TMS is like having a small hammer bang against your head repeatedly. Technically, each treatment session includes 55 trains of 36 pulses (for a total of 1980 pulses per session) delivered over 20 min at 18 Hz and intensity of 120% relative to the patient’s resting motor threshold (MT).
What does that mean?
Well, the resting motor threshold is the basic unit of dosing in transcranial magnetic stimulation (TMS) research and practice. There are several different approaches to estimating the resting motor threshold and apparently little consensus on the best method for estimating it. BUT don’t take my word for it. I am not a doctor or a scientist. There is a lot of research easily available on the internet so look it up if you are interested in learning more.
The little I know is that In a healthy brain, neural activity in the motor areas of both hemispheres is functionally related to muscle control. An active movement of a hand is associated with an enhanced neural activity in certain motor areas. My resting motor threshold has been determined multiple times through a process of stimulating my brain with magnetic pulses and measuring the correlating hand movement. It’s kind of cool.
When I have TMS, a cap is put on my head. The cap has measurements indicated on it that show where a magnetic coil should be placed. The coil sits near the front of my head over my right eye close to my eyebrow. The coil is in what feels like a helmet and the helmet is strapped tightly to my head. I wear ear pods to listen to music and I wear mouth guards to protect my teeth and jaw from the twitching caused on the right side of my face. My right eye twitches too but I do not need anything for that. I only need to not be wearing glasses.
The tapping is the minimum amount of power needed to stimulate my brain cells, the amount that meets my individual threshold that causes my thumb muscles to twitch. During the treatment, my right hand twitches so I cannot hold my phone or anything with that hand.
The actual tapping procedure takes twenty minutes and I am awake, sitting up in a comfortable chair. I cannot move since I am attached to a helmet that is attached to a machine. Every twenty seconds, the tapping taps tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap-tap for two seconds.
Every twenty seconds for two seconds.
After a while it’s meditative if you let it be. And after a while my brow goes numb. In a non-annoying way.
But the time goes fast if I listen to music. Sometimes I read texts or emails. by holding the phone up to my face and far enough away with my glasses held up and squinting since I’m not actually wearing my glasses.
Yes, it is a TMS shit show.
After treatment, I can go back to work. No sedation or anesthesia is necessary so after treatment I am good to go.
Treatment is every day for 30 days, Monday through Friday for six weeks or so.
I have been through two cycles of treatment with remarkable results. I should be on a commercial for TMS. It has changed my life.
Whether the effects of TMS will last or not is a different story, but for the first time ever I have major hope that I can live differently. With TMS, my brain is no longer the boss of me.
With TMS, my brain no longer bullies me into performing repetitive daily rituals that exhaust me and render me incapable of living a normal life.
Now TMS won’t work for everyone, obviously, since nothing works for everyone. But look at some of the links I’ve provided. The areas they’re researching for the use of TMS are amazing.
But there are so many options out there now that I urge everyone to research everything.
Even with TMS, there are different kinds of coils.
I began TMS for treatment of “Major Depressive Disorder” because that is what the insurance company will authorize, but it turned out that TMS release me from the chains of my Obsessive Compulsive Disorder (OCD).
Now we are trying to get the insurance company to authorize payment for a different coil that targets OCD.
If I could get that treatment, then WOW. I mean, W.O.W.
Like seriously. I could be a totally new person.
Because depression really isn’t my problem. I can manage my depression.
My real problem – the one that really wrecks the quality of my life – is the OCD.
So naturally I wish I had tried TMS years ago, but you don’t know until you know. So I didn’t know about TMS until I knew about TMS.
And I can’t dwell on time I could have been living life instead of waiting for life to be over.
But enough of that nonsense!
I have provided so many resources under the Resources tab. You should take a look even though you shouldn’t use the word ‘should’ and neither should I.
But ‘should’ is a discussion for another day.
For today, find something that gives you hope.
I have hope now that my life can be about living.
That’s not what it was about before.
It’s not that I didn’t want to live, it’s just that the OCD kept telling me to do violent and harmful things through constant intrusive thoughts I could not stop.
Medications helped me to manage those thoughts so I could hold a job and keep cartooning, but managing a life is not the same as living a life.
Now I have hope that I can live my life.
And now I have the ability to help other people figure out how to live their lives too.
A long time ago, I became a professional problem solver. In some parts, they call that a lawyer. In other parts they call that an advocate.
Now that my brain has backed off from sending me violent, harmful intrusive messages I can devote myself to advocacy. Just the way I always dreamed of.
Check out the resources. They are really good.
Today is a great day to do something different to make your life better and you may just find it right here.
This is a really helpful piece. The suggestion about researching really resonated with me. I research like crazy when I’m in the dark. And in my last darkest hour I found Ketamine. Now I’ve got Ketamine in my back pocket if I should need it again.
I really encourage those with treatment resistant depression to explore the possibility of Ketamine treatment, whether it is through a clinical trial, hospital or provider. Those with dual diagnosis or co-occurring substance abuse and/or bipolar conditions need to seek the advice of professionals with specific expertise in those areas.
I personally had great success with Ketamine. I have Major Depressive Disorder (MDD) and Obsessive Compulsive Disorder (OCD) with suicidal thoughts. I had treatment with Ketamine over the course of 18 months. I am available to talk with anyone considering Ketamine treatment – whether it is for them or for a family member. I believe Ketamine is a treatment that can save lives because of its potential to effect significant change faster than current medications and other treatments.
I come from a family of news junkies. I remember my mother’s father sitting in our living room devouring the daily papers. And my father’s mother lived long enough to become addicted to CNN and the 24-hour news cycle. She was a 24-hour news devotee debating local and global politics with anyone who enjoyed a lively discussion.
I became a news junkie too. Mostly, I love tragedies and legal procedure. Tragedies provided me an outlet for all of the sadness depression dumped on me. Legal procedure appealed to the other parts of my brain, eventually leading me to law school and then litigation.
I was on Amtrak’s Northeast Regional from DC to Baltimore when I got the alert that Kate Spade had ended her life. I couldn’t believe it and I desperately searched the internet for posts that proved the news a hoax.
But it wasn’t a hoax and the horrible news was confirmed immediately by credible sources.
I texted my sister-in-law.
“Kate Spade killed herself.”
Knowing she would be pressed for the best way to respond, I added “I can’t un-know that.”
Kakki, the sister I had always wanted, texted back.
Now I’ll get the info in sets of three since I follow all three sources.
I like Tom Brokaw. I like him in all of the basic ways – as a professional, as a journalist, as a man, as a human. He’s a good egg.
I’ve followed Mr. Brokaw’s journey through his diagnosis of multiple myeloma at the age of 73.
I like people with issues, especially medical issues and major life crises.
I like watching people confront struggle and triumph over life’s bad badnesses.
I like witnessing the humility of life’s constant reminders that we’re SO not in control when it all comes down to it.
I like when good, reputable, professional, accomplished, successful eggs like Tom Brokaw share their experiences of real life’s ongoing struggles. It helps me to know that I am not alone in feeling alone. And it helps to give me words to define my own struggle…and ways to understand my own struggle.
Specifically, I’ve been working lately to come up with my own “take” on my message. For the first time in my life, I’m sharing the stories behind my art, none of which are lovely, upbeat or positive. My art is dark and morbid and depressing. My art is the art of depression, which is dark, morbid and depressing, at least for me.
So basically it goes like this:
I’ve spent a lifetime living with depression. I’ve created a ton of art inspired by my dark experience. The art is dark. And now I’m sharing.
The thing is that darkness scares people. They assume you’re in the dark place at the very time when they themselves experience the darkness you’re sharing, even though the darkness you’re sharing could have been inspired by experiences from ages (or hours) ago.
So I like the idea of “Learning to Live With“….because it reinforces the reality that when you experience anything difficult, you experience it on a continuum. You experience the discovery of the difficulty as you define it and identify its scope. You experience the difficulty as you have it, hate it, fight it, embrace it, and own it. You experience the difficulty as you fix it and then move on to recovering from the fixing phase.
And then you clean up. You experience the cleaning up of the odds and ends that invariably result from any life disruption.
And then, just when you thought you’ve cleaned everything up and put everything back into its proper place, you experience the fact that your normal is no longer the normal that other people experience.
And, if you have a chronic condition, the cycle repeats.
And repeats. And repeats. And repeats.
I suspect my next essay will be about the stages of living with depression…. or whatever difficulty, struggle, condition or other life reality you’re living with. Because yes, we are all living with something. And yes, we are all somewhere in the journey or process….somewhere in the stages.
And it’s life.
It’s just life.
So go live it.
And help others live it if you’re lucky enough to be in one of the easier stages today.