How Transcranial Magnetic Stimulation Restored the Hope Depression Stole

I’ve had depression for as long as I can remember. It started when I was a kid, persisted through my adolescent years, and worsened in my adult years. I was lucky to have a mom who talked openly about her depression, so I never had to wonder what I was feeling. I always knew it was depression, so even as a kid I just decided to buck up and do the best I could with it. I figured since I could still function in school and later in a job that what I had must be mild depression, maybe dipping into moderate depression from time to time. It took me 22 years to realize my depression was actually severe.

I learned to grieve at a young age due to the sudden death of my brother. Grief has become the model through which I navigate change. This has generally served me well in my experiences with chronic illnesses. But one thing I’ve noticed is I have a tendency to accept circumstances very quickly. When a circumstance truly can’t be changed, such as the death of a loved one, this is a good coping mechanism. But in the case of my chronic illnesses, this has resulted in me not asking for help as much as I could be, and then not getting all the help I could have.

Due to this tendency to accept health problems, I never sought to treat my depression aggressively. I went to therapy and I tried several different antidepressants over the years, but I never even considered seeking help beyond those things. And then in May of 2021, a family member died by suicide.

I think anyone who loses someone to suicide asks a lot of the same questions. Why? Why didn’t they ask for help? What could I have done differently? What were they thinking? How did they not know how loved they are? As I ruminated on these questions, I realized this person was probably also depressed, though they never shared that diagnosis with me. And they had probably decided this was just how the world works, since they hadn’t really known anything else. And then I realized I was doing the same thing.

So, I decided to seek more aggressive treatment for my depression. I didn’t really know where to start but I knew I had to try something, try anything. I first heard about transcranial magnetic stimulation (or TMS for short) in a memoir by Jenny Lawson called “Broken.” Then, the next time I logged onto my psychiatrist office’s website, they were advertising TMS as a treatment they offered. That coincidence was the encouragement I needed to ask my psychiatrist about TMS specifically and about aggressive depression treatments in general.

As it turned out, my psychiatrist thought I would be a good fit for TMS and referred me for a formal evaluation with the psychiatrist who specializes in TMS treatment. He also thought I was a good fit, and then the army of office staff went to work convincing my insurance to cover it. I was lucky. The insurance did agree to cover most of it and I was able to start treatments about three months after my initial inquiry.

I didn’t know how to approach this new treatment. I wanted to be hopeful, but I was still super depressed. Hope is one of the main things depression stole from me. What I eventually settled on was as much hopefulness as I could muster (not much) and a resolute attitude that if this didn’t work, I would keep trying for other treatments.

My TMS protocol was 36 sessions over the course of nine weeks. For six weeks, I went five days a week, and then the last three weeks were a tapering period. The actual treatments took 18 minutes each, so I was usually in and out of the office in a half hour. I had some strange tingling sensations that went away within a half hour or so. My depression actually got worse for the first two weeks, a normal occurrence, often dubbed the TMS dip. I was also extra tired for the first couple of weeks and ended up taking naps pretty regularly after my sessions. But those were my only side effects.

And then, starting in the third week, I started seeing improvements. Waking up in the morning no longer felt like the worst thing in the world. It started taking less mental wrestling to get myself to do basic tasks like showering and cooking. I started feeling some motivation to do things. In week four, I even noticed I was assuming neutral or positive outcomes to things that I would normally catastrophize.

It felt like during weeks three and four, my depression just started to evaporate. It was pretty magical, though at the time I mistrusted it, thinking it was just a normal up which would be followed swiftly by a severe downturn. But that didn’t happen. It’s now been 12 weeks since I first started TMS and my depression is still in a very good place. I honestly don’t know if I’m in full remission because I’ve never had a time in my life I can remember when I wasn’t depressed. But at the very least, my depression is the lowest it’s ever been.

My psychiatrist told me when people see positive results from TMS, they can generally expect them to last at least a year, and sometimes longer. I’m looking forward to making the most of the next year or two.

TMS has been a proof of concept for me. A reason to hope for more effective treatments for my other incurable chronic health conditions. I had readily accepted my conditions would be both lifelong and incurable, with the only treatment options being for individual symptoms. Now I’m feeling much more hopeful for the future. There may not be treatments available right now for some of my other illnesses, but now I can believe there might be something coming down the line that could make a huge difference for me.

I’m not happy or bouncy all the time. I still live in the same world that everyone else does, with a pandemic hanging over our heads, political polarization, and climate change. I feel sad, lonely, angry, helpless, and afraid at times. I grieve for things that have been lost. But I also feel hope, inspiration, motivation, and joy. I feel a full range of emotions, not deadened by depression. TMS isn’t going to be a magic cure for everyone, but it can be really helpful to some people. I am one of those people, and I’m so grateful for this change and all the people who helped me on this path.