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,
h.
