The Carlat Psychiatry Podcast How to Explain TMS
5 snips
Nov 3, 2025 In this engaging discussion, Dr. Owen Muir, a clinical psychiatrist and expert in interventional therapies, dives into the intriguing world of Transcranial Magnetic Stimulation (TMS). He presents a unique perspective on depression as a 'brain rhythm issue' and explains how TMS acts as a rhythm generator to help resynchronize brain activity. The overlap between psychotherapy and TMS is explored, revealing how both approaches aim to reconnect patients with life. Muir also shares insights on which depression subtypes respond best to TMS and discusses the nuances of different TMS coils.
AI Snips
Chapters
Transcript
Episode notes
Depression As A Rhythm Problem
- Depression can be framed as a brain rhythm problem where being 'in sync' feels good.
- TMS acts as an external rhythm generator to help resynchronize brain activity and restore engagement with life.
Empty Chairs Despite Strong Outcomes
- Chris Aiken saw TMS patients recover differently than with meds: more affect and better functioning.
- Despite efficacy, his clinic struggled to recruit patients for TMS compared with ketamine.
Start By Understanding Their Story
- Spend time understanding the patient's perspective before explaining TMS.
- Frame TMS in the context of their life and impairment to make it relatable and acceptable.