I've been on anti-depressants for decades. While the most recent one -- Lexapro, combined with Wellbutrin and Abilify -- worked wonders for me, I expressed an eagerness to get off meds with my psych a year ago. The worst of my suicidal depression had stabilized, and I didn't want to be on meds forever. I was terrified of going off them though. So my psych suggested that I try TMS at her clinic. They had invested in two TMS machines and were recommending TMS to their clients whose depression had been treatment-resistant. She also said the TMS helped wean many patients off their meds.
TMS (Transcranial Magnetic Stimulation) is a noninvasive form of brain stimulation. It uses magnetic fields to stimulate the nerve cells responsible for depression. Here's more on the procedure itself:
"During a TMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved in mood control and depression. And it may activate regions of the brain that have decreased activity in people with depression.
Though the biology of why rTMS works isn't completely understood, the stimulation appears to affect how this part of the brain is working, which in turn seems to ease depression symptoms and improve mood."
At first, I balked at the thought. It sounded fishy -- having a plastic paddle over my head, submitting magnetic waves to my brain? Seemed like electroshock therapy (ECT), which I was NOT interested in. But I did the research and unlike ECT, you don't need to be under anesthesia to receive TMS. The ECT side effects such as memory loss, confusion, nausea, and headaches are non-existent with TMS, too.
So I signed up. My first round of TMS began in July of 2017. Five times a week for both depression and anxiety. (TMS treats the left side of the brain for depression and the right side of the brain for anxiety.) TMS started at 7am, prior to the start of my workday. This time commitment sounds grueling, but fortunately I'm a morning person and it had no negative impact on my work week.
When I walked into the TMS office for my first appointment, I saw a chair that looked like it belonged in a dentist's office. That chair ended up being where I sat as the TMS was administered. As I anxiously awaited treatment in The Chair, my TMS technician had me put on a thin, white skull cap liner (think: yarmulke). She then took several measurements with a measuring tape and placed marks on the skull cap with a black Sharpie marker. She explained that the measurements would assist her with making sure that the magnetic pulses were targeting the right spot, every time.
After my technician wrapped up her measurements, she asked if I wanted to watch something on their huge flat-screen TV that was mounted on the wall in front of me. I eagerly agreed and chose the soothing sound of Lounge V's night ocean waves on YouTube. (My technician must have gotten sick of me playing that same video every time I came in, but I found the affects of TMS combined with that video to be 100x more relaxing than meditation.)
Before the treatment began, my technician ran a few tests on me to assess my TMS "threshold". I can still recall how chills ran down my neck when the tests were administered. Prior to running the tests, she adjusted a small black plastic paddle to rest lightly against my skull. That paddle was affixed to the TMS contraption. (I'm calling it "contraption" for lack of a better word. Click here for a pic, if your curiosity is killing you.) She asked me to hold out my right hand and turned up the TMS frequency while a faint clicking noise began. As the TMS machine delivered a magnetic pulse through my virgin skull, nothing out of the norm happened. She kept turning up the intensity. Still nothing. A few more adjustments. And then Crazytown -- my right hand jerked up, involuntarily! I was shocked. I was leaving the fate of my brain in the hands of someone who had the power to move me -- literally! She dialed down the power of the machine until my hand stopped involuntarily twitching. Sweet spot found. Treatment began.
For around 10 minutes, I did TMS for anxiety on the right side of my skull. For another 20 minutes, I did TMS on the left side of my skull for depression. As the ocean waves crashed against the wall, I felt a slight tingling feeling against my skull every few seconds that the TMS machine fired. Before I knew it, treatment was done.
After my first TMS session, my brain felt like it went through a 5-star massage. Alas, that feeling didn't sustain itself; it only occurred during the first session. But I knew TMS was working because of the depression scales that the technicians had me fill out each week. (The depression scales were required for insurance purposes, to make sure that the treatment was working and/or to adjust the magnetic pulse's intensity.) Prior to treatment, I filled out my depression scales and scored quite high for both depression and anxiety. As the treatment progressed, I was surprised to see how much my depression and anxiety lowered. Nearing the end of treatment, I was so elated over my depression and anxiety scales that I asked the technician if I could take a copy of them home with me. I couldn't believe it; my scores were phenominal. They were the scores of someone who was happy.
Note that I said "happy" because happiness is a transitory feeling. While my depression and anxiety lowered because of TMS, I decided to stay on all of my meds because I was going through a stressful period with my job and transitioning out of it.
Fast-forward exactly one year, to date (not planned, strictly coincidence). After I quit my dead-end job and went freelance, life began to look brighter. In July, I spoke with my psych about going off meds. But this time, for real. I inquired about the possibility of doing TMS again to assist with the process. Insurance approved a second round of TMS, and I started my first session on July 26.
It's now September 11. I am in my first week of TMS tapering (i.e., going from 5x a week down to 3x a week, to 2x a week, to 1x a week, then done). How am I feeling? Calm. Content with myself. Not hating life and wishing I was dead. As I went through my depression and anxiety scales prior to starting TMS a second time, I was once again amazed over how my scores were lower than when I started the first round of TMS a year ago. I didn't even go through TMS treatment for anxiety this time around.
Since starting TMS again, I've seen my depression and anxiety scales go down even further. Last week, my technician commented over how pleased she was with my results. To say I'm pleased as well is an understatement.
I have only one bad thing to say about TMS. It's a travesty that the treatment is only available to those who can afford it. As I mentioned earlier, my health insurance is top-notch. Both times, they covered a full round of TMS that spanned over the course of several weeks (including tapering off sessions). I'm by no means rich, but I still had to cover a $10 co-pay over 36 sessions. My psych told me that a round of TMS without insurance can be as high as $15,000. $15,000 for peace of mind is priceless. But if you don't have the $15,000 (or stellar health insurance), you're left to suffer. I find this abhorrent when so many people could benefit from this treatment (1 in 4 Americans suffer from depression, as this site somberly states). But until our health care system changes and the amount of TMS providers increases, TMS is only attainable for a few.
That being said, if your depression is ongoing and treatment-resistant or if you're on a cocktail of meds and want to see a life without them, look into finding a local TMS provider. A demand for TMS in your city will increase the number of providers and hopefully lower its costs.
Until then, #itisourfight.