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Off Topic :
Transcranial magnetic stimulation for depression?

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 hurtbs (original poster member #10866) posted at 2:33 AM on Friday, December 9th, 2022

I'm trying to help a family member who has serious, chronic depression and anxiety. They have been in therapy for years, but they are incredibly medication averse. I learned about a treatment call transcranial magnetic stimulation. The details look very promising. However, they do required "failed" medication trials. Has anyone used this or know someone who has? Results?

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number4 ( member #62204) posted at 5:00 AM on Friday, December 9th, 2022

I tried it back in 2013; it's a commitment. Five days a week, and I was so depressed that many days, I had to have someone drive me. It did not work for me, but I have had conversations with several people who swear by it.

My current psychiatrist is a big believer (we lived in a different area of the country when I had it the first time) and says the protocol has changed, making it a possibility for me again if I need it.

After a failed TMS experience, I ended up with ECT and it was a miracle for me. In a matter of a few weeks, my life totally turned around. A 1.5+ year deep depression and debilitating anxiety melted away.

But before I did the TMS and ECT, I had gone through a number of medication trials - either they didn't work, or the side effects were intolerable.

Honestly, these days a lot is being done with psychedelics. Ketamine comes to mind, and there are clinics everywhere providing it; people are having good results. You can also look at psilocybin is being studied at major teaching universities with promising results. Or many other psychedelics.

Me: BWHim: WHMarried - 30+ yearsTwo adult daughters1st affair: 2005-20072nd-4th affairs: 2016-2017Many assessments/polygraph: no sex addictionStatus: R

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 hurtbs (original poster member #10866) posted at 2:33 PM on Friday, December 9th, 2022

Thank you so much number4. The protocols do seem to have changed in terms of how they do it (brain imaging first and targeting various areas) and for how long (3-4 minutes a day, 5 days at a time for 6 weeks). Their psychiatrist swears by the TMS and hates that they have medication protocols first (given that meds have side effects, lower efficacy on double blind trials, and take longer for improvement to show).

Can you talk a bit about your experience with ECT? I heard they do it under general anesthesia now. I hadn't heard of it still being used for depression.

I don't think this person would be a candidate for ketamine therapy; plus, it triggers their aversion to medication.

[This message edited by hurtbs at 2:34 PM, Friday, December 9th]

Me - 40 something. WXH DDay 2006, Divorced 2012
WBF DDay #1 9/2022 #2 11/2022
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posts: 15762   ·   registered: Jun. 1st, 2006   ·   location: So Cal
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number4 ( member #62204) posted at 3:09 PM on Friday, December 9th, 2022

I'll be honest with my experience with ECT, and hopefully this won't scare you off.

I'd been in a relatively deep depression for a year and a half, due to my debilitating anxiety, for which no meds had worked, other than benzos, and I didn't want to stay on those. I'd done a stint at a residential treatment program, and had gotten a little relief, but the depression came back. I'd lost almost 30 lbs. from not eating, and just felt like I was wasting away. My only saving grace was we'd gotten a new puppy, and that forced me to get up off of the couch a few times a day to let him out and in of the back patio door. But I remember cursing him at the time for being there and forcing me to get up off of the couch.

Like I said, we'd tried at least a half dozen medications, with no relief, and some with intolerable side effects. Every time we tried a new medication and it didn't work, I became more depressed as I saw it as running out of options. When I began having suicidal ideations, that's when we started talking about inpatient psychiatric. My p-doc had occasionally dropped the words ECT in our appts., but I'd always been so adverse, based on what I thought I knew. Then I read Kitty Dukakis' book about her mental health crisis, and having ECT, and became more open to the possibility. When I finally went inpatient, the p-doc there convinced me to give it a try.

I did nine treatments inpatient, then was discharged and had the last three treatments outpatient. I won't lie... it messed with my cognitive abilities for a while. I have little memory of my time in the hospital, but my p-doc told me that that level of depression alone can wreck with someone's memory and cognitive abilities. Not to say some of it wasn't caused by ECT, but some of it was probably due to how disassociated I was with the real world. It took months for some of those memories to come back, and sometimes I had to be nudged, meaning someone had to prompt my memory, then after I'd think about it, the incident would come back to me.

ECT is not necessarily a first go-to, and I suspect most providers will not suggest it without some medication trials, due to the seriousness of the procedure. But I'd like to think there are some out there who would understand someone's predicament and offer it. Honestly, I wasn't keen on many of the medications I was trialed on, but I reached a point where I was SO incredibly desperate, that I would cooperate with the suggestions of certain meds.

And no, they do not use 'general anesthesia'. They use a short-acting anesthetic, usually a barbiturate, such as Brevital, to put you out so that you're unconscious. And then they use a muscle-relaxant so that your seizure doesn't cause any bodily damage. My seizures would last around 45 seconds, then I'd relatively quickly come to, and after a few minutes of recovery, I'd be wheeled back to my room, where they'd often give me some Tylenol, some food, and I'd often take a nap (ECT usually takes place very early in the morning before they have a need for recovery rooms for surgical patients).

I'll tell you, if you research ECT, you will find some who say it ruined their lives; my experience couldn't have been further from those sentiments, as it is for many, many people. I follow a Reddit forum for people who have had ECT, and there are a LOT of people who swear by it. That might be a good place to ask if anyone there was given ECT without medication trials.

Within six weeks of finishing my treatment, I was basically off all medications, including the benzo I'd been on for almost two years for my anxiety. The weight came back on, and I totally re-engaged in life. I feel for the people who feel their lives were ruined, but I'd say the majority of those had bilateral ECT, which is a harder hit on the brain. I had unilateral on the right side, and whatever it did, it hit the right spots in my brain. I am incredibly grateful for what it did for me. I'm 9.5 years out from ECT, and have never needed it again, although some people do. I wouldn't hesitate to do it again if the need ever arose.

Me: BWHim: WHMarried - 30+ yearsTwo adult daughters1st affair: 2005-20072nd-4th affairs: 2016-2017Many assessments/polygraph: no sex addictionStatus: R

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