Depression

One Woman's Journey to a Depression-Free Life

July 19, 2019

Major Depressive Disorder (MDD), commonly known as depression, is a serious mood disorder that affects approximately 16.1 million American adults—and 322 million individuals worldwide—with likely many more undiagnosed cases.

Depression is also one of the leading causes of disability in Americans, since its serious symptoms cripple individuals and stunt their potential professionally, socially, and more.

Juliette DePalo, 21, recently shared her story of this very crippling depression, and how she felt inhibited by it from a young age. However, there is hope—DePalo began receiving deep TMS, or transcranial magnetic stimulation, treatment for her depression, and her results were calculated to have had an 80 percent improvement of depressive symptoms.

In this article, we will discuss:

  • DePalo’s success after deep TMS treatment sessions
  • How common DePalo’s case of depression is, and why it is different from standard depression
  • More on TMS and how it works to combat treatment-resistant depression

Juliette DePalo’s Victory Over Her Depression

DePalo, 21, began dealing with depression and related anxiety symptoms as a young girl in middle school and high school—as is the case for 3.1 million young people and 19.4 percent of adolescent girls who experience serious depressive episodes from the ages of 12 to 17. In fact, half of individuals who suffer from lifelong, recurrent depression started to develop their symptoms before the age of 15.

Depression in adolescents is just as serious as cases of depression in adults. Common symptoms or indications of adolescent depression, that also mirror symptoms of adults, include:

  • Withdrawal, or a loss of interest in things the individual usually likes to do
  • Changes in mood, including persistent sadness and easy irritability
  • Behavioral changes, such as an increase or decrease in appetite, fatigue, too much or too little sleep, and decreased academic achievement

Since teenagers get such a bad rap for being moody and irritable in the first place, it is often difficult for those around the teen to recognize their behavior as disruptive patterns of depression rather than “teen angst,” and it is estimated that only 30 percent of teens with depression are being treated.

Luckily, DePalo’s mother, Lorelei, recognized that when, on a regular and alarming basis, her daughter couldn’t get out of bed and didn’t want to eat, that she was not displaying normal behavior and needed to seek treatment.

When DePalo sought treatment, her doctor suggested a standard treatment regimen for MDD, which included medication and psychotherapy. However, even after taking her meds and going to therapy regularly, DePalo still didn’t feel like anything was working. She even struggled to take her medicine every day, which proved discouraging when it seemed like it wasn’t benefitting her at all.

When medication and therapy failed, a psychiatrist recommended she consider deep TMS as an alternative treatment route.


Example of a technician administering deep TMS on a patient. TMS is an alternative treatment for depression that is often employed when the patient’s depression is treatment-resistant, meaning that it does not significantly improve after standard methods of treatment such as medication and psychotherapy. Image courtesy of Med City News.

At first, the large machine intimidated DePalo, and her mother was worried that it would “mess with her brain.” However, DePalo grew comfortable with the sensation—merely a light tapping which slowly dissipates—and took 20 minutes to watch an episode of her favorite TV shows on Netflix. “It’s not uncomfortable, just odd at first,” DePalo says, “and then you get used to it. The first few sessions, I basically watched all of Brooklyn Nine-Nine on my phone.”

Within just a couple weeks, both DePalo and her mother saw a huge difference in her mood. She reported no trouble getting out of bed and felt like she could feel “normal” and go out with her friends, undisturbed by her mental state.

The usual treatment of medication and therapy usually only improves depressive symptoms by 30 to 40 percent, her doctor reported, but DePalo’s symptoms improved by a staggering 80 percent.

“It felt like a weight was lifted off of me,” DePalo shared.

Treatment-Resistant Depression

As we know, depression is a serious mental illness. Oftentimes, it can be so serious, or coincide—in medical terms, be “comorbid” with—other medical conditions, that it becomes treatment-resistant in some individuals.

In this section, we’ll discuss what treatment-resistant depression is, and why some individuals may be more predisposed to it than others.  

What is treatment-resistant depression?

If you have been treated for your depression, but your symptoms haven’t improved, then your depression may be treatment-resistant.

For most people, standard treatment of depression includes taking medication and going to psychotherapy sessions.

However, in the case of treatment-resistant depression, these standard methods of treatment simply aren’t enough. It may be the case that these standard treatments do not help at all or the symptoms improve only to keep coming back. This can be quite discouraging to individuals, which may cause more psychological damage and distress. So, the cycle of treatment-resistant depression is quite a toxic one.

Psychotherapy is more than just Freudian dream analysis—now, it is a common route of treatment prescribed to individuals suffering from depression. And while it certainly helps some individuals’ symptoms, it, in some cases, does not help enough.

“Although there is some disagreement as to how to define treatment-resistant depression, a patient is generally considered to have it if the individual hasn’t responded to adequate doses of two different antidepressants taken for a sufficient duration of time, which is usually six weeks,” says Jaskaran Singh, M.D., Senior Director of Neuroscience at Janssen Pharmaceuticals.

Possible Causes of Treatment-Resistant Depression

Here are a few factors that may cause a patient to develop treatment-resistant depression.

  • Duration of the episode: The longer the depressive episode, the greater the atrophy in specific brain regions, like the hippocampus, which cause cognitive and behavioral changes.
  • Severity of the episode: Depressive episodes are often categorized on a scale of “mild” to “severe,” and both ends (mild and severe) are hypothesized to increase the risk of poor response to treatment. In other words, although it may be tempting to think that “severe” equals “worst,” it is in fact true that persistent mild depression is just as damaging in terms of treatment-resistance as persistent severe depression.
  • Melancholic features: Treatment-resistant depression is more prevalent in bipolar depression than in MDD.
  • No improvement after treatment: Many individuals reap the benefits of medication and therapy after the first several weeks of treatment. However, if symptoms still persist past the first few weeks or even the first few months, then an individual’s depression may be treatment-resistant.
  • Comorbidity: Anxious symptoms and full anxiety disorders (e.g. generalized anxiety disorder) comorbid with MDD have lower rates of treatment response and remission. Personality disorders such as avoidant personality disorder and borderline personality disorder can also increase the risk of treatment-resistant depression.

TMS for Stubborn Depression

As we’ve discussed, TMS is emerging as a successful alternative for individuals who aren’t seeing improvement after seeking standard treatment for an extended period of time.

In this section, we’ll break down TMS a bit more in-depth and discuss why exactly it is such a great option for those who are suffering with treatment-resistant depression.

What is TMS?

According to Healthline, TMS is “a form of brain stimulation therapy used to treat depression and anxiety.” It has been used since 1985, but was approved by the FDA for use in 2008.

The therapy is non-invasive and uses a magnet to target and stimulate certain areas of the brain. This means that TMS is a drug-free procedure.

TMS sessions can last from 30 to 60 minutes at a time.

During sessions, TMS patients sit or recline while an electromagnetic coil is held against the head. The doctor will place the coil against the forehead, near the area of the brain which regulates mood. Then, magnetic pulses pass from the coil to the brain, which sparks an electric current in nerve cells.

Since she was a teenager, Juliette DePalo has experienced persistent and inhibiting symptoms of depression. Even after seeking medication and psychotherapy, she didn’t feel any relief. However, a few weeks after she began TMS therapy, DePalo was able to gain her life back and feel like a normally functioning adult.

It is thought that this stimulation of nerve cells may reduce depression.

Who is eligible for TMS?

TMS is commonly employed as a treatment for severe, treatment-resistant forms of depression. This is perfect for anyone who feels as though their depression is not being well-treated for any of the reasons in the preceding section on treatment-resistant depression, such as prolonged and intense depressive episodes or comorbidity of illnesses or medical conditions.

Antidepressants and psychotherapy may be used in conjunction with TMS, and it is often the case that a combination of treatments is most effective.

TMS: Changing the Way that We Think About Our Depression

For many individuals like Juliette DePalo, achieving relief from long-term treatment-resistant depression is not an easy process.

However, TMS is changing the way that depression is treated and understood—its overwhelmingly positive results prove that there is hope for those with long-term treatment-resistant depression.

Be sure to check out Transformations Behavioral Health for more information on TMS and treatment options to start your depression-healing journey today.


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