New ammunition against depression

MARSHALL – Depression is classified as a mental illness, but its effects can touch every part of a person’s life, from family to work and productivity.

“It’s the most costly disease in the world now,” said Dr. Clay Pavlis. Pavlis, a psychiatrist who has been practicing in southwest Minnesota for several years, said depression’s profound impact is one of the reasons it’s important to have treatment options available in the community. A new business that Pavlis and treatment coordinator Nick Noble have opened in Marshall brings one more option to the table.

Pavlis and Noble opened the Midwest Wellness Institute in offices at the Tiger Office Park in Marshall. Midwest Wellness Institute offers transcranial magnetic stimulation (TMS) therapy. TMS is a growing treatment option for people with depression, Pavlis and Noble said. It’s been in use since the 1990s and has been approved by the FDA for adults with depression who aren’t responding to medications.

In TMS therapy, pulses of magnetic energy are used to stimulate the left prefrontal cortex, a part of the brain associated with regulating mood. Brain scans have shown that in people with clinical depression, this part of the brain is underactive, Pavlis said. TMS therapy can help encourage the prefrontal cortex to become more active, and release chemicals that help relieve depression.

Pavlis said he’s stayed current on research being done on TMS’ uses and effectiveness. The research convinced him that it would be a good treatment option to bring to the Marshall region.

“A lot of people I work with need this (treatment), and I wanted to bring it closer,” Pavlis said. Until now, the nearest location to Marshall offering TMS therapy was Avera-McKennan Hospital in Sioux Falls, S.D.

Midwest Wellness Institute uses a specialized machine, the Neurostar TMS Therapy system, to give TMS treatments. The machine looks a little bit like a dentist’s chair, with an arm that allows the magnetic coil to be positioned over a client’s head. Clients receiving TMS meet with Pavlis to determine the right placement and strength of the treatment, while Noble actually conducts the therapy sessions.

The magnetic fields generated by a TMS machine are similar to those produced by an MRI, only smaller, Noble and Pavlis said.

The treatment typically causes little discomfort, they said, and there’s no sedation needed. Clients can come to TMS therapy and then drive back to work, or go about the rest of their day, Pavlis said.

Pavlis said one of the benefits of TMS therapy is that there’s a very low possibility of side effects. One of the challenges of treating depression with oral medications, he said, is that the medicine ends up being spread throughout the body, where it can trigger side effects like weight gain in addition to helping relieve depression. In comparison, the magnetic waves in TMS can be concentrated on the area where they’re needed.

And while it’s not ideal for everyone, TMS does work for many clients, Pavlis and Noble said.

“The really exciting thing for me is seeing the change,” in clients’ condition and quality of life, Noble said.

A course of TMS therapy usually includes several treatments a week for about four to six weeks, Noble said. Individual sessions are around 30 to 40 minutes long.

Pavlis and Noble said they work with prospective clients to help determine if TMS treatments could be helpful for them. Noble said not all insurance providers cover the treatment, but he will also help work with clients’ insurance providers.

“There is a cost to it, but one that’s been shown to be worth the investment,” Pavlis said.

Noble encouraged people interested in TMS therapy to call 507-337-0556 for more information, or visit Midwest Wellness Institute online at For now, hours are mainly by appointment, he said.

“Right now, we’re going to be very flexible,” as Midwest Wellness Institute is just starting out, Noble said.