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    I’m wondering if others experience a worsening of their symptoms when they start treatment. I’m almost done with my 2nd treatment and I’m still feeling a little worse. Has anyone else experienced this?



    That’s 2nd week of treatment



    The response to treatment is quite individual. On one end of the spectrum some patients feel better almost immediately while at the other end, some don’t feel improvement until after the end of treatment. This site addresses the real issue of the “dip” which some but not all patients experience. Some patients feel better, then worse, then better throughout treatment. If you are feeling discouraged, your supports both professional and personal/family as well as this site may provide the encouragement you need. TMS can be challenging at times just like other medical treatments. Communicating with your TMS coordinator as well as your prescribing physician can provide strength, encouragement and guidance. Good Luck.



    My own experience is that I felt bad throughout the initial TMS treatment . After about 20 sessions there was a radical shift in mood.Then I woke up one morning without anxiety. Before this positive shift came about my mood got worse it appeared during the course of treatment. I even felt that TMS was not going to work. Each individual is different . It’s important to be patient and talk with your TMS support team if you find that your mood is worsening. This can happen and at the begining or the the end of treatment.

    Now I am pleased to say I am better. I have TMS every two weeks now and soon this will go down to once a month.
    Courage !



    It sounds like you are pleased with the outcome of your TMS Treatments. I think you your advice is strong and on point. I felt the same as you during Treatment – that it wasn’t going to work, but it did. It does take the “courage” that you refer to. Continued health!



    Yes I agree .It requires a certain amount of courage as with any treatment for a serious pathology. Of course this courage and positive outlook is not easy when we are in the depressed mind state but what choice do we have ? If we are having difficulty then hopefully we can find encouragement in our entourage .
    I am absolutely pleased with the outcome of my TMS treatment it was obviously well worth the time and effort. We are unfortunate to suffer depression but so fortunate that we live in a time where TMS exists and can help us to overcome this illness.The future is bright !



    I’ll second that Colin06! And previous to TMS the outlook wasn’t optimistic. Gratitude flows.



    Does anyone know of another forum focused on TMS?
    Nothing against this one–there is a good deal of good information, much of which I have reviewed. But this forum has two big limitations – first, as it acknowledges, it is a site advocating for TMS (which is great btw!, but not objective and disinterested); and second, I am looking for a TMS forum where more people post comments and where users can start new topics. If anyone knows and would post a link here, I’d appreciate.

    I just started TMS treatment a couple days ago, and seem to be noticing an initial uptick in mood. I can’t know whether this is a placebo effect right now, mabye coming back from 5 days of vacation – but it is welcome and I am cautiously optimistic. It has been a LOOOOONG road.

    One (perhaps multifaceted) topic I am especially interested in is is What Factors or Things Should Patients Know To Do that can Increase Likelihood and Degree of Benefit?
    This might include anything from:
    -consistency of treatments without gaps
    -coordinating TMS treatment with “a well-designed and correctly-timed advanced psychopharmacological treatment”, as one psychiatrist and Neurostar early adopter (who has a now-discontinued specialized certification in pharmacological expertise) puts it.
    -receiving talk therapy or other forms of therapy during the period of TMS treatment and even engaging in quasi-talk about one’s condition and about the treatment with the technician while sitting in the chair – by provider has emphasized the importance of both of these.
    -and Data. Good, objective information on the status and quality of peer-reviewed research if any.


    In most cases, the key to enhance the odds of success with TMS to well over what is generally reported is accurate technique and (when appropriate) knowing how to integrate TMS with a well-designed and correctly-timed advanced psychopharmacological treatment. Incorrect choice or timing of medications may reduce TMS efficacy. As an advanced psychopharmacologist, Dr. Duzyurek pays particular attention to achieving a synergistic integration of the two modalities, and to the crucial technical details for a correct and effective application of TMS treatment at every session. He is able to offer personalized enhancements in the application of rTMS for increased efficacy, and an integrated delivery of other aspects of psychiatric treatment during TMS sessions for time and cost efficiency. With this approach, he has successfully treated patients with TMS after their failed attempts at high-volume TMS clinics.




    Because TMS is a new, innovative treatment option, it will take time to advance all avenues of information and support systems as well as public education and forums regarding TMS. I also have attempted to locate TMS forums previous to discovering TMS + You. Unfortunately the offerings I found were minimal and the most recent posts were in 2012.
    As TMS + You is in its inception, its development will most likely progress to address your areas of interest as well as related topics raised by other participants. Because you posted your comments, chances are a dialogue will begin.
    The first source of information for your question, “One (perhaps multifaceted) topic I am especially interested in is What Factors or Things Should Patients Know To Do that can Increase Likelihood and Degree of Benefit?” might be your doctor and TMS Coordinator. They observe first hand the process, outcomes and patient involvement and actions they (the patients) have taken to confront and deal with their depression in conjunction with TMS treatments. Your doctor and TMS Coordinator also are privy to the latest research on TMS related topics.
    Being proactive such as you are by asking questions and soliciting information to support your efforts to deal with depression and the TMS Treatments, is a strong asset. Every person’s experience with TMS is different, as much as there may be some generic similarities. Keeping a close connect and communication with my doctor, the TMS Coordinator and staff was key to helping me through the ups and downs of treatment and advancing my success. Also continuing to acquire a broad knowledge of what activities are helpful in confronting depression symptoms and engaging in those activities when possible can be helpful. Watching videos, reading articles, etc., can provide valuable tools to you in supporting your efforts. Asking for support throughout treatment if you need it can also advance positive thinking releasing those valuable endorphins!
    I am not sure if this would be helpful, but I came across this today:
    Best wishes in your journey.



    That makes sense. Thanks for the info. The Pinterest page is good.



    Hi Gandolfication:
    I too am looking for more activity in this forum. As I understand it though, this is a pretty new website and they’re still building a following for the forum. You and I and colleencasey may be some of the first to be on here. But like colleen, I haven’t found a forum for TMS that has a ton of activity. It is still pretty new therapy though, as far as being on the market, so maybe that has something to do with it. This site does have a lot of information though, so that’s something…



    Thanks Dave.

    Yah hopefully it will grow. And if it does, and it has open, uncensored information, I’ll be back here. I’ll post the results of my expeirence sometime in the near future after completing the initial phase. Here’s hoping…..


    Martha Rhodes

    Hi Gandolfication,
    This site is so new and public awareness is only catching up with OUR patient needs for more information as well as for more communication and sharing of our personal TMS experiences. I’m hoping you’ll be a willing participant to help spread the word about this life-saving therapy. Your questions, concerns, and requests are all good — other patients are going to want to hear from you, including me!

    I just got off the phone with a TMS device manufacturer in Wales, UK and they have introduced doctors and patients to this website in Australia last week. It’s all viral, and I’m seeing patients from Europe and South America showing up, so please know that you’re part of an international movement to bring an alternative treatment for Treatment Resistant Depression to people who otherwise might give up on life altogether if it we didn’t make the effort to promote knowledge, experience, data and belief in TMS.

    And sincere thank you’s to Colin06, colleencasey, Dave_Wigfield and almarge7 for participating on this!



    Hi almarge:

    I’ve been thinking about you since your initial post. Have you made any improvements as your treatment rolls on? Hope all is well with you.



    I’ve now finished 12 sessions and I am definitely worse than when I started. There have been other complicating factors in my life – illness in my family and being ill myself, as well as difficulties with scheduling TMS into my daily life. I’m the most frustrated with how much it wipes me out after every session. I’m a zombie, a very depressed zombie. My go-to coping mechanism for my longterm depression is already sleep, so I really don’t need any more encouragement there. My doctor is aware of the fact that things aren’t going well for me, and is increasing my dosage. If this is ‘the dip’, it’s really unpleasant.



    Hi sadmommy
    yes life can be tough but if you want to help yourself you need to carry on . Twelve sessions is not a lot although it may seem so at the moment . Remember it can happen that you seem worse . I had twenty sessions and it felt that all was lost … and then from one day to the next I was better. Good luck !



    Good Morning sadmommy:

    I have to support Colin06’s response. Sometimes it feels like your situation is worsening rather than improving through treatment. I almost stopped after two weeks but had much needed support and encouragement from my doctor and his staff to continue. It is early in your treatment. If you are experiencing the dip, the positive aspect is that it is temporary. Treatment can be challenging and takes patience that sometimes seems in short supply. Use your resources (including this site) for strength and support. Let us know how your are doing. Take care.



    Hi Sadmommy,

    I have heard this elsewhere from a number of people, so I don’t think it is uncommon.

    I would be in close consultation with your doctor about it, and I hope it improves for you.



    Martha Rhodes

    Dear sadmommy,
    You may very well be experiencing what I did at the exact same point in my TMS six weeks process: “The Dip”.
    I did TMS almost five years ago and there wasn’t too much information about this “Dip” phenomenon, but since then they’ve discovered that some people will feel WORSE before they get what I call the “The Lift” and it sounds like you’re right on target with this timing that’s identical to mine: 12-13 sessions into the process.

    My Dip lasted about a week, and then on the morning after my 19th session, I suddenly felt lighter. It wasn’t a huge, dramatic difference, but it was unmistakeably a feeling that I could manage the day. When I opened my eyes that morning I felt as if something was missing. It was the dreaded, disgusting UGGGGHHH! feeling of having to be alive. It just went missing. I didn’t even realize it was the TMS effect at first, that’s how subtle it was, but I had a hunch TMS was starting to work and it did. I continued for the next three weeks with daily treatments and I had full remission from my depression (HAM-D scales went from 29 down to 0). Now I use TMS once a month for maintenance, and although the depression hasn’t gone away (it’s a chronic, medical condition), I at least have the effective tool to keep those dreadful thoughts under wraps and without the side effects of antidepressant meds.

    Don’t give up on your TMS process. The fact that you’re feeling the Dip might mean TMS is waking up your brain and it will eventually bring you to a happier place where you can cope with the other disturbing factors in your life more easily.



    Just to update, I’ve had another five sessions, up to 17 now and still no improvement. I still hate getting out of bed. I have 32 sessions approved from my insurance and I plan on using every one of them, but ugh, I am not enjoying this process.



    You are ½ way through your sessions. The good news is that it is not unusual not to see progress yet. And the better news is that you are determined to see treatment through to the last one.

    In an article on the TMS Health and Wellness website, it says, “Over time, mood is affected (when treated with TMS). Because depression is mostly caused by an imbalance of chemicals in the brain, TMS therapy can help restore balance and relieve the symptoms of depression without the use of medication.”


    It can be quite challenging to be patient and let the treatment take its course. To be effective, it does take time though. I know words are not quite as comforting as we would like them to be, but science does show that the results are progressive and accumulative.

    It is nice that you are able to use this site to express your frustrations, as treatment can be challenging and difficult for various reasons and we need an outlet to release them. Keep in touch.

    Sending support.



    As I think I have alreday said , I didn’t get better until the end and I actually felt worse as time went by . I was getting anxious that the rTMS was not going to work in my case. I discussed increasing anxiety about achieving results with my psychiatrist who had referred me to the hospital where my rTMS took place and he prescribed a medication called Zyprexa . Within 24hrs I was feeling much better , less anxious. It is very important to talk with your doctor throughout the rTMS treatment . It can be the case that rTMS can help the medication you may be taking to work more effectively that seemed to be my case but you should know that we are all different as individuals and respond to the treatment in different ways and at different speeds.
    It is good that you are staying in touch . We understand what you are going through . Keep going living day by day. All shall be well.



    Hi Sadmom

    Hang in there!
    I just had my 16th treatment and I can relate to your feelings. Some-days I feel as if it is starting to work and the bamb I have a couple of bad days.
    Please keep the faith because that’s all we have right now.
    HOPE! that this will work.
    The TMS technician told me that she has had almost no one that stuck to the treatment and did not get some relief.
    With most getting substantial relief!
    I know that is not what the odds say but I believe her.
    So please hang in there and try to be positive.I am rooting for you!



    Now had 25 apts and no improvement. I’m feeling anxious that I only have 7 left approved by my insurance, and my doc said that insurance is more likely to approve more sessions if my self-assessments show some improvement. My doc is trying different things – we started at 3000 pulses and then moved to 3500. This week we moved back to 3000 but added 10 minutes of right-side low constant pulse treatment. The right side is supposed to help with anxiety, and though my primary issue is depression, there’s anxiety too.

    I’ve tried anti-anxiety meds before but haven’t found any that don’t completely knock me out. My doc has talked about me going back on some kind of anti-depressants, which means me trying to pick which miserable side-effects I want to go back to. That’s certainly anxiety-causing – the idea of going back on meds that either make me want to sleep all the time, give me terrible constipation, or give me nausea and body-aches.

    Hey, at least I get to watch some good TV shows during my sessions…



    My doc is talking about moving to deep TMS. I am fortunate to have a very experienced doc, one of the leaders in TMS use, but despondent that even he thinks it’s not working.




    It is discouraging when you invest so much hope into a treatment for your depression and the outcome may not be what you and your doctor wanted.

    Your account of faith in and gratitude for your doctor’s expertise can be a stabilizer on your journey to mental health. As long as there is still another avenue to try to reach your goal, then there is continued hope. When listening to testimonials of people with many difficult mental health diagnoses, a common thread to recovery seems to be guidance from a knowledgeable, compassionate doctor who is willing to walk the path side by side with her/his patient, as the patient does their work towards managing/recovering from their illness. From your account, it sounds like you have this.

    More importantly though, when discouraged and doubt settles in, listen to the voice inside that drives you to continue to try new options in combating your illness; the voice that although at times is weary and tired, does not give up and just settles.

    Support from a network of caring people can be quite helpful. Besides your medical team, family and friends, and TMS + You, there are local support groups in most areas with members who have walked the road before us, who share valuable suggestions and insights that may contribute to our arsenal of tools and skills.

    Globally there is much funding and activity being invested in brain research, so there is new understanding and treatments on the horizon. Keep walking forward no matter what roadblocks you happen on.

    Keep in touch. You and your experience are important.



    Thinking of you.




    Just wondering if you mad the move to deep TMS and just to see how you are doing?



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    I’m really struggling with TMS. I’ve only undergone a couple of sessions but my mood has gotten much, much worse. Whenever I’m not crying hysterically over how miserable I am in my life, I’m yelling at people and punching walls. My mood was fine before I began treatment. I don’t think I can work through it. I have so many more weeks to go and I’m barely able to get through a single day at a time. I don’t know what to do. I went into the session optimistic and hopeful and came out angrier than I have ever been in my entire life. Honestly, I’d rather be sad than blisteringly angry all the time. I don’t think I’ll continue with treatment.



    Hi whocares: I read your post and am wondering how you are doing? Are you continuing with treatment?
    Please let us know.



    Just had my fourth treatment. I felt pretty good after the 2nd but after that, went downhill. I heard there is something called The Rollercoaster effect. This is my last hope. The Lexapro just seemed to stop working. Maybe because of menopause? I am panicked all the time afraid I will lose my job, no concentration, afraid of being alone (I live alone), feel there is no hope or anything to look forward to (parents very old and experiencing issues)…Can someone please give me some hope that this will get better?



    Hi Weezay,

    I’m not sure how much hope I can offer, but perhaps we can share our journey. I just had my 4th treatment yesterday. My insurance will pay for 36 sessions, but I’m only doing 3 a week (more when possible) because of work. I’m on the rollercoaster too. After the first couple I had some good days, or at least hours, then today was really hard. I’m almost afraid to go tomorrow and Friday, but there’s part of my that just wants to plow ahead to 36 in hopes it will make a difference. I’d be happy to connect for mutual support if you’re interested. Hope you’re doing better than on the 3rd!




    Yes, I just finished my first week of treatment. I, too, feel worse. I am tired and weepy. I have noticed I am less stressed, but I am very, very sad and tired. I am hoping this will lift because no medications help me and I can’t afford ketamine which DID help but was $400 per dose and insurance does not cover it.



    Hello forevermom, Courty140 and weezay65:

    I am a patient who had NeuroStar TMS 7 1/2 years ago. It seems like from your posts you all have shared experiences with the “dip” or the Rollercoaster Effect (first time I have heard that term). You are undergoing a medical treatment and it can be challenging to say the least. Throughout treatment if you can support each other and try to stay as positive as possible the new research is showing that it may help with the outcome. There is an update on TMS research video that I will include the website of below. The information is fascinating and it may help you with some of your concerns. I go for booster treatments once a year and now am using an updated adminstration technique of having three treatments in one day for only one day and I am back to remission. Stay connected and let us know how your are doing. Sending support and hope to you all.



    I guess I also fall into the catagory of feeling much worse.

    I have had 5 treatments thus far for my severe depression and I am sleeping more than I thought was humanly possible… Upwards of 12 hours for 3 out of those 5 days and around 10 for the other two while feeling ridiculously tired and lathargic while awake.

    I am losing focus throughout my day and feel like a shell of a person. I am also losing basic motor skills and coordination.

    I went to turn the faucet on to wash my hands and missed the handle and knocked the soap bottle into the sink. I had a piano lesson today and broke down crying in front of my teacher because I couldn’t even hit basic chords that were an absolute piece of cake a week ago before treatment.

    I am not going to stop treatement and I have reached out to my doctor to let him know since it’s the weekend, but the treatment is not going as expected and wondering if I will get permanent damage as a result.

    This is sort of my last option though as alllll the medications I went through previously had awful side effects.

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