Original article from Men’s Health (May, 2018) by Jordyn Taylor.
According to the latest estimates, more than 300 million people worldwide are living with depression. Medication and talk therapy are effective treatments for most patients — but not all.
If first-line treatments don’t work, some people with depression turn to brain stimulation therapies. One such treatment is transcranial magnetic stimulation (TMS), which uses a pulsed magnetic field to stimulate nerve cells — or neurons — in the regions of the brain that regulate mood. When stimulated, the neurons release neurotransmitters like serotonin, which are otherwise depleted in people with depression.
“Serotonin is supposed to flow from the neurons to the front of brain and tell us, ‘This is a happy moment!’ But for a depressed person, that doesn’t happen,” explains Dr. Kalyan Dandala of Associated Behavioral Health Care, a network of treatment centers in the Northwest that offer NeuroStar TMS Therapy. “We’re waking up that part of the brain that’s been dormant.”
TMS has been used for more than a decade, and was approved by the FDA in 2008. It’s proven to be helpful for at least half of patients who complete several weeks of near-daily treatments, according to the National Institute of Mental Health. But it’s a major time commitment — and some patients experience relapses.
Benjamin*, 26, dealt with depression for years. He tried various types of medication, but none had the effects he was looking for. In March 2018, at the recommendation of his psychiatrist, Benjamin began TMS therapy. This is his story, as told to MensHealth.com news editor Jordyn Taylor. This interview has been edited for length and clarity.
It started with anxiety, actually.
It came out of nowhere. After I graduated high school, I came to Seattle to learn how to be a restaurant cook. I was surprised at how well I was handling the stress — and then a couple of years later, stuff just started happening.
I was having panic attacks and feelings of, “I just can’t handle this.” I was working at my first restaurant job, and I can vividly remember having a mental breakdown while I was cooking during a rush. The order had all these different modifications, and I kept messing up. The anxiety kept building and building until it erupted, and I kind of lost it. I was trying to keep a calm face about it, but my coworkers could tell that something was going on. I felt embarrassed, but I had to be like, “Guys, I need help. I can’t get through this.”
I went to a psychiatrist, and I was given medications to help with the anxiety. I would use one, and then it would lose its magic a little bit, and we would go to something else. We tried two or three; there was one that kind of stuck, and the anxiety came into check.
But then the depression took over.
Anxiety is like, I can’t handle it. Depression is more like, I don’t care. 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: I ran in high school, but I didn’t want to go outside or exercise. Music was also a huge part of my high school career, but I didn’t want to do anything.
I thought I was going to keep having to cycle through medications until I eventually hit the jackpot — and even then, would it still have worked? I definitely had a feeling of hopelessness, like, is this going to be me forever?
There was a point when my psychiatrist left to work somewhere else. She gave me a long prescription, but after a year, I was running low on my medication, and I decided I really needed to go back to somebody.
I was talking with my new psychiatrist about how my depression medication, Wellbutrin, hadn’t been working. She was like, ‘Okay, since you’ve tried different classes of medications and they haven’t been working, I think you qualify for this new treatment.’
She starts telling me about transcranial magnetic stimulation therapy, and I start laughing because I tell her I’ve heard about it. I had read about TMS therapy — I thought it was really cool and futuristic, but that I’d probably never do it in my lifetime.
One of my hangups was the daunting idea of going there for 30 minutes a day, five days a week, for six weeks. It’s a huge commitment. But beyond that, I was excited to try it, because I liked the idea of a non-medicated treatment.
They say the first day is always the hardest, and I can truly say that is is. Normally they’re 30-minute appointments, but the first appointment is an hour and a half. They need to take the time to find the area of the brain associated with depression, so they do the whole mapping process.
You’re basically sitting in a dentist’s chair. You have your arms on a rest, and you put your hand up: Your fingers are all spread out like you’re holding a football, and then your thumb’s pointed out like you’re trying to hitchhike. Then they use the machine — it’s a coil that kind of cups the top, back part of your head — to send these electromagnetic waves in. They’re trying to get a reaction from your thumb. [Editor’s note: the magnetic pulses are targeted at an area in the left upper part of your brain that controls your mood, which is a few centimeters in front of the area that controls your thumb.]
It feels like a tapping sensation; I joked that I want to look around and see this woodpecker sitting on the chair and poking at my head periodically. I would feel a tap, and then they would look at my thumb. If there wasn’t a reaction, they moved it and tried again until they got a good one.
Next, they calibrate the starting dose for you. That part was the hardest. They administer what the treatment will be like on a certain level, and they ask you, ‘Okay, how painful was this from 0 to 10?’ They did it for the first time, and I’m like, ‘Alright, that’s 1 or 2.’ They raised it up — it was a 3 or 4 — they raised it again — 5 maybe — but you know, the pain was bearable. They kept going up, and once it felt like 7 or 8, I was just like, ‘Nope, that’s way too much — let’s bring it down.’
It was also really hard because it triggered emotions for me. March 29 is when I went in there, and the whole month of March was really crappy for me and my family. You’d naturally get teary from the tapping, but I was also trying not to cry because it was bringing up all these emotions. It was a crazy trip, but what I really loved about this whole process was that from day one, the TMS specialist told me, ‘We care about you and your journey through this, so we’re here for you.’
The first day was incredibly tough, but it was a place of no judgement — everybody was there for me. I came back the next day and started everything.
Now, I only have four treatments left. The only side effects they told me I might experience is headaches or a sensitivity in the scalp at the area of the treatment, but I felt neither.
Going into this, I knew it wasn’t going to be a magical Cinderella transformation, but I definitely feel like a newer person. In the beginning, I started feeling more moments of happiness, but there were also some days where I didn’t know if it was working or not — but it could have been the depression talking. It really took a lot of my closest friends and family to start noticing these differences. I talk with my dad, and he’s like, “Your demeanor has changed. You just sound happier.” My best friend at work, she’s like, “Yeah, you just look better — even as far as your posture goes, just the way you carry yourself.” I’m feeling like myself again.
After these treatments, 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.
Interestingly enough, I’ve been entertaining the idea of going into the mental health field. I don’t know exactly what I’d do, but I just like the idea of helping people with depression or other mental illnesses. I want to give people the hope that I was given — to tell people it’s okay, this isn’t a forever thing. You can overcome this.
*Last name has been withheld to allow subject to speak freely on private matters.