On February 3, 2016, I began TMS (trans-cranial magnetic stimulation) treatments at Memorial Hospital. Being a now-and-again mental health blogger, I thought I would take some time to reflect on my treatment, my doctors, and my overall experience with TMS - a proven, non-invasive, non-drug therapy for depression, anxiety, and even certain forms of autism.
The first day would be a longer than usual appointment. My psychiatrist had to spend up to an hour with me doing some simple neurological tests that would pinpoint exactly where the machine's metal coils should be placed on my head. I sat in a large chair that looked like it could be in a dentist's office. There was a poster on the wall that read, “You are braver than you believe, stronger than you seem, smarter than you think, and even more beautiful than you ever imagined.” Sounds cheesy to me now but at the time I found it comforting. The doc had me place my right elbow on the arm rest while allowing my wrist and my hand to remain limp. After he had me make a loose thumbs-up sign with my hand, he moved the metal coils around my head until he found a spot that when stimulated with just one pulse, would make my hand move. This process went well - in fact the doc said my brain was "easily stimulated," as it didn't take him very long to find the “sweet spot.”
Then the actual treatment began. I experienced periods of four-second magnetic pulses in between twenty second intervals of rest. The pulses made repeated clicking sounds that was like a tapping sensation on my head. Each treatment would last for about 37 minutes - back and forth between the magnetic pulsations and periods of rest. The pulses were not exactly comfortable the first few times. Looking back in my TMS journal (all patients are required to keep a journal during treatment), I described them as "painful" that very first time, but I can assure the reader that this sensation quickly alleviated itself with time and familiarity with the machine. I remember how I could feel the pulses on my head, in my temples, behind my eyes, and even momentarily in my teeth. Getting acquainted with the TMS machine wouldn't take long. It certainly helped that you could stream Netflix while going through treatment.
That's the basics. It doesn't really involve more than that from the patient’s perspective. The machine does its thing while you sit and remain still in the chair. I had headaches those first few days, which is completely normal. They went away within the first week. You make friends with the nurses who sit in the room with you and supervise you during treatment. You talk about the different things you watch on Netflix day in and day out. Every Friday you fill out a self-evaluation form that gives the doc some idea of how you're doing, and more importantly, how you're feeling and your overall mood. The nurse then leads you through a verbal survey that recaps similar questions. She then forwards this information to my psychiatrist and my therapist so they are kept up to date throughout the treatment.
Since hindsight is everything, I thought I would further recap some things I learned about TMS and about myself after the treatments concluded.
No. 1 ~ TMS IS A B-I-G (TIME) COMMITMENT
When I began treatment, I did not realize just how much of a commitment TMS therapy actually is. You’re at the hospital everyday, five days a week for six weeks in a row. You end up scheduling your life around your appointments because you absolutely cannot miss a treatment. After all, consistency is partially what makes TMS work. The magnetic pulsations are literally re-teaching your neurons how to make those good chemicals we want in our brains – the dopamine, serotonin, and norepinephrine. The hope is that after the treatments are through, the brain will make these chemicals all on its own and without the use of antidepressants.
No. 2 ~ YOU MAY NOT FEEL THE EFFECTS OF TMS IMMEDIATELY, AND THAT’S OK
If you’re reading this blog, you know that I’m pretty open with my struggles with mental illness. Therefore, I told many close friends, family, and colleagues about TMS before I embarked on this six-week long journey. Out of love and support, they often asked me, “So do you feel any different yet?” I really wished I could have told them all a resounding, “YES!” but the truth is, I really didn’t notice a difference until the end of my treatments and thereafter. In fact, during treatments, I felt extremely exhausted, which is that exact opposite of how I thought I’d feel. Why would I be so tired after having my brain stimulated? I often had to come home and take a nap after treatment just to recharge. I was fortunate in that my family and colleagues were very supportive and operated with lots of patience and understanding during my treatments. I am ever thankful for their kindness and support.
No. 3 ~ DRUGS
The main reason I began TMS was because I was not achieving the results I had hoped for by taking antidepressants. The side affects have been many and some of them difficult to handle. The extreme fatigue, the absent libido, the excessive weight gain. In fact, I am now on medications just to counteract the side affects of the antidepressants.
My post-TMS goal is to be weaned off of all of my antidepressants and mood stabilizers. Perhaps I was a little over zealous to think at my first post-TMS appointment that my psychiatrist would lower the dosages of ALL of my medications at once. “No, no, no,” he told me. “That’s not quite how it works.” As of right now, I am taking 150 mgs of Effexor. This is half of the amount I was taking before TMS. At my next appointment in mid-June, my doc will lower the dosage again. He will do this – one at a time – with each medication until I am drug-free. What a day that will be. It’s been more than six years since I started taking drugs for my depression. I can’t wait to see and feel what it will be like to live without all of these pills.
No. 4 ~ TMS IS JUST THE BEGINNING
Depression and anxiety run in my family. This stuff is in my genes. Therefore, even though I would not describe myself as “depressed” at this point in time, I am aware that I am prone to depression and negative thinking. I was given this awesome opportunity to undergo a fairly new (within the last ten years or so) treatment for my depression, and hey, I think it actually may have worked!
Now, it’s up to me. I’m the one who has to work on building healthier habits to complement this new chance at life without depression that I’ve been given. I’ve got to start focusing on my health and fitness – to shed some of this weight that I put on while on antidepressants. I’ve got to keep friends and family close. They are my support system, and give me strength when I am sinking. Being social and maintaining relationships has become a big part of my life in a way that it never has before. I think we are here to help one another3, and I have been on the receiving end of that idea for quite a while. I hope that in the future I will figure out a way to give back to my community for all it has done for me. But I’m slowly working on that one…
No. 5 ~ TMS AND ME
This is just one story – my story – of how TMS has changed a life for the better. TMS gave me the kind of relief that I had always hoped my antidepressants would provide. With the drugs, I hoped that my extremely low episodes of depression would find some relief. I hoped that my mood would stabilize and I wouldn’t be so negative and irritable all the time. I hoped that I could go about living a “normal” life as a twenty, now thirty-something year old woman. None of these things happened consistently, and I was always back in the doctor’s office having my meds adjusted. “Maybe this time, it will work,” I would often think. Now, I think I have a real shot at beginning to deal with some of the things that my depression kept covered up for years – but that’s a whole other blog.
Since TMS, my mood has stabilized. I no longer feel what I would often describe as that low-lying, undulating wave of depression that was always with me no matter how good I felt. I feel lighter, more optimistic, and able to keep my head above water when faced with all the little things that life tends to throw at us in the day-to-day. I have goals that I’m beginning to act upon, and most of the time, I feel confident that I can achieve them.
So be well, be kind, do good work in the world, and thank you for reading my story.
To our health,