A couple months ago, I wrote about my decision to try Transcranial Magnetic Stimulation (TMS) as a treatment for depression. This little-known treatment is covered by most health insurance companies, cleared by the FDA, and recommended in treatment guidelines for managing depression in medical and psychiatric publications.
I was initially baffled by the fact that TMS is not more well known, because it’s super effective. Studies have shown that 60% of people who get TMS will see a decrease in depression symptoms by at least half. This is significantly higher than the number of people having decreased symptoms with medication. Just based on the numbers, it seems like TMS should be the first line of treatment. I figured it was probably too good to be true, or more people would do it.
How It Works
When we’re depressed, certain areas of our brain show a lack of activity, compared to people who aren’t depressed. There are several of these areas in the brain associated with depression.
Treatment with TMS returns the brain to the normal, non-depressed levels of activity by stimulating the brain with strong magnetic pulses, using the same technology that’s found in an MRI machine.
The magnetic pulses stimulate the brain cells to complete normal electrical impulses, which travel deeper into the brain to all the areas associated with depression, causing them to be stimulated as well.
In practice, the only area of your head that is actually “zapped” is about the size of a quarter, and the magnetic field only travels about 1.5 inches into your brain. But because the brain is a wonderful thing, treating one small area affects the entire brain and effectively “reboots” the inactive brain areas that are causing depression.
What It’s Like
The first thing to note about TMS is that it’s time consuming. You have to go 5 days per week for 6 weeks, and then 2-3 times per week for 3 weeks after that. So you’re looking at just over 2 months of an intense schedule. However, the treatment itself lasts only 3 minutes. I averaged about 15 minutes per visit. This could easily be done over a lunch hour.
Each TMS provider is going to be different, but my provider also required that I take one of their classes one hour per week during treatment, and there are a number of assessments to do to track the effectiveness of the treatment.
My insurance covered most of the cost of TMS. I did, however, have to pay a $30 copay for each visit. When you consider that this was 36 visits in rapid succession, my out of pocket cost was just over $1,000 that I had to come up with quickly. Fortunately, I have an HSA through my job and was able to cover this cost without much trouble. The treatment center I went to mentioned they had financial aid and payment plan options for out of pocket costs, and I’m sure most do.
I won’t lie to you, TMS is pretty uncomfortable. It’s not painful, exactly, but it’s a lot. Because of coronavirus, I wasn’t able to take a picture or video of myself receiving treatment, because I wasn’t allowed to get my phone out in the building (too many germs).
I would arrive for treatment and be taken into a treatment room. The room had a reclining chair and a TV. Once in the chair, they’d put the special cap on my head which tells them exactly where to give the magnetic pulse. I had to keep my mask on and I was also required to wear ear plugs and a mouth guard. If you’re someone who has sensory issues or is highly claustrophobic, this would be tough.
After I had all my gear, they’d recline the chair and turn on cute animal videos on the TV. The magnet that administers the pulses looks like something you might see in a dentist’s office, just an unassuming piece of medical equipment. The technician would place the magnet in the right spot against my head and lock it in place. That feels like having a book resting on your head. I wasn’t strapped down or anything like that, just asked to remain still.
With everything in place, the technician counted down from 3 and the treatment started. The treatment consists of a burst of magnetic pulses, off and on about every 10 seconds. It’s really almost impossible to describe the feeling of the magnetic pulses. It’s like having a woodpecker tapping on your head, but with a little electrical zap included. Also, the magnetic stimulation caused my eye to twitch and my jaw to clench involuntarily, hence the mouth guard. It’s weird and uncomfortable.
They asked the whole time to rate my discomfort on a scale of 1-10. I never got above a 5. Taking ibuprofen ahead of time helped immensely. The first two weeks were the worst, mostly because I couldn’t get the ibuprofen dose right. After I got that figured out, my discomfort rating never got above a 2. Here’s the thing, the treatment is 3 minutes. Even on days it was most uncomfortable, I would just tell myself, “You can deal with almost anything for three minutes.”
It’s especially easy to deal with the 3 minute treatment when there are almost no side effects! Apparently some people do get headaches in the first couple of weeks, but that didn’t happen to me. The worst thing that happened to me was some days I would become instantly tired. The kind of tired when you’ve exerted huge amounts of mental energy, like you’ve just finished taking the bar or spent all day focusing intently on one task. It makes sense, though, given the fact that my brain did just go through a lot. I usually didn’t have anything mentally taxing to do after TMS, so this wasn’t very disruptive.
I am happy to report that TMS literally cured my depression! The medical term is “in remission,” because I may become depressed again sometime in the future, but I may not. When I first started TMS my score on the BECK depression scale was a 45. The maximum possible score on this assessment is a 63, and anything over a 40 is classified as “extreme depression.”
My final TMS treatment was September 21st, and at that point, my score on the depression scale was a 0. ZERO! It continues to be a zero more than a month after finishing treatment.
The doctor told me that 80% of people who respond as well as I did will stay in remission for at least two years. That’s incredible! If I had to do TMS every two years for the rest of my life, I would.
I started to notice changes after about two weeks of treatment. My overall sense of wellbeing started to improve, followed by a general enjoyment of life which motivated me to be more productive and take better care of myself and others. I responded more empathetically to the plight of others and felt a sense of control over my emotional state. It’s truly a night and day difference and I feel like a different person. I’ve gotten positive feedback from the people closest to me, as well.
At the risk of sounding overdramatic, TMS has really been a game-changing, miracle treatment for me. I will be a champion of TMS as long as I live.
I would absolutely recommend TMS to anyone struggling with depression, especially those who have been on several different medications, struggle with the side effects and don’t get meaningful relief from them. For anyone feeling like they’re doomed to be depressed forever, I implore you to give this a shot. For people who have just a touch of depression that is well controlled with medication, I’d still say try TMS. However, as I mentioned, it’s intensive and it may be hard to stay motivated to stick with it if you’re not in “hail mary” mode.
I will say, that if my kid ever experiences depression, the first place I turn will be TMS.
I also must give a disclaimer that this is my personal experience, and your experience and mileage may vary.
If you have a question about my experience, leave it in the comments below! I’ll be happy to answer!