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Medicare rebates for TMS for Depression

Recently, Medicare rebates have become available for TMS, for those with depression who have not responded to antidepressant medications or psychotherapy. Medicare rebates reduce out of pocket costs and can benefit thousands of Australians each year needing access to alternative care for treatment-resistant depression.




Treating Depression

Approximately 15% of the world’s population will suffer from depression at some point in their lifetime and, in many cases, they will not seek treatment.   According to the World Health Organization (WHO) there are around 280 million people worldwide currently afflicted with depression.  As a result of the COVID-19 pandemic, a recent study estimates a staggering  27% increase in major depressive disorder worldwide.

Some people with depression have found antidepressant medications and/or a form of ongoing psychotherapy with a trained mental health professional to be helpful.  In some cases, however, these interventions may not have worked, or the effects of the medications have not maintained over time.  Antidepressant medications can carry other unwanted side-effects such as weight gain, anxiety, loss of libido or sleeplessness.

In recent decades, outpatient neurostimulation techniques such as TMS and tDCS have come to the forefront as a way to treat depression without medications and can offer long-term sustained effects.

Often these neurostimulation treatments can be delivered in a relatively short time frame and because they target the underlying brain activity, you can experience more sustainable effects.  These therapeutics are appealing to many individuals looking for medication free relief from major depression.


What is Depression and who is affected

It is normal for people to experience fluctuations in their mood and short-term negative emotions as a response to life’s many challenges.  A diagnosis of Major Depression, however, is a serious mental health condition that requires professional treatment and care.  Depression can lead to significant reductions in quality of life and daily functioning, and at its extreme and without the right support depression can be a life-threatening illness.

People diagnosed with major depression experience saddness and a feeling of emptiness or a loss of interest for most of the day, every day, for a minimum of two weeks. They may also struggle to concentrate, feel hopeless about the future or display other symptoms, which we outline below.

Depression is rarely caused by one single factor. In most cases, it is the result of interactions between a complex combination of biological, psychological, and social factors. Adverse life events like bereavement or unemployment can also make you more likely to develop depression. Chronic physical health conditions like cancer, cardiac disease, pain, or sleep problems may lead to depression.

Women are twice as likely as men to suffer from depressive episodes, according to the National Institution of Mental Health (NIMH) and the WHO..  Rates of depression typically have a first peak between 25 and 35 years, and a second peak in late-life, however depression can affect people of all age groups.


Symptoms of Depression

Common symptoms and feelings associated with depression include:

  • Sadness and hopelessness
  • Tiredness and loss of energy, initiative, or strength
  • Feeling numb or devoid of joy, often combined with a fear of happiness
  • General feelings of fear and intimidation
  • Thoughts of worthlessness and a lack of self-respect
  • Thoughts of guilt and self-blame
  • Loss of interest in your surroundings
  • Social withdrawal
  • Loss of willingness to participate in activities
  • Physical agitation, leading as far as inhibited behaviour
  • Reduced productivity
  • Emotional episodes
  • Excessive crying
  • Suicidal thoughts and tendencies

In isolated cases, the sufferer may have an altered perspective of reality


Different diagnoses of depression

Major (unipolar) Depression

Major depression is a mood disorder characterized by a loss of life pleasure or a significantly depressed mood. When depression treatment is not undertaken in the right way, it may worsen and can be life-threatening. Major depression assessment must meet certain criteria as defined in the DSM-V, the Diagnostic Manual for Psychological Disorders.

Bipolar Depression

Bipolar depression is characterized by alternating periods in which a person experiences periods of major depression and subsequent periods of abnormally and persistently elevated mood, energy, and activity.

Other forms of Depression

Some people may experience a less severe but more persistent form of depression known as dysthymia.  In individuals with melancholic depression, symptoms are more severe in the mornings, lead to early morning awakening, and are associated with marked changes in activity levels.


Depression treatment methods

Antidepressant Medications

Medications have been available since the 1950s for the treatment of depression. They have become a mainstay treatment for moderate, severe, and chronic depression, however professional opinions on their effectiveness and side effect profile vary.

Antidepressants work by adjusting the concentration of certain chemicals in the brain associated with mood regulation.  Changes in these so-called neurotransmitters corresponds with a relieving of the symptoms of depression to help the individal feel a returned sense of emotional stability.

Like many oral medications, antidepressants can have side effects, which are often more noticeable at the beginning of the treatment. Individuals may experience headaches, dizziness, dry mouth, weight gain, loss of libido and other side effects depending on the type of antidepressant.

At neurocare we are exploring the use of QEEG, a brain mapping technique used in our clinics, to help predict which patients will respond best to certain antidepressant medications.  This may allow prescribers to better target and personalise treatment for depression.

Psychotherapy

Psychotherapy – also known as talk therapy –  can be an effective treatment for depression. Psychotherapy can be delivered by a trained Psychologist, Psychiatrist, or other Medical Doctor. In particular, cognitive-behavioural therapy (CBT) and Interpersonal Therapy have repeatedly been shown to provide lasting improvements in depressive symptoms, and there are other evidence-based forms of psychotherapy that may be recommended and tailored to you.

Psychotherapy can help you adjust to difficult circumstances, and build awareness of your thinking and behaviour.  Together with your mental health professional, you will learn to identify self-defeating behaviours and beliefs and develop alternative perspectives and coping strategies.  Psychotherapy empowers individuals to develop a healthier mindset, allowing them to regain a sense of confidence and an improved perspective or resilience to tackle everyday challenges.

Psychotherapy is based on the principle of neuroplasticity, that is: with targeted support you can harness your brain’s innate ability to learn and heal.  Combining psychotherapy with other treatment approaches can often be an effective way to boost neuroplasticity.  At neurocare we therefore often integrate psychotherapy with neurostimulation techniques like TMS.  Our combined treatment approach can lead to superior relapse and remission rates for major depression.

Transcranial Magnetic Stimulation (TMS)

TMS as an intervention for depression has been widely researched for over 30 years. TMS works by delivering magnetic pulses to alter the activity within the brain networks that regulate our mood.  To help those with depression, we offer a holistic approach, which combines TMS with psychotherapy – or talk therapy. This combined approach maximises the brain’s natural ability for change and recovery.  Hour-long sessions are held at least twice per week and antidepressant effects may be noticed within the first 5 sessions. Up to 20 – 30 sessions are usually needed to consolidate the antidepressant effects. A full course of treatment can be completed within 1-2 months, and with our combined approach, over two-thirds of individuals experience long-term positive effects. This makes TMS an effective, fast-working treatment program for those looking for an alternative to medication.

Neurocare’s expertly trained clinicians can advise if this may be the right treatment for you.

Refer to our TMS webpage for more information on this highly effective treatment.


Are you looking for help in assessing or managing Depression for you or a loved one?

Our clinics offer comprehensive assessments and personalized medication free programs

Want to learn more about this program or our assessments?

Please write to us below, briefly telling us about your situation and how you think we may be able to help.



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