During the first year of COVID-19, depression and anxiety saw 25% growth globally.

In 2020 at least 21 million adults in the U.S. suffered from this malady. Two more years of COVID-19 with its attendant social isolation, disruption of face-to-face interaction at school and work, rampant inflation and burgeoning war in Ukraine has further escalated the likelihood of depression and anxiety.

Unfortunately, not all cases of depression are easily resolved with talk therapy or medication. However, people are increasingly turning to an effective form of magnetic stimulation, known as transcranial magnetic stimulation, or TMS, to treat resistant cases of depression. It is approved by the Food and Drug Administration and paid for by most insurance.

It is done in the comfort of a doctor’s office and is a relatively gentle form of treatment for depression. It bears no substantial relationship to the more controversial electroconvulsive therapy, or ECT. Transcranial magnetic stimulation involves carefully placing a hand-held device over the head to provide pulsed magnetic treatment while patients are fully conscious. TMS has been around since the 1980s.

Magnetic resonance therapy, or MeRT, is a newer, highly customized use of TMS based on sophisticated diagnostics. It utilizes an electroencephalogram in a novel manner that is used to identify and locate areas of brainwave dysfunction. With MeRT, each individual’s brain scan, or EEG, is analyzed to inform and create an individualized TMS treatment protocol, which enables targeted brain treatment. Because it is more specific, the amount of magnetic stimulation for a therapeutic effect is typically less, compared with “one size fits all” TMS.

MeRT is a painless, drug-free, noninvasive option for treatment of depression, the most common mental health issue in the U.S. It also might provide therapeutic benefit for anxiety, obsessive compulsive disorder, autism, post-traumatic stress disorder, traumatic brain injury and some causes of dementia as well as post-COVID-19 brain fog. MeRT also might provide benefit for some causes of brain-related sleep apnea.

Symptoms of depres- sion can include feelings of sadness, emptiness or hopelessness. Symptoms may be accompanied by a loss of interest or pleasure in normal activities, such as relationships, sex, work or sports. Many will self-isolate and withdraw from human interaction.

Others might notice angry outbursts, irritability, agitation or frustration, even over small matters. Anxiety and restlessness are not unusual. Sleep disturbances are common, including both insomnia or excessive sleep. Tiredness and lack of energy are frequent complaints. This might involve slowed thinking, poor concentration or memory loss and difficulty making decisions. Feelings of worthlessness, guilt and self-blame might arise.

There also can be loss of appetite and weight loss or increased cravings for comfort food and resultant weight gain. Frequent or recurrent thoughts of death, suicidal thoughts or actual suicide attempts might occur. Depression also can be associated with unexplained physical problems, such as back pain or headaches that resolve when depression is healed.

Depression can be the result of gripping, sustained or situational challenges or genetic tendencies and is often associated with underlying health conditions such as traumatic brain injury, post-traumatic stress disorder, chronic pain, sleep apnea, stroke, heart attack and cancer.

With resistant depression on the rise, MeRT, a highly customized form of magnetic stimulation informed by the interpretation of specialized EEG information, offers a painless, drug-free, noninvasive solution to depression and other mental conditions. MeRT is especially valuable when embedded in an integrative setting with services that include diagnosis and treatment of sleep apnea, acupuncture, psychological and neurological services.

Manakai o Malama recently moved to the Gold Bond Building in the heart of Kakaako, between the John A. Burns School of Medicine and SALT. Our providers are eager to support JABSOM in a meaningful way and influenced this decision to move to the new location. We decided to add MeRT to our suite of multidisciplinary, team-based services for whole-person health care. Our psychology department and primary care medical providers have noted a progressive increase in patients with mental health issues, especially depression and anxiety that are not amendable simply to psychotherapy and medication. We believe that MeRT will round out our larger tool set to support our patients to achieve optimal health.

To learn more, visit synapsehawaii.com.

Ira Kawika Zunin is a practicing physician and medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center: manakaiomalama.com. Submit questions to info@manakaiomalama.com. The column appears the first Wednesday of each month.