Nashville TMS- Offering effective new treatment for depression

“Seven months ago I was so depressed I wasn’t able to function. After six weeks of NeuroStar TMS Therapy, I was back to work; feeling great; I was enjoying my kids again and I had my life back.” -Craig, 38 years old

TMS (Transcranial Magnetic Stimulation) therapy is a new therapy that involves no drugs and has been proven safe and effective. TMS is free of the negative side effects often associated with taking antidepressants.

Care for Yourself While Caring for an Aging Parent

The Oxygen Mask Metaphor

Caring for the CaregiverOne of my favorite sayings is; “Put the oxygen mask on yourself first, THEN assist your child”. It makes sense in the event of an airplane emergency, and it makes sense in just about every situation in life, in which YOU are the caregiver! If your reserves are empty, then you have nothing to give. This isn’t a criticism, it’s wise and helpful guidance.

If you find yourself in the situation of caring for your aging parent (or in-law), one of the most important things you can do is to actively plan ways to take good care of yourself. As a caregiver, maintaining a very stable and healthy condition yourself is vital to your overall effectiveness and happiness!


Caring for the Caregiver – Do You Have Time?

Caring for an aging parent can be at least a fulltime, daunting task. It may take so much time and effort that you forget to even think about what makes YOU happy. Sometimes you feel sad, resentful, discouraged, lonely, frustrated, confused or even angry. Caregivers often ‘stuff’ these feelings, especially anger. In general, they often don’t allow themselves the emotional release they desperately need, and become overridden with a big burden of guilt for even feeling these things, which they interpret as negative. But they are NOT negative. They’re just the result of the situation.

Let’s try a new technique to turn your beliefs about these feeling around. It could be the first step in putting the oxygen mask on yourself first! For example, start with your feelings of loneliness. Because you spend so much time caring for your loved one, you miss the lunches, golf or shopping trips that used to be such a delight. You may recognize that you feel lonely, but also helpless to do anything about it. Now, re-think these feelings of loneliness, and figure out how you can schedule some time – try once a week - to connect with others, perhaps in new ways. Instead of going out to lunch, you could invite someone over while your aging patient sleeps. Or, ask a friend or relative for respite from caregiving for four hours, while you go out to lunch.

The crucial thing here is to change the way you view the issue, and make time for your basic needs – the oxygen mask.


Caring for the Caregiver – Tips for Caregivers

Taking care of yourself can take many forms - anything from saying kind and loving things to yourself - to joining a caregiver’s club online. These online caregivers’ communities are springing up and are easy to find by search. I did a quick Google search using the terms:

  • elderly caregivers forum 2015

  • elderly caregivers support group

The search returned websites related to reputable and helpful organizations such as AARP, and Try it. You’ll find a plethora of resources available 24/7 – when you need them most. If you don’t see a topic which is bothering you the most at that moment, just type in your question or need, and submit it for others to respond. You just may make a new, supportive friend.

These caregiver communities can really make a difference. It’s great to know that someone else actually understands what you’re going through. And you’ll find others who have more complicated situations than your own. This is a sure way to feel grateful – quite a relief from your previous anger!


More Ways to Start Caring for Yourself

Quick highlights of some other ways you can start caring for yourself while caring for aging parents:

  1. Spend time with friends – Quality time with friends actually helps to focus on happy things – rather than negative thoughts and feelings. By changing your environment for some time, you could come back refreshed and ready to care again.

  2. Get exercise - as much as you can – Exercising yourself helps to reduce stress and free your mind. It keeps you active and alert. Try a stationary bike, or a mini-trampoline for the living room!

  3. Eat healthy food – Eating good and nutritious food will help energize your body and your brain, and reduce your risk of getting sick. As a caregiver, every part of your body is working at all times. Sometimes you hardly have time to rest. Your body needs to be well nourished and energized in order for you to perform optimally. Think about choosing to drop the sugar!

  4. Ask for help – In order for you to take time for your needs, you might ask a friend or a family member to come and help you, perhaps for just a couple of hours the first time. Don’t be hesitant to ask for help. You don’t have to do everything by yourself.

  5. Try to be balanced spiritually – Being spiritually balanced can help you to cope better as a caregiver and attain a higher sense of balance and inner peace. Meditation has helped millions.

  6. See your doctor regularly – It is also imperative for you to see your doctor for checkups. Your aging patient isn’t the only one who needs professional medical care!

Taking at least a few of these actions can start to bring you relief and also keep you from getting ill or depressed. If you suspect that you are depressed, try’s online depression screening tool to give you an indication.  Then print it out and seek the help of a professional, preferably a psychiatrist who specializes in the many ways available to treat depression.

Hear what Nashville TMS patients have to say about their depression treatment experiences and outcomes!

About Nashville TMS:
In April of 2010, Dr. West brought the technology of NeuroStar TMS to Nashville, becoming the first physician in Tennessee to offer the option of Transcranial Magnetic Stimulation for patients whose severe depression has not responded to a course of antidepressant medication. The Nashville TMS Team has treated patients from Tennessee, Kentucky, Colorado, California, Missouri, New York, and Alabama.

Written by: Lisa Chapman

Older Adults – Coping With Depression

Older Adults Often Deal with Depression

How Does Depression Affect Older Adults?

As our population ages, researchers seem to generally agree on one fundamental assumption; in the coming years, the signs and symptoms of depression will increase significantly in the older adult population. And their depression will likely touch the lives of the vast majority of families in the U.S.

Not surprisingly, many older people suffer from depression silently, thinking that it is actually something else entirely.

What is the cause of their suffering in silence? When queried, depressed older adults revealed that feeling sad, loss of interest in pleasurable activities, constant fatigue and decreased energy are all a part of the normal process of aging. But it doesn’t have to be this way!


Older Adults and Depression

Especially in the older adult population, the risk of clinical depression is higher because depression is more common in people who also have other illnesses (such as heart disease or cancer). Statistics have shown that 80% of older adults have at least one chronic health condition, and 50% have two or more.

Additionally, even professional healthcare providers often mistake an older adult’s depression symptoms for just a natural reaction to illness or aging, and therefore may not see the depression as a serious clinical diagnosis, to be treated immediately.

Based on these observations and statistics, it is especially important for older adults themselves to be aware of how they feel and to be alert to the symptoms of depression, so that they can seek proper medical attention and get adequate treatment. Instead of ignoring the symptoms, they can reach out to family and friends to talk about these things in order to get feedback and support.  Our older adults need not shoulder all this responsibility themselves. We all need help at one time or another, especially with such important issues in which we lack experience.


Clinical Depression is a Complex Disease

As researchers continue to study the relationship between major depression and complicated grief, we should also note that a complicated and/or intense grief that seems to last longer than usual is also a sign that treatment may be appropriate.

Older adults have a higher risk of depression because apart from the fact that they may have other illnesses, they also may be taking medications with side effects that contribute to depression.

Vascular depression, as doctors call it, also known as arteriosclerotic depression, is a complication that can result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood flow to the body’s organs, including the brain. Older adults with this kind of depression may have, or be at risk for, co-existing heart disease or stroke.

From this we can certainly recommend that potentially depressed older adults make an appointment to get a physician’s assessment on a regular basis.


Depression treatment

Older adults with clinical depression, when treated with an antidepressant, psychotherapy, or a combination of both, can sometimes show noticeable improvement. Psychotherapy alone has been known to be effective in helping older adults stay depression free, especially those with minor depression.

However, as many as two-thirds of people with depression aren't helped by the first antidepressant they try. And up to a third don't respond to several attempts at treatment. When antidepressant medication fails to provide relief and the condition becomes chronic, it may be classified as “treatment resistant”.


Treatment-Resistant Depression

Research suggests that 60%-65% of antidepressants are prescribed by primary care physicians. Although a primary care doctor can treat depression, it may be best to see a specialist, like a psychiatrist, if you think you may have treatment-resistant depression.

Psychiatrists are often quite experienced with alternatives to antidepressant medications. Transcranial Magnetic Stimulation, or TMS, has proven to be a rising star with proven effectiveness and long term success rates for treatment resistant depression. You’ll find more information on TMS at Hear what Nashville TMS patients have to say about their depression treatment experiences and outcomes!



About Nashville TMS:

In April of 2010, Dr. West brought the technology of NeuroStar TMS to Nashville, becoming the first physician in Tennessee to offer the option of Transcranial Magnetic Stimulation for patients whose severe depression has not responded to a course of antidepressant medication. The Nashville TMS Team has treated patients from Tennessee, Kentucky, Colorado, California, Missouri, New York, and Alabama.


Written by: Lisa Chapman

What You Need to Know About Depression and the New Types of Brain Stimulation Therapies

The brain is affected by depression

Background on Depression

By now you’ve probably heard the estimate that one of every five people in the United States has experienced clinical depression sometime in their life.

Stop and think about how many people you know. How many are in your email contacts, or Facebook friends? Neighborhood Association? Hobby group? How many school mates have you met over your years in school? Depression can be passed down in families. How many co-workers, associates and colleagues have you met in your career?

One in every five – that’s 20% of all those people. Together, all these likely total thousands. I’d venture to say that you know hundreds of people who have been touched by depression. Perhaps you’ve had the experience yourself.

Depression is an illness that involves the functioning of the brain. The chemistry in your brain, or environmental factors such as stress, may also cause depression.

Depression is different from feeling sad or feeling down just every now and then. People with depression feel deeply sad, may lack the energy to even move, feel bone-tired, or are unable to enjoy activities just about every day.


Other Symptoms Of Depression Can Include:

  • Changes in your sleeping habits, such as sleeping poorly or sleeping more than usual

  • Less interest in activities you usually enjoy

  • Not eating as much, or eating more; whether or not you are hungry

  • Strong feelings of despair

  • Feeling worthless or hopeless

  • Finding it hard to think or concentrate

  • Feeling overly guilty or guilty for no reason

  • Serious thoughts of suicide

Depression Is A Serious But Treatable Problem That Should Not Be Ignored.

There are many treatment options for people with depression. The information in this article is right for you if:

  • Your doctor* said you have Major Depressive Disorder (MDD) - a kind of clinical depression that lasts longer than 2 weeks.

  • You have taken at least one antidepressant medicine for four to six weeks, and your depression has not improved.

  • You want to know about other options to treat depression, and then talk with your doctor.

Depression in the Elderly can be Successfully TreatedOptions to Treat Depression

This article will offer you options to treat your depression if your antidepressant medication did not work or did not work well enough. There are many options that work to treat depression. But no one knows exactly which option might be best after a medication did not work, or did not work well enough. The information in this article can help you talk with your doctor about which treatment to try next.


What Treatments Are Available When An Antidepressant Medication Does Not Work Well?

There are many options a doctor may suggest for people whose depression symptoms do not improve enough from their current antidepressant treatment. Physicians may consider that you try:

  • Increasing the dose (amount) of the antidepressant you take, or

  • Switching to a different antidepressant, or

  • Adding an antipsychotic medicine to your antidepressant, such as:

    • aripiprazole (Abilify®),

    • olanzapine (Zyprexa®), or

    • quetiapine XR (Seroquel XR®).

Antipsychotic drugs — which are now commonly prescribed as an add-on therapy for the treatment of depression — offer few benefits and risk significant side effects, according to a new study. Antipsychotic medicines work by affecting the way certain chemicals act in your brain. Taking an antipsychotic medicine does not mean you have psychosis.

Only one-third of patients with depression responds to antidepressant medications — one of the main reasons that physicians are prescribing additional antipsychotics. In fact, the practice of using antipsychotics as an adjunct therapy has nearly doubled from the mid-1990s to the late 2000s.


What Are The Possible Side Effects Of Antidepressant And Antipsychotic Treatments?

The FDA lists the following possible side effects for antidepressant and antipsychotic medicines. Not everyone who takes one of these medicines will have side effects. And many of these side effects could be temporary. Your doctor can suggest ways to lessen these or other side effects.

Antidepressant Medications may cause:

  • Headaches

  • Dry mouth

  • Dizziness or light-headedness

  • Sexual problems

  • Anxiety

  • Feelings of dullness or lack of sensation

  • Weight gain

  • Sleep problems

  • Feeling tired or having low energy

  • Upset stomach

  • Thinking about or attempting suicide

Antipsychotic Medications may cause:

  • Weight gain

  • High cholesterol or diabetes, which could be caused by weight gain

  • Uncontrollable movements, such as tics and tremors

  • Low blood pressure

  • Difficulty swallowing

  • Seizures

  • Drowsiness

  • Dizziness

  • Headaches

  • Dry mouth

  • Constipation

  • An increased amount of a hormone in the body called prolactin, which can cause problems with sexual function and enlarged breasts in both men and women

Non-Pharmaceutical Treatments

With all the unpredictable and worrisome side effects of these medications, it is a good idea for patients to seriously consider non-pharmaceutical treatments for Major Depressive Disorder, such as:

  1. Talk Therapy

  2. Exercise

  3. Brain Stimulation Therapies

Talk Therapy:

In this type of therapy, a trained clinical therapist talks with you about how you think and feel about your depression. You might talk about specific symptoms or life events, ways to cope, or ways to address problems. Sometimes a therapist facilitates talk therapy with a group of people (called “group therapy”).

To illustrate the positive effects, in one German study, researchers took MRI scans of depressed people’s brains before and after a year of Freudian psychotherapy. In the earlier scans, the depressed group showed increased prefrontal cortex activity, meaning they had higher levels of self-focus and emotional processing. After a year of talk therapy, the depressed brain patterns changed - with the limbic activity going back to normal, and other parts of the brain associated with depression calmed down. Similar results have not been observed with medication.


Good exercises include those that get your heart rate up or strengthen or stretch your muscles, such as yoga. Regular exercise probably helps ease depression in a number of ways, which may include:

  • Releasing feel-good brain chemicals that may ease depression (neurotransmitters, endorphins and endocannabinoids)

  • Reducing immune system chemicals that can worsen depression

  • Increasing body temperature, which may have calming effects  

Brain Stimulation Therapies:

Brain stimulation therapies involve activating or touching the brain directly; with electricity, magnets, or implants. Different types of Brain Stimulation Therapies include:

  1. ECT - Electro Convulsive Therapy

  2. VNS - Vagus Nerve Stimulation

  3. MST - Magnetic Seizure Therapy

  4. TMS - Transcranial Magnetic Stimulation

ECT: How Does It Work?

Before ECT is administered, a person is sedated with general anesthesia and given a medication called a muscle relaxant to prevent movement during the procedure. An anesthesiologist monitors breathing, heart rate and blood pressure during the entire procedure, which is conducted by a trained physician. Electrodes are placed at precise locations on the head. Through the electrodes, an electric current passes through the brain, causing a seizure that lasts generally less than one minute.

Despite its effectiveness, the use of ECT is widely believed to be limited by its side effects, especially the development of cognitive deficits and, in particular, memory impairment.

VNS: How Does It Work?

Vagus nerve stimulation (VNS) works through a device implanted under the skin that sends electrical pulses through the left vagus nerve, half of a prominent pair of nerves that run from the brainstem through the neck and down to each side of the chest and abdomen. The vagus nerves carry messages from the brain to the body's major organs; like the heart, lungs and intestines, and to areas of the brain that control mood, sleep, and other functions.

VNS is not without risk. There may be complications such as infection from the implant surgery, or the device may come loose, move around or malfunction, which may require additional surgery to correct. Long-term side effects are unknown.

Other potential side effects include:

  • Voice changes or hoarseness

  • Cough or sore throat, difficulty swallowing

  • Neck pain, discomfort or tingling in the area where the device is implanted

  • Breathing problems, especially during exercise

Despite FDA approval in 2005, VNS remains a controversial treatment for depression because results of studies testing its effectiveness in treating major depression have been mixed.

TMS uses magnetic coils much like MRI technology

TMS: How Does It Work?

Transcranial Magnetic Stimulation (TMS) uses a magnet instead of an electrical current to activate the brain. First developed in 1985, TMS has been studied as a possible treatment for depression, psychosis and other disorders since the mid-1990's.

Unlike ECT, in which electrical stimulation is more generalized, TMS can be targeted to a specific site in the brain. Scientists believe that focusing on a specific spot in the brain reduces the chance for the type of side effects that are associated with ECT.

A typical TMS session lasts about 30 minutes and does not require anesthesia. An electromagnetic coil is held against the forehead near an area of the brain that is thought to be involved in mood regulation. Then, short electromagnetic pulses are administered through the coil. The magnetic pulse easily passes through the skull, and causes small electrical currents that stimulate nerve cells in the targeted brain region. And because this type of pulse generally does not reach further than two inches into the brain, scientists can select which parts of the brain will be affected and which will not.

MST: How Does it Work?

Magnetic Seizure Therapy (MST) borrows certain aspects from both ECT and TMS. Like TMS, it uses a magnetic pulse instead of electricity to stimulate a precise target in the brain. However, unlike TMS, MST aims to induce a seizure like ECT. So the pulse is given at a higher frequency than that used in TMS. Therefore, like ECT, the patient must be anesthetized and given a muscle relaxant to prevent movement.

MST is currently in the early stages of testing and its effect on treatment-resistant depression is not yet established. Studies are underway to determine its antidepressant effects.


What Research Is Underway On Other Brain Stimulation Therapies?

Brain Stimulation Therapies hold promise for treating certain mental disorders that do not respond to more conventional treatments. Therefore, they are of high interest and are the subject of many studies.

Researchers continue to look for ways to reduce the side effects of ECT while retaining the benefits. A recently published study on TMS has proven the efficacy (effectiveness) and durability (long term success) across many patients’ actual clinical treatments at many different clinics around the world over an approximate two year period.

Other researchers are studying how the brain responds to VNS by using imaging techniques such as PET scans. Finally, although DBS as a depression treatment is still very new, researchers are beginning to conduct studies to determine its effectiveness and safety in treating depression, OCD and other mental disorders.



After treating 220+ patients with over 5500 TMS treatments, Nashville TMS provides Transcranial Magnetic Stimulation as a method of Brain Stimulation Therapy, that has proven to produce results that successfully overcome patients’ debilitating Major Depressive Disorder - with little to no side effects of other recent therapies.  For more information about Dr. Scott West and Nashville TMS, see the links below.


About Nashville TMS:

In April of 2010, Dr. West brought the technology of NeuroStar TMS to Nashville, becoming the first physician in Tennessee to offer the option of Transcranial Magnetic Stimulation for patients whose severe depression has not responded to a course of antidepressant medication. The Nashville TMS Team has treated patients from Tennessee, Kentucky, Colorado, California, Missouri, New York, and Alabama.

Hear what Nashville TMS patients have to say about their depression treatment experiences and outcomes!

Written by: Lisa Chapman
Do you know someone who suffers?

‘Normal’ Depression vs ‘Clinical’ Depression. What’s the difference? Download and share this article.

Nashville TMS Patients Tell Their Stories

Watch these patients discuss their TMS treatment experiences and outcomes.

About Scott West, MD

Dr. Scott West has dedicated his professional career to helping people overcome clinical depression. He has practiced psychiatry in Nashville Tennessee since 1986, when he finished his residency in psychiatry at Vanderbilt University Medical Center.

Prior to that, he graduated Magna Cum Laude from the University of Tennessee, Knoxville and received his medical degree from the University of Tennessee Medical Center in Memphis. He is a Diplomate of The American Board of Psychiatry and Neurology in the specialty of Psychiatry and a Distinguished Fellow of the American Psychiatric Association.

More about Scott West, MD