My heart was pounding as the doctor tilted my chair, tilting my head back while raising his feet. He was out of sight, as my head and eyes were turned forward, thanks to a long metal arm with a magnetic plate at the end, which he had fastened tightly against my scalp. I was about to undergo a new and emerging treatment for a serious mental illness called Transcranial Magnetic Stimulation (TMS).
“You will feel a pulsation where the magnet is and a corresponding tapping sound,” the doctor said. “Are you ready?”
I guess my answer would have been the same if he had asked, “How desperate are you to recover from your depression and anxiety?”
“I’ll do whatever it takes,” I said.
I had despaired of ever escaping the deep, lonely, cylindrical death spiral I had lived in for the past four years. “Isolating” is the psychological term. Of course I was still physically I lived with my husband and two young children in our home in Los Angeles, but I was virtually unreachable on more than a superficial level.
During the first year of my depression and anxiety, I had lost my self-esteem and self-confidence, my autonomy not far behind; I dreaded going anywhere, especially alone. As the years passed with no real relief from my symptoms, I slipped into a deeper state of voluble self-loathing. I would have thoughts like: You caused your own depression, by not meditating properly or not exercising enough or eating mindfully. You lack character traits like courage, resilience, and strength to heal yourself. You are a revolting, weak and worthless loser and you deserve it.
My mind was so noisy, buzzing with self-blame and negative self-talk, that it was hard for me to talk about it. My husband noticed this, but as my depression got worse, it became harder for him to reach me.
I tried to deny the vicious thoughts in my head by spending a month confined to a convalescent home perched atop a cliff in Malibu, to no avail. Later, my psychiatrist recommended a popular outpatient program at UCLA Medical Center. As a Phi Beta Kappa graduate of UCLA, where I was also a sorority girl, I hoped I could find healing in my beloved alma mater. I found both purpose and camaraderie in participating in the program. It gave me something to get out of bed and I enjoyed getting to know the other program participants, whose struggles mirrored my own.
Halfway through the program, in a moment of madness – or, arguably, sanity – I confessed to my social worker that I had lied about the Beck Depression Inventory she had given me during of our weekly checks. In fact, I was having suicidal thoughts, and they were growing day by day.
She responded by accompanying me to the admissions department of Ronald Reagan Neuropsychiatric Hospital, which was only a building away. In front of the door of the psychiatric hospital, with its revolving light, its digicode and its padlock with chain, I panicked. What had I done? I grabbed my social worker like a scared toddler who doesn’t want her mom to leave her at preschool. She carefully removed my fingers from her arm and reminded me that I could leave as soon as I felt better, because I was a “voluntary admission”.
My team of doctors at UCLA declared me treatment resistant. I agreed because it didn’t matter what type of antidepressant or antipsychotic I was prescribed or how many therapy sessions I attended. I was no better. My GP urgently recommended electroconvulsive therapy or ECT, commonly known as shock therapy, to get me out of what he called an “almost psychotic state.” I actually underwent the invasive ECT treatments. Unfortunately, I did not feel any relief from my symptoms.
Turns out I wasn’t the only one resistant to treatment. One in five Americans suffers from mental illness, and up to 30% of them do not respond to the first treatment: antidepressants and psychotherapy.
About six months later, a dear friend told me that she had secured an appointment for me with her psychiatrist, who had helped her recover from her postpartum depression. While I strongly doubted that his psychiatrist could help me – coming, as he did, after quite a long list of qualified medical professionals who had already tried – I neither wanted to let my caring friend down, nor give up. myself.
My husband accompanied me to Dr. Sparago’s office for the appointment and sat with me during his comprehensive review of the many medications I had been prescribed over the past few years. We both heard him mumble something about how I “seemed like a candidate” and the words “new treatment option”. Our eyes met on the sofa. Hoping.
Dr. Sparago stood up and asked us to come with him to see the treatment room. It was small and windowless, with a reclining dental chair at its center. He bent down and grabbed a brochure from a lucite stand and showed us what looked like a “Just Say No” advertisement. Two brains were photographed side by side, one dark with muted gray and blue flecks, the other illuminated with gold, red and green. I expected the caption to say “This is your brain. This is your brain on drugs”, but instead it said “Normal brain” and “Depressed brain”. The normal brain had lights on, like a cozy house after dark with people inside, while the depressed brain was gray, muted, and without lights. Hopeless.
I felt my thoughts drift into their usual dark place and enjoyed Dr. Sparago touching my shoulder which brought me back to the present moment. It explained how TMS worked.
“TMS was approved in the United States in 2008 for use in treatment-resistant patients like you,” Dr. Sparago explained. “TMS uses a pulsed magnetic field – similar to that used in an MRI – to create an electrical current on the surface of the brain, which will reset your body’s mood regulation system.” Think about how turning off your smartphone and then restarting it will often “fix” a problem.
The following Monday, I was able to confirm insurance coverage and begin the TMS protocol, which involved half-hour sessions five days a week for six weeks between October and November 2018.
TMS didn’t hurt. But the tapping is quite strong and rhythmic, and always followed by a time of silence. There was a TV for watching Netflix, positioned at eye level which helped to pass the time. I was also warned that I might have a slight headache after the treatment, but I did not experience this.
While some TMS patients report a marked change in mood in just one week, my recovery was more gradual. I lived in almost complete emotional darkness, but as the days and weeks of TMS went on, I began to see rays of light appear.
Soon I found myself singing for my baby girl while we played, baking my son’s favorite apple pie to celebrate his flag football win, and looking forward to the time I could spend with my husband. -like. As the new year approached, I continued to enjoy life by reconnecting with friends and re-launching my PR consulting business.
Almost four years after starting treatment, I still do TMS once a month to maintain my incredible progress. The psychiatrist suggested the interview as an option, but only if I wanted it. I know a woman who did TMS for her postpartum depression. She does no maintenance and is still doing well. But I will continue to do it every month. It doesn’t hurt, there are no side effects and it only takes about 20 minutes. Insurance doesn’t pay for maintenance, however, and I realize I’m privileged to be in a position where I can afford to pay $75 a month for treatment.
I feel like myself again, but better. Because I now know that mental health is rooted in the physical: in the chemistry and circuitry of the brain. It wasn’t my fault; it had never been my fault. And with depression being the leading cause of disability worldwide, this knowledge is almost as vital as the cure.
Diana Daniele is a writer and publicist living in California. She is currently working on a dissertation. For more information, visit: dianadanieleauthor.com
All opinions expressed in this article are those of the author.