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TMS for Phobias: Can TMS Help Put Irrational Fears to Rest?


A phobia is an intense and irrational fear reaction to a person, place, object, or situation. A person with a phobia may experience a panic attack or feelings of dread when they encounter the trigger, and their feelings of fear are out of proportion to the actual danger that exists.

A phobia is a type of anxiety disorder. However, unlike general anxiety disorder (GAD), which is a general feeling of anxiety, a phobia is related to something specific, for example, a fear of spiders or of heights. According to the National Institute of Mental Health, approximately 12.5% of adults in the US will experience a phobia, and 31.1% of adults in the US will experience an anxiety disorder, at some point in their lives.(1,2) 

While phobias can be debilitating, almost all phobias can be treated. Transcranial magnetic stimulation (TMS), mostly used to treat depression, may be a safe and effective new treatment option for phobias. 

The Link Between Phobias, Anxiety Disorders, and Depression

Depression and anxiety disorders are some of the most common mental health disorders in the US, and they often occur together. While depression and anxiety appear to be completely different disorders (depression is commonly associated with low-energy, and anxiety is commonly associated with high-energy), these two disorders are very closely related. A person with a phobia can develop depression later in life, while a person with depression can experience anxiety to the point of having panic attacks.

Deep TMS (dTMS) for Treating Anxiety-Disorders and Phobias

Current treatments for phobias typically include a combination of therapy, lifestyle changes, and medication. One type of therapy used to treat phobias is called exposure therapy. During exposure therapy, the patient is gradually introduced to the object or situation that causes the fear response. 

New research tells us that TMS may be able to calm overactive regions of the brain associated with anxiety. When a person experiences anxiety, brain cells in a region of the brain called the prefrontal cortex are overactive. TMS may be able to reduce the activity of brain cells in the prefrontal cortex to reduce anxiety symptoms.(3)  

An analysis of 11 previous research studies shows that TMS significantly reduces anxiety in patients diagnosed with an anxiety disorder, including specific phobia, social anxiety disorder, panic disorder, agoraphobia (fear of not being able to escape uncomfortable or embarrassing situations), and generalized anxiety disorder. This analysis highlights the need for larger studies that will allow researchers to fully understand how TMS may help people diagnosed with an anxiety disorder.(4)

Although more research is needed to fully understand how TMS may be able to help people with phobias and other anxiety disorders, the current evidence suggests that TMS may be a safe and effective alternative to anti-anxiety medication. 

Do You Have a Phobia and Would Like to Seek Treatment?

If you have a phobia and would like to learn more about TMS and whether it may be right for you, contact us online or call (212) 731-2033. 


Resources:

1. National Institute of Mental Health. Specific Phobia. Publication Date Unknown. https://www.nimh.nih.gov/health/statistics/specific-phobia. Accessed August 16, 2021.

2. National Institute of Mental Health. Any Anxiety Disorder. Publication Date Unknown. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder. Accessed August 16, 2021.

3. Balderston NL, Beydler EM, Roberts C, Deng ZD, Radman T, et al. Mechanistic link between right prefrontal cortical activity and anxious arousal revealed using transcranial magnetic stimulation in healthy subjects. Neuropsychopharmacology. 2020;45:694–702. https://www.nature.com/articles/s41386-019-0583-5. Accessed August 16, 2021.

4. Vergallito A, Gallucci A, Pisoni A, et al. Non-invasive brain stimulation effectiveness in anxiety disorder treatment: a meta-analysis on sham/behavior-controlled studies. medRxiv. 2021.01.15.21249892; doi: https://doi.org/10.1101/2021.01.15.21249892. https://www.medrxiv.org/content/10.1101/2021.01.15.21249892v1. Accessed August 16, 2021.

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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