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The thing that almost worked

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OCTOBER 03, 2019

“Ready?” the technician asks. I give a thumbs up — I can’t nod, or I’ll displace the exact position of the machine the technician has spent the past few minutes setting up. I have a personal cap that has my measurements written on it in Sharpie. I try not to flinch as the pulses begin: tic tic tic tic. The right side of my head feels as though it’s being tapped with a small mallet. This goes on for 28 minutes. Then we repeat the process on the left side of my head, and I brace myself. For some reason, this side is far more painful. I try not to bite down too hard on my mouthguard as I endure a sharp pain that feels like a knife stabbing my skull for three minutes. 

I had previously tried eight medications for depression. These medications came with a host of side effects. Some were mild, such as tremors — and some more extreme, like wetting myself and obsessive suicidal ideation. I cried to my psychiatrist after trying four different medications in a month with no success. She took out a business card and wrote four options on the back of it. Three were other medications, and the last option was for TMS, or Transcranial Magnetic Stimulation. 

Transcranial Magnetic Stimulation is a type of therapy for treatment-resistant depression that targets the brain’s neurotransmitters the same way medication does, but without ingesting anything. In simpler terms, it can be thought of as a much milder form of electroconvulsive therapy (which is a highly effective and still-utilized treatment.) TMS has a 50 percent success rate and is purported to have almost no side effects.

The idea of zapping my brain felt like a last-ditch effort, as though my depression had become an unsolvable problem that required an extreme solution.  But I didn’t want to try another medication, and the lack of side effects with TMS felt promising. Additionally, TMS was free under my insurance plan. And I had the time; I was lucky that I had jobs with flexible hours, so for eight weeks I could do TMS every morning before work. I felt hopeful that a new tactic might be more successful. 

The reality was that the process was lonelier than I anticipated. Waking up at 7 a.m. and trekking to the doctor every morning wasn’t fun, but I wanted so badly to feel normal that I was willing to go through a treatment most people were unfamiliar with.

During treatment, the technicians were nice, but I always felt more like I was being sold a product and less like I was in a doctor’s office. One doctor told me I would start receiving “deep TMS” treatment, which would be more effective because it would penetrate deeper into my brain. When I spoke to another doctor, however, he said that “deep TMS” was a marketing term used by the companies that produce the machines. He admitted that no one really knew how TMS treatment worked and that they were judging new TMS techniques on a trial-and- error basis.  I had entrusted these medical professionals with my brain and my health, and it was terrifying to hear different doctors telling me different information. I felt like they valued my money more than my recovery.

TMS wasn’t exactly what I had been promised. Although advertised as painless and without side effects, I did experience symptoms. At some points, I felt more depressed than when I started. Beyond the physical pain of treatment, my skin felt sensitive: I couldn’t stand wearing tight clothing or rough fabric. The worst symptom was mental fogginess. It felt like I couldn’t think or remember anything. I started to do crossword puzzles during treatment, to fill the time and silence — and to prove to myself that I could still think and wasn’t losing my mind.

But my TMS therapy wasn’t fruitless. After five weeks, I switched from treating the right side of my brain to both sides. Switching to a machine with a different intensity of electromagnetic stimulation, and treating both sides of my brain seemed to be what I needed. I started to feel better and most of the side effects went away. I ended up having a “partial improvement,” which meant my depression was alleviated by around 25 percent based on assessments I completed every week. This is not an insignificant number. 

I am glad I tried TMS. If I hadn’t, I would have always wondered if it would have been the “Thing That Finally Worked.” I walked out feeling more hopeful and ready to try a new tactic. 

I realized the “cure” for my depression is finding a combination of treatments that allow me to live a life worth living, to get out of bed in the morning, to find joy in life. TMS got me 25 percent there. Hopefully whatever comes next gets me a little closer.

Salwa Meghjee writes the Thursday column on destigmatizing mental illness. Contact her at [email protected].
LAST UPDATED

OCTOBER 03, 2019


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