Depression

Personal Insights on Treating Depression with Transcranial Magnetic Stimulation

October 30, 2018

It’s estimated that 300 million people around the world suffer from depression, and while many benefit from medication and talk therapy, some do not respond to first line treatments. For those that do not find relief from prescription drugs on the first or second attempt, there are brain stimulation therapies now available, such as Transcranial Magnetic Stimulation (TMS). This relatively new therapy works by stimulating neurons with a pulsed magnetic field near the areas of the brain that affect mood. Doing so will release serotonin, the neurotransmitter that is lacking in people dealing with depression.

In a typical brain, serotonin travels to the front of the brain to signal feelings of happiness. For depressed individuals this does not happen at the typical level and that dormant part of the brain needs woken up.

Brain scans of individuals with depression show reduced blood flow to multiple areas of the brain, including the frontal cortex, that may be woken up TMS.

Approved by the FDA in 2008, TMS has a success rate of about 50% for those who complete several weeks of therapy. It can be a significant time commitment requiring almost daily treatments, and like all mental health treatments there is a chance for relapse, which can be addressed by a new round of treatment.

Below is an excerpt from a personal account of a 26 year old man, John*, who did not see improvement after trying various prescriptions.

TMS Testimony

How it Began

John first noticed mental health issues several  years after high school while working as a cook. He first began to feel anxiety, experiencing panic attacks and thoughts of “I can’t handle this.”  He recalls having mental breakdowns during rushes at work, starting with feeling overwhelmed by the demand, causing errors, until eventually it built up so much he “lost it.” This motivated him to seek psychiatric help.

The psychiatrist would prescribe various anxiety prescriptions that eventually he would build a tolerance to and become ineffective. After trying 3 different option, one seemed to work more consistently. But once the anxiety was managed, John began noticing the depression.

"The best way to describe it is just kind of wandering aimlessly through life with no enjoyment. I lost sight of myself. I couldn't really figure out who I was anymore. I wasn't enjoying the activities that made me me."

“Anxiety is like, I can't handle it. Depression is more like, I don't care,” John explains. “ The best way to describe it is just kind of wandering aimlessly through life with no enjoyment. I lost sight of myself. I couldn't really figure out who I was anymore. I wasn't enjoying the activities that made me me.”

After his experiences with anxiety medications, John was concerned about beginning another arduous cycle of testing various prescriptions and all of their related side effects. He continued to see his psychiatrist, but when the doctor moved away leaving him with an extended prescription of his latest drugs, he decided to go see someone new when he began to run low.

A New Treatment

John’s newest psychiatrist recommended a new approached when he mentioned the Wellbutrin he’d been taking was no longer working. When she introduced TMS, he initially thought it sounded interesting but not something her likely go through with especially because of the time commitment of 30 minutes a day, 5 days a week for 6 weeks. Eventually the allure of a non-medicated treatment won him over and he began his TMS journey.

John noted the first day was the hardest, lasting three times the typical session in order to find the area of his brain associated with depression through a mapping process.

The Process

Image Courtesy of M Health

During the mapping process John sat in a chair similar to one found in a dentist’s office. He had to hold his hands out like he was holding a ball, then just hold up his thumb. The machine they used looked like a coil that cups the top rear part of the head that sends electromagnetic waves. The mapping focused on looking for reactions from the thumb, because the area that controls the thumb is a few centimeters in behind the area that controls mood.

John describes the sensation he felt like a tap. He would feel a tap, they would observe his thumb and if it didn’t move, they moved the coil.

After mapping they next need to “calibrate the dose” by administering the treatment as a certain level and asking what the discomfort level was from 1-10. Once John reached 7 he explained it was too intense and they brought the levels down.

John also experienced emotional triggers during the treatment and noted at times he was trying to hold back tears.

After the initial more challenging first day, John notes the treatment got easier and easier. He was told there may be side effects of headache or tenderness in the areas of application, but he did not experience either.

The Results

“I feel like I'm more connected with myself and the world around me, and I can truly say that I'm happy with myself. I like me..."

While John did not expect a magical recovery, he does note after treatment he feels like a new person. “I feel like I'm more connected with myself and the world around me, and I can truly say that I'm happy with myself. I like me. It took a long time to get to that point, because throughout depression, I kind of hated myself. I hated life, and I hated who I was. Now I have a lot more clarity — I'm even thinking about my future,” he explains.

Johns says he definitely recommends TMS to people who are struggling to find the right treatment for depression.

*Named changed to protect privacy

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