Approximately one in 10 adults in the U.S. have experienced depression in the past 12 months, and according to the National Institutes of Health, the most common mental health concern in the United States is major depression. In addition, around 19% of adults have been diagnosed with an anxiety disorder.

Many people experience symptoms of both depression and anxiety at the same time. Sometimes, this can result in a condition known as anxious depression. Treatment for anxious depression may include a variety of traditional therapies, including medication, cognitive behavioral therapy, and trauma therapy.

An innovative treatment known as deep transcranial magnetic stimulation (Deep TMS) offers new hope to those who aren’t experiencing symptom improvement with traditional therapies alone.

Understanding Anxious Depression

Anxiety and depression are closely linked. Both conditions are associated with distress and a person’s coping mechanisms. People who are depressed are more likely to experience sadness when faced with distress, while others may experience extreme forms of anxiety as a result of stress.

A large number of people are living with symptoms of both depression and anxiety. According to the National Institutes of Health, between 60-90% of depression patients also have anxiety.

Anxious depression is not the same as having both major depressive disorder (MDD) and an anxiety disorder at the same time. Anxious depression is a separate diagnosis that refers to people who have been diagnosed with major depressive disorder and also suffer some anxiety symptoms.

The condition is also referred to as MDD with “anxious distress” specifiers. To be diagnosed with anxious depression, an individual must meet the criteria for MDD and experience at least two of these anxiety specifiers:

  • Restlessness
  • Fear of losing control
  • Excessive worry
  • Problems concentrating
  • Physical tension in the muscles
  • Fear that bad things are going to happen

Neurobiology confirms that anxious depression is different from previously known types of depressive disorders. Studies on brain activity show more asymmetrical activity among those with anxious depression. Specifically, there is poorer function in the part of the brain associated with anxiety.

What Causes Anxious Depression?

Several factors contribute to the development of mental health concerns, including anxious depression. A combination of genetics, life experiences, and personality traits are thought to be responsible for the disorder.

High levels of stress may exacerbate symptoms. Divorce, the loss of a loved one, or a major life change is challenging for anyone to deal with. People who are already struggling with MDD may be even more impacted, which can lead to anxious distress.

People who are naturally more negative or introverted are also at a higher risk for anxious depression. A lack of healthy coping mechanisms — such as talking to supportive friends — may also worsen feelings of anxious distress.

Treatments for Anxious Depression

People living with anxious depression have treatment options. Typically, a mental health professional will develop a treatment plan after a full health evaluation has been made.

Some physical conditions can cause symptoms associated with depression and anxiety, so it’s important to rule out any physical health problems before seeking mental health treatment.

Treatment plans may include one or more evidence-based therapies.

Psychotherapy

Talk therapy has been found to be effective for the treatment of anxious depression, especially a branch of talk therapy known as cognitive behavioral therapy (CBT).

CBT helps clients learn new, more productive ways of thinking and acting. Forms of trauma therapy, problem-solving therapy, and interpersonal therapy will likely be included in the treatment plan, depending on the individual’s needs.

Psychopharmacology

Medications play an important role in the treatment of anxious depression, but finding the right combination of medicines can be difficult. It can take months to find an effective medication or combination of medications that alleviates symptoms.

Even when medications help, they can cause unpleasant side effects. Many people stop taking medication because of the unwanted side effects.

Lifestyle Changes

Practicing better stress-reduction habits won’t cure anxious depression or any type of mental health disorder, but incorporating healthy new habits into your schedule can be helpful.

Eating a healthy diet, meditating, improving sleep habits, and getting treatment for substance use disorders are some of the most commonly suggested lifestyle changes.

Deep Transcranial Magnetic Stimulation

Deep TMS is still unfamiliar to many people. It is an FDA-cleared treatment that uses magnetic coils to treat specific areas and improve brain health. The coils are housed inside a comfortable helmet that the client wears to receive treatment.

These coils deliver a magnetic pulse to stimulate neural structures within the brain that are associated with anxious depression.

Deep TMS is non-invasive and does not require anesthesia or a lengthy recovery time. It may be used in conjunction with other therapies or as a stand-alone treatment for anxious depression that isn’t responding to conventional therapies.

10 Benefits of Deep TMS

Transcranial magnetic stimulation was first developed in 1985 as a tool to enhance the brain’s natural electrical activity. Brain cells and neurons depend on minute electrical charges to send information to the brain and the rest of the body. TMS targets the parts of the brain that influence pleasure, emotions, and decision-making.

Since its invention, TMS has been used to treat many different mental and physical health conditions, including:

  • Parkinson’s disease
  • Chronic pain
  • Alzheimer’s disease
  • Bipolar disorder
  • Addiction
  • Post-traumatic stress disorder
  • Depression
  • Anxiety
  • Stroke complications
  • Traumatic brain injury

Deep TMS uses magnetic coils that can deliver electrical current deep into the skull and cerebrospinal fluid, where it can more effectively stimulate brain neurons. The magnetic field generated by a conventional TMS device provides more shallow penetration.

Deep TMS was FDA-approved to treat anxious depression in 2021. Specifically, the treatment works by stimulating the dorsolateral prefrontal cortex, which is associated with anxiety and depression.

This list includes some of the most important benefits offered by Deep TMS for people living with anxious depression.

1. Non-Invasive and Painless

Receiving a Deep TMS treatment is fast, simple, and painless. A client sits in a comfortable chair while a trained healthcare provider puts a helmet-like device on their head. The exact pulsation pattern will be mapped out before the appointment and based on information gathered during consultation.

Clients can hear a tapping noise or feel a tapping sensation during the treatment, which lasts about 20 minutes. They are free to read or relax during that time. Because there is no anesthesia or recovery time required, you can drive yourself to and from the appointment and return to normal activities after the treatment is complete.

2. Fast Results

While they are helpful, medications and talk therapy can take many months to provide symptom relief from anxious depression. Results from Deep TMS may be noticeable in as little as one to two weeks after the first treatment. The best results are realized approximately four weeks into a treatment regimen.

Sessions are typically spread out over a two- to three-month period with five appointments per week.

Another advantage of Deep TMS is that, unlike other therapies, the results of transcranial magnetic stimulation can be measured. A tool called the TMS-iEEG can provide hard data on how the brain is responding to TMS treatments.

3. Reliable Results

Relapse rates for the return of symptoms are approximately the same as they are for other therapies, including medication and psychotherapy. It is natural for depression symptoms to come and go as life stressors occur. Maintenance therapy sessions could reduce the chance of relapse.

TMS has been found to reduce depression symptoms in 50-60% of people who try this treatment, according to Harvard Health Publishing.

4. Most Healthy People Qualify

Most people in generally good health are good candidates for Deep TMS. People with seizure conditions and those with an implanted electronic device, such as a pacemaker, may not qualify. Those who are pregnant and nursing cannot undergo Deep TMS.

If you have not yet tried antidepressant medication, your healthcare provider will likely suggest trying medications before scheduling Deep TMS treatments.

5. Deep TMS Is An Evidence-Based Clinical Treatment

Deep TMS is medical care. It can only be performed safely in a clinical setting by licensed practitioners. As an FDA-cleared treatment, it has been tested for safety and efficacy. There are few side effects associated with TMS, especially when compared to psychopharmacology treatments.

6. Multiple Symptom Relief

People living with anxious depression may also be experiencing physical pain or additional mental health concerns such as post-traumatic stress disorder. Deep TMS addresses many related symptoms with the same treatment.

If you are also struggling with headaches or chronic pain or you are seeking recovery from an addiction disorder, Deep TMS may help manage those symptoms as well.

7. No Age Limit

Some anti-depression medications increase the risk of suicidal thoughts and can cause other unwanted side effects, especially in younger people. There is no age limit for receiving Deep TMS. It can be safely used to help teens or the elderly combat anxious depression without the dangers associated with some medications.

8. May Be Covered by Insurance

Each client’s coverage is different, but if deep TMS has been recommended by your primary healthcare provider, the cost of treatment may be covered by your health insurance. You can easily check insurance verification on a provider’s website or speak with a helpful customer service representative about verification.

9. Deep TMS Does Not Interfere With Other Treatments

Deep TMS is a complementary treatment for anxious depression that does not require you to stop taking prescribed medications or halt any type of non-invasive depression treatment. Additionally, Deep TMS may enhance the effectiveness of other treatments and encourage clients to make more positive lifestyle changes.

10. Deep TMS Saves Lives

Depression is a key factor in suicide and increases the risk for all types of self-harming behavior, especially when it is untreated. Including deep transcranial magnetic stimulation in your mental health treatment plan can relieve the feelings of hopelessness and sadness that often lead to suicidal ideation.

Should You Consider Deep TMS for the Treatment of Anxious Depression?

Anxious depression is a unique type of major depressive disorder. Sufferers experience the common symptoms of depression, including feelings of helplessness, self-isolation, and loss of interest in favorite activities, while also experiencing specific symptoms of anxiety such as excessive worry.

Traditional treatment for anxious depression includes forms of talk therapy, medications, and lifestyle changes.

Deep TMS is a non-invasive, drug-free approach to treating mental health disorders. It is safe for most people and can be used to treat anxious depression in adults, no matter their age. Deep TMS has been scientifically tested and found to be effective in relieving the symptoms of anxious depression and other health issues.

Deep TMS at Plus by APN

At Plus by APN, we use Deep TMS as one of our innovative treatment options to help those struggling with depression. To get started with treatment at Plus by APN, fill out our confidential online contact form or call us at 424.644.6486 today.

References

  • “Anxious Depression: Symptoms and Treatments.” BrainsWay, 25 Jan. 2022, www.brainsway.com/knowledge-center/anxious-depression-understanding-symptoms-and-treatment/.
  • Brown, Jennifer. “Researchers Develop New Tool to Study How TMS Affects the Brain | Carver College of Medicine.” Uiowa.edu, 2024, medicine.uiowa.edu/content/researchers-develop-new-tool-study-how-tms-affects-brain. Accessed 3 Nov. 2024.
  • Kessler RC, Nelson CB, McGonagle KA, Liu J, Swartz M, Blazer DG. Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. Br J Psychiatry Suppl. 1996 Jun;(30):17-30. PMID: 8864145.
  • National Institute of Mental Health. “Any Anxiety Disorder.” Www.nimh.nih.gov, National Institute of Mental Health, 2024, www.nimh.nih.gov/health/statistics/any-anxiety-disorder.
  • Orsolini, Laura et al. “Understanding the Complex of Suicide in Depression: from Research to Clinics.” Psychiatry investigation vol. 17,3 (2020): 207-221. doi:10.30773/pi.2019.0171
  • Stern, Adam P. “Transcranial Magnetic Stimulation (TMS): Hope for Stubborn Depression – Harvard Health Blog.” Harvard Health Blog, 27 Oct. 2020, www.health.harvard.edu/blog/transcranial-magnetic-stimulation-for-depression-2018022313335.