[Altered Moment]

Someone in a thread in the med section asked me about TMS. I wrote a very long response about my experience with it so I thought since I wrote all that I would share it here.

A year and a half ago I had lost two good jobs in a row because of depression. After that it got even worse and it was pretty bad before I even lost the jobs. I was very suicidal and broke and could not pay my rent. I thought I was going to be homeless.

I was in CA and my family is all in Michigan. I moved away when I was 19 and worked my whole life and had good insurance. I got clean and sober and started getting treated for depression when I was 32 and developed a very strong support network in CA. So I never bothered my family about it all. They are very supportive and knew about all my problems but never saw it first hand and didn't think about it much. I was getting treated and had this good support network so they didn't worry.

So here I was 49 suicidal, broke, and had pretty much isolated myself from my previous support network. I still had a pdoc and T but my insurance with Kaiser would run out in six months so I would lose that too. And besides I had a terrible pdoc who told me to suck it up and go back to work and wouldn't put me on state disability. If he had done that I could have made it.

Any way I was at the end of my rope, had given up all hope that anything would work because I am so treatment resistant, and broke. So for the first time I really reached out to my family. Thank God they were there for me. They decided the best bet was to come back to Michigan then at least I could relive the financial pressures of rent and utilities and all of that.

My brother who is a pharmacist and very active in his community met a pdoc who was into all the latest research on supplements and all this. He still used meds but was looking for something more effective. He was frustrated with meds. So he invested in a TMS machine and had a lot of faith in it. My brother, who knew better then others in my family the struggles I have had with treatment, talked me into trying this TMS. He said he would pay for it and had the means, bless his heart.

I agreed to come home and try it. Like I said I had given up all hope that anything would work but I held out a glimmer that this new fangled thing would work. My attitude may have had an effect on the outcome I don't know. I would think that if it was going to work it would have worked.

I went in for six weeks three times a week and each session lasted an hour. They get a base line of where to put the thing on your head based on moving it around and sending a pulse and when they find the spot that makes your thumb twitch that is the spot. Then it is a set of very powerful magnetic pulses last last about 5 seconds every 30 seconds for an hour. They set the pulse thingy on the same spot on your head each time and kind of strap your head in. The only way I can describe the pulses is it is like a jack hammer hitting your skull for five seconds. That is not really accurate though because it is not really that uncomfortable. That is just what it sounds like...bap bap bap bap bap. You get used to it. The worst effect is getting a head ache. If I remembered to take some tylenol or aspirin before hand I never got a headache. Your head is immobile and leaned back for an hour so that gets a little annoying. All in all a little annoying but very non invasive and not a big deal.

At first when my brother suggested it I thought it was a bunch of quackery. But I looked it up and places like the Mayo Clinic, John Hopkins, and Kaiser Permanete were doing clinical trials. They were taking it seriously and there was some very positive research on it so I thought it was worth a try.

It is based on new research that says that there is a very strong link between the pre frontal cortex (which is where they position the pulse thingy) and the limbic system. In severely depressed patients the circuit between the prefrontal cortex and limbic system is whacked so the theory goes and there is a lot of research to back it up. So the idea of TMS is to stimulate this "dead" circuit and get it working right again. Makes total sense. It didn't work for me. Now I don't know why. It could be that the TMS is just not doing the intended job and is just not precise enough to hit that circuit. Or it could be that the whole theory it is based on is whacked. Or maybe it works for some and not others. According to this pdocs experience he has had very positive results with it but he has a vested interest in saying that. He does track his patients after and says he has an 80% success rate base on about 14 patients. My Mom talked to the lady who is top dog and runs the community mental health clinic in my home town and she said they are finding it doesn't work as well in people who have very cyclical depression which is me. But that it does work better in people who tend to have much longer term depression. It is really to early to tell.

I am a believer in the prefrontal cortex/ limbic system theory. The prefrontal cortex is the thinking rational part of your brain and the limbic system is the more primitive emotional part of your brain. The limbic system is a whole bunch of things like the amygdala and hippocampus and a bunch of other stuff. If that circuit is whacked than it makes sense to me that it could cause depression. If it is true how do they treat it? TMS is one attempt. ECT which is very effective may work on this circuit. One study says that the hippocampus is 9-13% smaller in depressed patients. In the chemical imbalance theory that is much easier to treat with drugs. The problem is that is only a small part of the picture.

I am sorry for the long reply. I usually do a lot of journaling but it seems I am doing all that here in these forums now. I would rather do it here in public than in my private journal. And besides I would never put all this in my journal because it was your question that caused it. And it helps me to write about it and reflect on my past experience. If no one reads it because it is so long that is ok. It was meant for you bluetriangle because you asked so I hope you will read it.

If I was you I would look up all the latest research on it and see how the clinical trials are going and the clinical evidence on it. If your insurance covers it or you have the means it may be worth a shot. My brother never told me what it cost but I am sure it was a lot. For me it did not work. I was already in a depression and I went into a six month long very deep depression after. That was going to happen anyway and had nothing to do with TMS. During treatment I did notice some hard to explain differences in my thinking and in my brain. This was all a year and a half ago so there is probably more known about it now and it is probably in clinical practice more now.

Also check out ketamine which is starting to be used in clinical practice and studies have shown very promising results.

[LaborIntensive]

Well Zinco,

Let me just say that today I am down in the dumps and although my family is nothing like yours and you at least found support and aid I have not. But your thought process, your writing style and your knowledgeable writings are an inspiration to me. Each time I see your posts they are constructed with a great deal of thought and show the amount of information you posses.

Keep up the good work, I know you will!

[Altered Moment]

Originally Posted by LaborIntensive

Well Zinco,

Let me just say that today I am down in the dumps and although my family is nothing like yours and you at least found support and aid I have not. But your thought process, your writing style and your knowledgeable writings are an inspiration to me. Each time I see your posts they are constructed with a great deal of thought and show the amount of information you posses.

Keep up the good work, I know you will!

Thank you very much. That means a lot. Let me assure you it comes from a life time of suffering, and treating, and studying. Many years of hard work at getting and staying clean and sober, and throwing the whole book at my depression. The depression part largely unsuccessful. So I keep trying and studying. So most of it comes from suffering. A large part comes from family support and my family history and the many discussions we have had. Also my Dad is a Pharmacist, my Brother is a Pharmacist, my sister in law is a pharmacist, and my mother worked in the mental health field on and off for many years. It all started with her going to Alanon when I was 16. I owe a great deal of gratitude to her and so does my family. She is a very strong and persistent woman in a very quiet sort of way. Also my dream as a kid was to be a bio chemist. The drugs and alcohol and depression pretty much squashed that idea. But that didn't stop my interest or reading. I was whacked with the depression gene and the alcoholism gene, but I was also blessed with a good mind, lots of interests, and a good immune system and overall good health.