistant Depression). rTMS has also shown similar efficacy as Electroconvulsive therapy or ECT, but without the side effects and the need for hospitalization. Furthermore, rTMS can also be a good add-on therapy for clients wishing to get rid of their antidepressant medication and to prevent relapse.
What is rTMS - magnetic brain stimulation?
rTMS (repetitive Transcranial Magnetic Stimulation) uses a pulsating magnetic field through which specific parts of the brain can be excited or inhibited with the goal to increase or decrease metabolisation in that area of the brain. Here you can read more about the efficacy and the rationale for rTMS in the treatment of Depression. Our scientific results with rTMS treatment demonstrate that within 20 sessions 75% of the clients show full remission of their depression (no longer depressed) and that clients show an almost 80% reduction of their depressive symptomatology. Under client experiences you can also read some of the personal experiences of some clients together with their individual results, however this is only available in Dutch.
Through the repetitive pulses of rTMS, the neurons in the brain are excited or inhibited. This technique enables one to normalize deviant brain activity associated with complaints such as Depression. In our practice we combine rTMS treatment with psychotherapy, in order to achieve long-term effects of the therapy. The rTMS has a strong antidepressant effect, but using rTMS alone the chances for relapse in 6-8 months are still high (which can be resolved by giving some 5-10 booster sessions), whereas the psychotherapy should mediate the long-term effect. This therapy is always carried out by a multidisciplinary team of experts such as a Biological Psychologist, a licensed Psychologist and an rTMS specialist.
October 2008 the American FDA officially approved the first device for rTMS in treatment ressistent depression. Furthermore, the Dutch Health Council published a positive advice on the use of rTMS therapy for Depression. Therefore, rTMS for Depression can be regarded as an evidence-based treatment.
Is this treatment reimbursed by health care insurance?
The treatment is carried out under supervision of a licensed psychologist (GZ-psycholoog, Klinisch Psycholoog BIG, Psycholoog NIP). Therefore, depending on the insurance company the therapy might be reimbursed as psychotherapy or psychological treatment. It is advisable to check with your insurance company first if psychological care with these registrations is covered.
Under rTMS treatment in practice you can also view a demo video to see how rTMS works in practice.
If you have any more questions or are interested in this therapy, don't hesitate to contact us using the Contact page or call +31(0)24-7503505. For price information also see our overview of prices.
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Depression: Background information
"You just don't know what to do with your life, you are tired, you feel sad and everything is too big of an effort"
Everybody recognises these symptoms, you feel down. Often these complaints are brief in comparison to Depression. Different factors can contribute to a depressive episode.
Research has shown that for example too much, or too little, of certain chemical substances in the brain can have an influence on depressive feelings. Negative patterns in your mind, emotional trauma's in the past and side-effects of medication can also play a role. For an extended overview of depression and the different biological causes, please visit the depression section of the personalized medicine section on our website.
What does depression exactly mean, because not every depressed, sad or unhappy mood is a psychological disorder.
Depression is not just a bad mood that you can easily get rid of. It does have something to do with personal vulnerability. It is a serious psychological disorder which people of all ages can suffer from. Research has shown that 1 on 33 children and 1 on 8 adults suffer from depression. Depression can lead to impaired performance at work, social isolation and it makes relationships with friends and family more difficult.
Major Depressive Disorder is a mood disorder that can be characterized by a loss of excitement in life or a down mood. When a depression is not being treated in the right way, it can worsen over time and even lead to a life threatening situation.
For more information about rTMS therapy in depression, please visit 'What can rTMS do for depression'
Major Depressive Disorder has to meet a few criteria, for instance the criteria that can be found in the DSM-IV, the diagnostic manual for psychological disorders.
Symptoms depression:
Psychological symptoms
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depressive mood: down, sad, miserable, gloomy, depressed; the depressed mood is sometimes worse in the morning (variation over the day)
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anergy: tiredness, loss of energy, initiative and strength
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feeling: a feeling that is reported often by people suffering from depression, is anxiety. You can sometimes speak of severe flattening of affect: you don't feel anything, no joy, sadness or happiness.
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formal cognitive disorders (in ways of thinking): problems in concentration and memory, difficulty in decision making.
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thoughts about guilt, selfblame, feeling worthless and a lost selfrespect
Behavioural symptoms
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social withdrawal, loss of interest in the environment
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anhedonia: losing the ability to experience fun
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psychomotor agitatation: restless or even inhibited behaviour
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decreased productivity
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suïcidal
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crying
Functional symptoms (vital or biological functions)
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eating disorders: decreased (mostly) or increased appetite
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sleeping disorders: difficulty falling asleep, early awakenings, or an urge to sleep all the time
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sexual disorders: loss of libido
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physical complaints: obstipation (mostly) or diarea
Psychotic symptoms
About 10 to 15% of the people that are suffering from depression, also experience symptoms of psychotic behaviour. There is a disturbed awareness of reality. A psychotic depression in which the person experiences moments of delusional or paranoid being. Often the content of the delusion is comparable to the theme's in the depressed mood: the theme's are often about personal shortcomings, failure, guilt, death, punishment or a feeling of not being worthy. This kind of psychotic depression used to be called melancholic.
There are different kinds of Depression. An Unipolar Depression is characterized by a depressed feeling over a longer period of time. A Bipolar Depression is defined as various periods in which a person can feel depressed or times that he or she feels very energetic, cheerful, but also restless. When someone experiences this, we speak of a manic episode. Bipolar depression can also be called a manic-depression.
Recent research has shown that depression relates to some kind of disturbed pattern in the brain activity. It is described in the literature that certain asymmetry is important between the two hemispheres. Usually, the left hemisphere is more active, which is characterized by a fast electrical activity in the EEG. When there is more beta activity (15-30 Hz) in the right hemisphere and less alpha-activity (8-12 Hz) in the left hemisphere, you often experience depressed feelings. Elevated alpha-activity in the right frontal lobe can construe depression combined with anxiety and/or agitation.
Facts:
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Depression affects about 121 million people in the world. In The Netherlands this is about 6% of the population with a depression or has recently experienced one. One on seven people in The Netherlands ever has to deal with a depression.
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It is the number two cause of death after heart diseases and it is shown that depression contributes big part to coronial disease.
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About twice as many females as males report or receive treatment for clinical depression. This difference is mainly seen in the age of 25-45 years.
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Less than 30% of the people with a depression experiences a decrease in complaints by taking anti depressants, like Seroxat (Paroxetine), Efexor (Venlafaxine), Cipramil (Citalopram), Remeron (Mirtazapine) or Doxepine.
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Depression causes more absence than any other disorder and it costs employers a lot of money because of loss in production.
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It is the number 4 contribution to the global disease burden.
Depression: Causes
It is very difficult to name only one cause for depression, it is more a combination of different factors.
Biochemical factors
Research has shown that there is a disturbance in the balance of certain substances in the brain (like serotonin and noradrenaline). But there is research that has shown that this is more complex than just a decreased level of serotonin.
Light
A specific kind of depression that is related to shortening of the days, Seasonal Affective Disorder, is mostly caused by a shortage of light. An effective way to prevent this from occurring is light therapy, which can also be a very good addition to rTMS treatment.
Biogenetic factors
There is a genetic component that plays a role in depression. Children of parents with a depression have a three times higher chance of developing depression themselves than children of parents without a depression..
Psychosocial factors
Radical life events, like a divorce or death, but also having a child and getting a promotion can play an important role in the occurrance of a depression. These kinds of events can invoke a lot of tension or stress, which can make you feel hopeless.
Having a social life can have a healing effect on a depression. Also a stable relationship, friends that support and help or a nice job attribute to a good structure in your life and a social support system.
Psychological factors
Supressing or avoiding difficult or painful feelings and thoughts, caused by traumatic experiences can heighten the chance of developing a depression.
Organic factors
Certain medication and different kind of drugs (a few high blood level medications, sleeping pills, alcohol, amphetamines, cocaine) are known for causing depression. There are also a few physical disorders that can increase the likelihood of getting a depression (like a stroke).
More information about rTMS for depression can be found on 'What does rTMS do for depression'
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