The Transcranial Magnetic Stimulation Journey Begins

I had my first transcranial magnetic stimulation (TMS) treatment this morning. It was interesting. For those who don’t know, TMS is an FDA approved treatment for major depressive disorder. It is prescribed in cases where medication has not been effective. Basically, the doctor uses MRI magnets to stimulate the brain and “wake it up” so it functions normally. The treatment is five days a week for six weeks, then a taper down for three weeks.

My therapist first suggested I look into the treatment a few months ago. I’m just starting now for a couple of reasons. First, I wanted to do it over the summer so it wouldn’t interfere with work. (Sadly, I have no job over the summer.) But, more importantly, there was a whole process to getting it prescribed. I had to do some research to make sure it was a therapy I was comfortable with getting. Then, I had to talk to my psych prescriber and my PCP to find out if they thought I was a good candidate for the treatment. After that, I had to get a consult from the doctor that would be doing the TMS to make sure I fit the clinic’s criteria. Finally, I had to talk to the insurance company to make sure it was covered. That might not sound like much, but when you’re in a depressive episode as I have been, it was kind of a heroic effort.

I got everything checked off a couple of weeks ago and today was the day to start. From my research, I knew what to expect, but I also didn’t know what to expect if that makes any sense. I showed up a little early, but they were ready for me, so we got right down to it.

I started with paperwork, consent forms and things like that. Then, I filled out a depression checklist. This will act as my baseline to see if I’m improving as the treatment goes on. My score indicates that I’m pretty gosh-darned depressed. That’s no surprise. I’ve been really feeling the depression the past month or so. It’s almost like my depression knows I’m doing something new to get rid of it and is digging its heels in.

After that, the nurse had me sit in the chair where the treatment happens. It looks a lot like a dentist’s chair but can be adjusted in a lot more ways. She made all kinds of adjustments until we found a way I would be comfortable sitting without moving for more than half an hour at a time. Then, we did the same thing with the headrest. Apparently, it’s important that my head is positioned precisely for this to work.

Next, the doctor came in to “map my brain”. They put what looked like a swim cap with a grid printed on it on my head. She moved the magnets around the left side of my scalp until the fingers of my right hand started to twitch involuntarily. It was painless, but a little spooky. She somehow used the twitching to judge the correct placement of the magnets and then started testing strength. She said she was getting the proper readings with the lowest setting and told me that was a good thing.

Once I was mapped, I was ready for the actual treatment. The doctor left and the nurse handled everything else. I spent the next 20ish minutes sitting very still and the machine did all the work. I felt a tap, tap, tap, tap (with a click to go along with each tap) for about four seconds. There was a pause, then a chime, then it repeated. During the taps, my left eyebrow twitched a little, but they told me that was nothing to worry about.

After the 20 minutes, I was done. I did have a mild headache, but I was really no worse for wear. Unlike my IOP posts, I don’t think I’m going to give daily updates on my TMS. Today was more involved being the first day. Every other day will just be the 20-minute treatment. There’s a limit to how many times I can write tap, tap, tap, tap, pause, chime and have it be interesting. Apparently, they will have me fill out a new depression checklist every couple of weeks to track my progress. I’ll probably use those to update you, too.

Wish me luck. I’ll keep you posted.