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Since completing my series of 32 TMS (Transcranial Magnetic Stimulation) therapy treatments, one every week day, for a bit over 6 weeks, I have been totally depression-free. I'm not saying this will be the answer for you, if you have severe, "treatment-resistant depression," as I did, I'm merely relating my story.
What really scared me was the fact that, over the last few years, the episodes of 100% disabling illness were growing longer and coming closer together. It appeared to me that I was looking at spending, maybe, the rest of my life in a state of major depression. That was unacceptable to me, so despite my being told that "everything that can be done has been done, and I'd just have to live with it," I kept looking and asking different doctors until I found something that appeared to offer hope—at that point, I had nothing left to lose and was willing to try anything that might even have a chance of working.
My current psychiatrist suggested TMS therapy treatments, but he cautioned me that I'd probably have to travel a good distance to get them and have a prolonged battle with my insurance company to get coverage. Both turned-out to be true, but after a series of denials and appeals, letters of medical necessity from two different psychiatrists, and an arm-twisting phone call by one of them directly to my insurance company, they approved coverage at 80% (the maximum my policy allowed). This made it possible for me to proceed. (At the time, there were only about 14 centers in the U.S. offering TMS. I have read that, since then, that number has mushroomed to 145.)
I've had 3 ECT or "shock treatments, been prescribed a virtual pharmacy of antidepressants and even, in desperation, some "off-label" prescriptions for antipsychotics! None of these things worked, although I tried for years.
TMS was approved by the FDA in 2008 for the treatment of depression, the first non-surgical, non-drug treatment for depression that the FDA has approved since "shock" treatments were approved in the 30s.
The sole manufacturer of the TMS machine in the U.S. quoted these statistics to me: that 1 out of 3 patients experience COMPLETE REMISSION, and that 1 out of 2 experience SIGNIFICANT RELIEF. Maybe I was just one of the lucky ones who got completely better, but that's what happened to me.
The basic principle behind it is this discovery: just as they have identified which physical parts of the brain control finger movement, the sense of hearing, smell, speech, and so on, they have now identified the little part of the brain that seems to control mood and depression. It's only a 2.5 inch formation called the left prefrontal cortex, on the left side of your brain near the front. They shoot electromagnetic pulses through your skull to that target area only, and they've found that it stimulates that part to work again. When that happens, the depression goes away—it sure did for me, anyway, when NOTHING else worked. By the way, I had no memory-loss or other side effects.
Unlike ECT, which shocks the whole brain, causes a seizure, unconsciousness, and, in all to many cases, memory loss, during TMS treatments you are fully awake, can talk or even sleep, they don't hurt, and they have no side-effects, that I experienced, at least.
louis 1888
Thanks for sharing your story here and letting others know that, whether it's TMS that helps or something else, there is hope out there.
I'm so glad this treatment was such a huge help to you.
It wonderful.After four good years on prozac I have had trouble find another antidp.
The only down side so far is that the psychiatrist will be taking a one week vacation one week after I start treatment...oh well.
I believe that clinical depression and anxiety disorder are from the same cause. In other words it's like it's depression/generalized anxiety disorder--it's all part of the same syndrome. I, too, have had panic attacks.
When I was depressed, no one worried more than me. No one was more scared of things than me. I imagined the worst in virtually every aspect of my life. I figured I'd end up as a mindless bum on the street, totally disabled, with no way to make a living and being a burden on society and those around me, just the opposite of what I passionately wanted.
Over a six-week series of TMS treatments, one every week day, I noticed nothing for the first two weeks, but during the third week, I noticed that my long-gone appetite was returning. During week #4, I noticed that my my mind was clearing-up to the point where could sit at a desk and do mental types of work, like using a computer. In the middle of the fifth week, I noticed that I was beginning to enjoy things again--little things like watching a movie on TV, and I started running on the hotel's treadmill for 30 minutes a night. (In order to receive my treatments, I had to travel four hours from my home and stay for six-weeks in a hotel room by myself.)
It was the first time in 30 years that I was without the daily "cheerleading" of my wife (she had to work--she's a registered nurse), but of course we talked on the phone every evening, and she even came to visit me a couple of times.
However, by the end of the fourth week of treatments, I conservatively estimated by improvement at 50%. I was well enough that I could drive myself home for weekends (four hours each way, over strange roads, usually at night).
In the middle of the sixth week of treatments, I realized that I was completely normal again--absolutely 100% remission. I had all this energy and wanted nothing more than to get back to work.
The pdoc said I should have a couple of taper treatments, so they added two more, spaced-out a few days apart, at the end.
I was ECSTATIC to be my normal self again, in top form, and happy as a clam. My wife was ecstatic. My kids were ecstatic.
My last "taper treatment" was on 3/19/10, and all I can tell you is that I have been absolutely depression-free, every moment of every day since then. I've started a new business, written and directed television commercials for it, built a website, put together a 32-page color catalog featuring my inventory, and finished the marketing of a screenplay I had written that a film-rights manager in L.A. says he wants to try to sell to a major motion picture studio.
So, apparently, TMS worked for me, when NOTHING else did. (I had even been told that "everything that can be done, has been done, and I'd just have to live with it." But, that was unacceptable to me, so I tried different pdocs until I found one who recommended TMS.
I did thorough research on it--it's all over the web, and I became convinced that it was worth a try--after all, I had nothing left to lose.
The biggest obstacle was that TMS is so new (it was approved by the FDA for depression only in 2008), that the medical insurance companies routinely deny coverage on the basis that it is "experimental." It took a months-long battle with them, which included letters of medical necessity from two different psychiatrists, and an arm-twisting phone call from one of them directly to my insurer, enduring a series of denials and appeals (you can appeal ANY denial for 180days) before my major medical insurance carrier approved coverage at 80%, which allowed me to proceed. You see, the treatment centers presently have to make the patients pay up-front (about $9000.) for the treatments, because the history has been that insurance won't cover it.
This post is telling me that I've used-up almost all the "characters" allowed for a post. I'll try to submit this one and then finish-up in a second post
louis1888
By filing simple medical claims with my insurer, I have received checks totaling about $9400., (a mere $200 or so short) of what I had to pay up-front for the treatments. That was for 80% of the cost, covered by my primary insurer. Because I have been classified as 100% disabled by the Social Security Administration, I have medicare as a secondary insurer. I have filed a claim for the remaining 20% of the cost with them, but I haven't heard back from them yet.
Like I said, I've done a lot of research on this, and while I was an outpatient at the treatment center, I asked every question I could think of. I've spoken on the phone to a researcher at Columbia University School of Medicine's Brain Studies lab, which was recommended to me as being one of the leading research facilities ub the U.S., having conducted over 20 years of clinical trials on TMS as a treatment for depression. I asked her two questions: 1. What happens if a relapse occurs. She said that, in responders, a series of five or so "maintenance treatments" (about a week's worth) was sufficient to put the patient back into remission. She even said, that, in a few cases, a single 40-minute treatment was sufficient.
The second question I asked her, was is there a "burnout effect," that is, if you undergo these maintenance treatments for years, do they eventually seem to have less and less of an effect (as I've found to be the case with antidepressant drugs.) She replied that, in 20 years of clinical trials, they have seen NO EVIDENCE of that.
So, maybe, just maybe, I have found, after 14 years, a permanent solution to the depression that has done its best to destroy my life.
In a nutshell, the science is this: TMS was initially used for "brain-mapping," that is, determining which physical parts of the brain control things like the sense of smell, touch, hearing, and so on. They have now identified that small part of the brain that is thought to control mood and depression. It's just a 2.5 inch formation called the left prefontal cortex, located on the left side of your head, near the front.
After they painstakingly identify the location of this "target area" on in your particular head (they have a procedure for doing this), you sit in a high-tech chair that looks like a dentist's chair, a magnetic coil is placed on the outside of your head, just over that spot, and between 3000 and 4000 electromagnetic pulse are delivered through your skull to that target area only. You can feel them, and they do cause a very mild discomfort that lasts only about 5 seconds, while the pulses are actually being delivered. Then, for about 30 seconds, nothing happens, and then the machine plays a little musical scale to let you know the next 5-second burst of pulses are coming. Each treatment lasts about 40 minutes, and during the whole time, you are in a reclining position, totally relaxed, but your head is held absolutely still by a support on the right side and by the magnetic coil on the left.
All the while, a nurse sits at her own computer that tells her if the "target area" has moved, in case you wiggle or something. The positioning is so exact that it's checked by a laser beam. The chair itself is programmed to automatically shut itself off if it senses that that target area has moved at all, but that never happened to me. At the end of every 40 minute session, I did notice a MILD headache and a period of SLIGHT disorientation that lasted about half an hour, so that I had to be more careful driving back to the hotel after the treatments than I was when I was arriving.
The MILD headache went away EVERY TIME, in about an hour, after I returned to my hotel and took 600 mg of Ibuprofin and also are a meal.
Look, I don't know if this is the answer for you or not--I'm just telling you what happened to me.
I'm sorry to go on so long, but I have rather a lot to say about this subject.
louis1888
Make this point loud and clear to you insurance company. MONEY IS THE LANGUAGE THEY UNDERSTAND.
Anyway, once this happens, and TMS becomes routinely covered, then the providers will be able to drop their requirement that the patients having to pay up-front (maybe this is already happening), thus making these treatments available to the people who need them the most without paying a dime.
Just to reiterate, if drugs are working for you, count yourself lucky. TMS is for the people, like me, for whom the drugs stopped working.
louis1888
louis1888
first, thank you so much, louis, for your acct of your experience with TMS. i had heard about it but had never gotten anyone's perspective who had had it.
for J and other readers, the neurostar website is at http://www.neurostar.com/Home.aspx .
-- susie margaret
I've had 3 ECT treatments that made me worse--much worse. Maybe they help some people, but in my case, I refused to have any more and left against medical advice (I was a voluntary inpatient in a hospital psych ward.)
Whatever meds you've tried I bet I've tried too, and more. NOTHING HELPED.
TMS not only helped, it (over a six week period of 32 treatments) brought me back to DEAD SOLID NORMAL. I went from being 100% disabled to 100% able. I now own my own small business.
I don't know if your experience will be as effective as mine, but i can tell you I've been through eight pdocs before found one who recommended this treatment. It's so new, many of them don't know much about it.
My advice to you is to hock the farm if you have to, to get these treatments. That's what I did, and I'm 100% depression-free now, for the first time in 14 years.
louis 1888
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