Podcast: Scott Laidler Interviews Dr Leigh Neal

Personal trainer and fitness expert Scott Laidlaw interviewed Smart TMS Medical Director Dr Leigh Neal for his latest ‘Healthy Ambition’ Podcast.

Causes & Treatment of Depression + Integrative Medicine Solutions With Consultant Psychiatrist Dr Leigh Neal

Scott introduces the interview, saying:

“In this episode, I speak to Consultant Psychiatrist and medical director at wordpress-719692-3717963.cloudwaysapps.com, Dr Leigh Neal.

“During our conversation, Dr Neal and I discuss the effects and origins of depression, its relationship to other forms of mental health challenges and addiction and the treatment of TMS as a solution.

“We discuss also in this episode additional strategies for wellness we can all start to implement ourselves, as well as his personal approach to make sure he maintains his full potential.”

How TMS Works

Scott asked Dr Neal to explain how transcranial magnetic stimulation works on the brain. Leigh responded:

Dr Leigh Neal“Transcranial magnetic stimulation is basically a very high powered magnet. It produces a magnetic pulse which pulses very rapidly and at different pulses which we can control.

“When that’s put against – just touched against the scalp, it induces electric currents in the brain tissue below to a depth of about 2-3cm, a core of tissue about that big. So it’s very focal stimulation of the brain cortex, which then modifies, over a period of time, changes in the brain tissue, so it causes neuroplasticity, which increases connections between neurons, increases the number of synapses and strength of synapses and also makes changes to the neurotransmitters between the neurons.

“So that effect, because you have this treatment on a daily basis, anywhere between 20-30 sessions, the effect propagates down from the surface of the brain to deeper brain tissues and interacts with those circuits which cause depression and various other psychiatric conditions that we treat.”

First port of call or last resort?

Scott asked whether this treatment should be considered early or later in the patient’s journey. Dr Neal explained:

“Probably in the course of treatment you would normally have psychological treatment first, then they might try a number of different antidepressants, then they might find/try TMS after that. That would be the typical treatment course.

So TMS wouldn’t be the first line in treatment; but some patients, for example don’t like having talking therapies, so they might try antidepressants first and then come to TMS. And some patients don’t like taking antidepressants so they might try just psychological treatment in front of TMS.

“So there are no hard and fast rules, it really depends on the individual’s preference. There is no reason why TMS can’t be given as a first line treatment if patients wanted that.”

Does TMS depend on the root cause of depression?

Scott queried how TMS as a physical treatment would work if there was a psychological root cause for the depression. Dr Neal explained:

“…it doesn’t really matter what the cause is, whether it’s a biological cause or a mostly biological cause or a mostly environmental cause, that doesn’t appear to modify the response to TMS; so the background history isn’t really a factor which determines whether we decide whether a person has TMS or not – we really make the decision on the basis just of cross-sectional diagnosis of depression at the time we see them.”

Listen to the full podcast on scottlaidler.com.

The full interview includes further discussion of TMS as well as alcohol and general health. You can also download the mp3 to listen offline.

Smart TMS Clinics

Smart TMS was established in 2015, providing TMS treatment at their original South Kensington/Brompton Cross centre in London. The company now has the UK’s biggest network of TMS treatment centres and is committed to further expansion in order to make the treatment available in more cities, reaching patients who need an alternative treatment option for their conditions.

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