Overview
The investigators will administer theta burst stimulation (TBS) in efforts to observe a decrease in severity of reported depression symptoms. A subset of participants will receive positive affect training during this intervention.
Description
The study has a longitudinal design in which participants complete a baseline assessment, 20 or 30 theta burst stimulation (TBS) sessions, a post-TBS assessment, and a follow-up assessment 4 months later. Ideally, TBS sessions will be delivered two or three times a day, 5 days/week, for 2 weeks. This procedural design of a shorter treatment duration is based on findings of pattern of improvement and newly developed SAINT protocol. A subset of participants will receive training in enhancing positive affect, with 10 training sessions occurring between pairs of TBS sessions. In this study, "response" to intervention will be defined as a greater than 50% decrease in severity of depression symptoms reported by participants.
Eligibility
Inclusion Criteria:
- Current Diagnostic and Statistical Manual (DSM-5) Depressive Disorder
Exclusion Criteria:
- Bipolar disorder (lifetime)
- Obsessive-compulsive disorder (lifetime)
- History of psychosis
- Daily use of nicotine
- Past-month use of cocaine, amphetamines, Methyl enedioxy methamphetamine (MDMA), Phencyclidine (PCP), Ketamine, or gamma-hydroxybutyrate (GHB)
- Past 6 month substance use disorder
- Binge drinking (using NIAAA criteria) within the past week, alcohol use in the past 12 hours
- Neurological disorders: Epilepsy, Parkinson's Disease, brain tumor, brain injury, stroke
- History of head trauma with a loss of consciousness (e.g., concussion)
- History of seizures
- MRI contraindications: body shape/size too large to fit in scanner, claustrophobia, and ferromagnetic metal in the body
- Pregnancy
- Current use of Clozapine, Bupropion, or prescription stimulants
- Current use of benzodiazepines or mood stabilizers
- Body shape/size too large to fit in MRI scanner
- Claustrophobia
- Metal in the head or ferromagnetic metal in the rest of the body
- Implanted medical devices
- High-risk suicidality