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I completed 22 treatments now. During the 1st week, I thought maybe there was a subtle uptick in mood. Actually, I think there was, and I believe it was because I made a very strong, concerted commitment and effort to do a number of things to either help ‘make it work’ given the time, money, effort, and feeling that it was a ‘last resort’ for me to feel better, or at least maximize the chances. So, I worked very hard to be sticking to better sleep, eating and exercise habits and making an effort at work to fight through the anxiety and procrastination that plagues me.
And I did this for a week or two. I finished the last 2 weeks of treatment during the holidays, while off work for 2 weeks with family, so the routine changed, although I kept up with a modified schedule and version of most of the good habits.
Unfortunately, the full weight of depression returned and has not abated. I can’t say I have or am experiencing any benefit from the TMS treatments, plus, in all honesty, I now also have the added weight of one more thing that didn’t work, which I’ll have to pay for and have no idea how.
Obviously my personal experience should not be generalized for everyone, any more than should be the experience of someone who has benefited from TMS. Right now, I could not recommend TMS as a treatment to others.
What really bothered me, was the lack of service from the doctor, neglecting to be really on top of a couple factors that I clearly communicated on multiple occasions to the technician, and then at the end, seeming to have no real interest in my actually getting better. His only points of hope or possibility at all were for me to query whether my wife thought I had seen improvement, and whether I noticed improvement in the following month. My wife’s assessment is about the same as mine – that I have been showing some real signs of progress associated with the hard, DBT skills work I have been doing, and unfortunately, I’ve noticed no improvement this month.
It is very difficult to convey the level of disappointment and even somewhat disillusionment and feeling like I was a sucker for trying this expensive, time-consuming therapy, giving it a really serious go for 22 sessions straight, etc. and experiencing no benefit whatsoever.
I think people here and elsewhere deserve to hear these accounts along with the positive ones when evaluating their chances to benefit from this treatment
I am so sorry to hear that, and appreciate you taking the time to write about it.
Having a doctor that does not seem to care on top of these treatments not working for you must be devastating.
Maybe you should call him out on this forum so others don’t fall into the same situation.
My understanding from what I read is 30 treatments seem to be the norm as far as duration?
If you don’t mind me asking what is your next step? Is ECT a possibility for you?
My heart really goes out to you my friend and you will be in my prayers!Greg,
Hey, thanks for the feedback.
Yes, it is pretty difficult to take. I don’t recall offhand if there is a particular benchmark number of treatments that is typical. What I read and was told though was that one should really see some improvement or not at least sometime during about the 3rd or 4th week. I just can’t really justify continuing with something further when I have no reason or evidence to think it would help – and I didn’t really even have to persuade the doctor, who himself seemed not inclined to encourage me to go forward further with TMS.
If I thought ECT would help, I would do it (no idea how I’d pay for that either). From what I have read (and seen and heard from a few acquaintances who have done it) though, I do not think this is likely a good option and also tends to have very serious side effects even in its better modern incarnation.
I have been blown away from a TED talk I saw on deep brain stimulation, but these are still quite exotic treatments that seem very far out of reach.
I honestly don’t know. Right now, I plan to continue with DBT, from which I have seen definite progress, albeit, it takes a lot of time and right now, the immediate concerns of finance, finding a job I can stay engaged in, and surviving are paramount. I know the resources available and have a plan to use them if I really feel suicidal, but candidly, I do not feel like living, and am scraping by each day to continue. Presumably this isn’t the forum to go into that too much.
I may put some comments on a healthgrades review or something if it helps someone, including possibly the doctor himself. I don’t think I really want to call out a doctor by name in this forum. It just feels like nurturing a resentment, which I don’t want to do..
First I would like to commend your efforts in continuing to move forward with a path to combat your illness and secondly for presenting your disappointing experience with such integrity.
I am saddened that your experience had the outcome it did. I agree with Greg that from what I have read and discussed with others, (including several doctors), is that typically (there are variations) treatment is 30 days with roughly 3 treatments of tapering. What is disturbing is the lack of professional care you received. There are several experiences of patients who did not see results until after 30 days – after treatment ended.
TMS is a medical procedure and like others does not work for everyone. It is a risk no doubt. But there is much activity and focus in brain research occurring around the world right now and hopefully soon scientists will be able to advance treatments so they are more effective.
I keep in touch with a patient out West who has had a similar experience with an inept doctor. TMS did not work for her. She had to be hospitalized and is now being treated by a doctor whom she said really cares how she is doing. A combination of decreasing ECT treatments and the right meds and she is doing better. She has more good than bad days now, which is a vast improvement.
Good luck with your efforts and know advancements are being made routinely. I do hope you have found a doctor who cares about you and your mental health and employees every effort to help you with your persistence in dealing with depression.
With respect,
Colleen
Hi gandolfication,
There are so many factors that enter into the success of most depression therapies, and for those of us who have had success with TMS it is all the more heartbreaking that you didn’t get any relief with it, especially since we know how hope and hopelessness play such important roles in our mental health. You had your hopes set on getting relief and it didn’t happen for you, and that in itself is hugely depressing. Please don’t give up on finding the tool that will work for you, even if it is ECT or DBT.And please don’t be a stranger to this forum because we’re all in this together, and as new therapies and efficacy reports come in, there may be some valuable information for you as well as YOU might discover a remedy that we’d be very grateful to you for sharing.
I also hope you will post your experience on a HealthGrades site for the sake of others who might fall prey to this doctor’s uncaring practice. We can’t afford to let this type of mistreatment go un-noted considering the cost of time and money to patients and their families.
I am so sorry to hear of your struggle- I know that is frustrating. It is disturbing to think that doctors are supposed to be here to help us get better but, unfortunately, many only make things worse. That has been a contributing factor in my current state of depression. I was diagnosed with chronic pancreatitis 25 years ago. My physicians told me that surgery was my only option and that if I wanted to have “a normal life” I should undergo surgery on my pancreas which I finally did seven years ago. Unfortunately, the surgery did not go well and, long story short, I did not get to have that normal life. Instead I wound up with an addiction to painkillers and benzodiazepines. I have always struggled with my depression but in the last few years it has turned into a hellish nightmare. It is now physically painful and most times unbearable. I rarely leave the house I am so crippled by depression now. I definitely feel suicidal but have decided to look into ECT and TMS since antidepressants have not helped. I found this site and am hoping to gain a clearer perspective about my treatment options. I am wondering what makes someone choose TMS over ECT?
Claire,
There are probably a number of things that would make someone choose TMS over ECT.
TMS is no-invasive, so there is no sedation or anesthesia needed (although I did take Ibuprofen at the nurses’s suggestion, and candidly, it was uncomfortable bordering on some pain).
The major difference is that while ECT can be very effective in relieving some severe depression, it also is known to have very serious and very common side effects that range from loss of memory and feeling empty and zombie-like.
I don’t know much about the costs of ECT and whether one has to have someone drive them home, etc., but TMS is outpatient and you just come and go and feel fine the moment it’s over.
Of course from my perspective–a downside of TMS is that it flatly did not work. This is highly specific to each individual, although certainly I have come across quite a number of others here and on other fora who have said the same. FWIW, my psychiatrist says the other patients she referred to the TMS provider I used, experienced good results, but this is also highly anecdotal as I think the numbers may be int he realm of 2 or 3. I don’t want to sound like I’m discouraging anyone to try this, but just understand like any treatment, there is no guarantee of results, and I’m not sure there’s much can be done to know without trying it. The cost of TMS is easily $10k.
There is a lot more information I’m sure you can find out there, but hopefully I’ve hit on a few of the high points – a treating psychiatrist should be able to speak much more intelligently about the pros and cons of each.
gandolfication:
I was happy to see you post. I have wondered how you are doing and if you have decided on another option to treat your depression. Would be interested in an update if you are agreeable. We are here to support all, not just those who were successfully treated by TMS.
ColleenClaire:
Welcome to TMS + You. The information and support you receive here can be quite helpful in your journey.
I only speak from a patient perspective. I do believe gandolfication speaks accurately about the points he made in comparing ECT and TMS. His advice, “a treating psychiatrist should be able to speak much more intelligently about the pros and cons of each.” is an important direction to follow. There are certain criteria, like with any medical treatment, that determine an appropriate candidate for TMS. A knowledgeable administering TMS psychiatrist should be able to perform an assessment and guide you with choices.
Because there is not a definite criteria that can predict the outcome of TMS Treatments, the same end as ECT, the choice if considered, rests ultimately with the patient. Gathering as much information as possible and consulting a competent doctor are important elements in the decision making process.
Please keep us posted and know that we are here to support you.gandolfication-
Thank you for replying. You really should be very proud of yourself for all the work you have done so far- that is really quite impressive and should not be overlooked. It sounds like you have made such an effort like with the managing your schedule and doing the things you mentioned. The fact that you gave the TMS treatments a valid try (22, wasn’t it?!!!) is commendable. I hope you don’t really feel like a “sucker” as you mentioned. I think it shows a lot of initiative. I know it’s frustrating to not get any validation for something that seems to end poorly and which doesn’t show any evidence of being effective but you never know what may come of the TMS in the future. The mind can be a very crazy and unpredictable thing. I mean did the docs say TMS should work immediately and if it doesn’t work right away it never can or will? Maybe it could start to take some sort of effect later on in the future, like if something triggered or activated the chemicals or something… hopefully some good can and will still result. Do you think the depression is a result of a chemical imbalance? I just mention that because it seems like treatments such as TMS and ECT and even antidepressant medication are really only gonna be effective in treating depression that is chemical and not circumstantial. That’s just my opinion. As far as ECT, I guess I feel like memory loss and even feeling like a zombie are still preferable to the horrible pain of depression. As I said before, though, you never know how the brain may respond on down the road to the TMS treatments. I don’t know much about them but it’s entirely possible that they could help you in time and maybe in conjunction with other therapeutic tools like sun therapy or exercise or vitamins/ supplements etc. From what I understand, at least they can’t do any harm. Anyway, I hope you start to feel better soon. It sounds like you are doing all the right things so maybe that will pay off soon and you can get some relief. Thank you again for replying- it helps so much to get encouragement from other people- you have no idea how much it means! 🙂Claire, thank you for your encouragement.
I guess you’re right, I should give myself the credit that I have tried and at least basically seen through quite a few different types of treatment, including TMS, CBT, DBT therapy, and A LOT of medications, to name only a few. I have developed such a persistent depressive explanatory style (a pessimistic set of beliefs and view of how the world works).I guess my view of my own depression is that it is a combination of different causes – probably some predisposed tendency at least coming from biological/chemical precursors and learned behavior and environment – neither of which is my fault (even though I feel like it all is), learned/practiced behavior and thought patterns–which I definitely have some ability and responsibility to change, and yes circumstances and the way I respond to them.
Sure the TMS Doctor said I may notice improvement in the month following concluding TMS treatments. It would be magnificent to be surprised, but I January has passed, I have not so far, and being honest, do not hold hope that I will. There were no negative effects whatsoever (sans loss of time and soon to be money, and inevitably some disappointment). When and if I get the bill, that is going to be very difficult, but Mostly, I try not to dwell on it and haven’t much – and that is very significant and helpful for me.
As far as what I plan to do to treat my own depression and improve. As daunting a question as that feels, the things that I believe can and will help to the extent I am able to do them, include:
-continuing to practice DBT (CBT + mindfulness) skills – right now at least, I plan to continue in the group/therapy course, although costs (and time) are not easy (this involves a lot but perhaps paramount of me is practicing present moment mindfulness without judgment, and and learning to accept painful emotions and do the next right thing anyway even despite that I feel like doing the opposite);
-getting back into some of the really good 12-step groups and networking with other people here – I have seen quite a number of people who have gotten better and who I know with no doubt, have experienced the same depressive and other challenges in life that we have;
-forcing myself to find opportunities to help others in their journeys (a key 12 step principle and one that takes me out of my own head and away from self-centered fear)
-I continue to work with my psychiatrist and keep hoping that perhaps some medication may help even a little, though I must be on the 20th one now, and really nothing;
-taking steps to find work I can be more productive and engaged with and believing that I can eventually find an opportunity to better use some of the strengths I know I still have somewhere within me, the skills I developed through law school, etc. I would ultimately like to find some ways to write and perhaps speak about some of the things I find really interesting and worthwhile these days, which include depression, neuroscience/psychology, spirituality, information theory, quantum physics and politics. I have no idea how these are related if at all, nor how my background in law and sales–(other than the ability to research, read, analyze, synthesize and write)–may help me get there, and there is a ton of doubt.Anyway, thanks for listening. I hope you make progress in your journey too, and would appreciate hearing how things go for you.
You both talk so intelligently and really seem to understand your illness.
I wish you the best in your fight against this insidious disease.
Honestly, you have helped me just reading your posts.
Sharing ideas and other treatments options to fight and gain hope is what this forum is all about it seems.
Please keep us updated on your progress.
I have though long and hard about ECT and to be honest it frightens me.However, Claire’s point about choosing between a life of depression and misery verses taking a chance on losing some memory would be a fair trade off if I knew for sure it would work.
I still have some hope for TMS as I had my 24th treatment today.I am rooting for you both!
Greg, thanks,
If I thought ECT was a simple decision that would have a very high likelihood of working in exchange for some short term memory loss or even a deeper mixup of memory, I’d do it in s second also. Unfortunately, from my what I have read and heard, it’s a bit more involved than that, and ECT is an on-going treatment you have to keep going back for.I wonder if anyone here has ever seen or heard of deep brain stimulation? There is an utterly fascinating TED talk on it by a doctor who has been performing these procedures implanting an electrode spear into the head controlled by a remote control wired up through the torso – you can actually see on the video how it virtually cures conditions like the Parkinson’s tremor, and the doctor talks about remarkable success he’s having with more or less curing or alleviating severe, resistant depression, and even beginning to see some effect on alzheimer’s. It is breathtaking to watch.
Anyway, not very accessible yet, and also it is obviously a very invasive procedure. Anway, just musing….Maybe someday if I can make it long enough.
greg-
Thank you for sharing about your situation. Though I am sorry you are dealing with depression, it does help to hear from others who also suffer. I certainly hope the TMS treatments go well for you so please keep us posted. Yes I think this forum is a great place to share and support (if the TMS folks don’t mind us using their site for that…?) I admit that ECT frightens me too. However, before my pancreas surgeries forced me to have to give up my job, I worked as a nurse in a psych hospital and spent some shifts in the ECT lab so I got to watch it done and talk to some of the patients as well as the staff. From what I saw and gathered it was a very successful treatment for the depressed patients. It was not scary. If you’ve never seen it done, it is not at all like what you see in the movies. As you already know you are sedated (mildly- you wake right up within a few mins) and the whole thing takes less than five minutes. Your big toe twitches and your face gets a little flushed and that’s about it. The reports I got were that it was effective and helpful. I never heard anything bad about it. I asked the docs and nurses who had been doing it for years and they said people come in regularly for maintenance treatments but did not report any negative side effects- no brain damage or significant memory loss. I now see ECT sort of like cardioversion- if your heart has an abnormal rhythm you would have a cardiologist “shock” your heart with electricity to get it back to beating normally. It is easy, safe and can be done as an outpatient. With the chemically imbalanced depressed brain, it is basically not handling the serotonin et al production properly so electricity is used to reset the brain’s functioning. (This is just my own simplification of ECT in an effort to reduce the creepy scary dangerous factor in case I ever do it!) As for TMS, this psych hosp also did treatments and studies with it too. I took part in a paid study one time to see if TMS would help my pancreatitis pain. It was hard to tell if it did but I figured as long as I was doing it maybe it would also help my depression. Again it was hard to tell if it did but I didn’t feel any happier after doing it. But I also did not have nearly as many treatments as seems to be necessary- certainly not 20. I seem to remember having just a handful.gandolfication-
I could relate to all you mentioned except for the quantum physics! ha ha. I’ve also tried every medication known to man several times and I’ve been deemed “treatment resistant.” (20 years ago they helped but no more.) I too would like to write about my experience with depression if nothing more than to just chronicle what all I’ve learned from it. And maybe to find some humor in it too- they say out of pain can come humor and I’ve always thought laughter is the best medicine. I’d also like to work with or help others who suffer with it- doing that usually helps me as much as it does them, if not more so. I agree with you when you mentioned something about getting outside your head. That is the worst thing a depressed person can do is stay trapped all alone inside his or her head obsessing about negative stuff or engaging in negative self talk/ negative thoughts. I am so guilty of that! Distraction is sometimes the only way to help myself. Another thing I’ve learned is that the depressed mind is kind of like the out of shape body- it must be “exercised” and trained to be strong and forced to fight back against negative self talk. I’m sure I’m not telling you anything you don’t already know but I’ve found it really is true, though it sounds corny and cliche. I grasped this concept after reading David Burns’ “Feeling Good: The New Mood Therapy” which talks about CBT. I’ve found when I start thinking negatively I start to feel worse emotionally and even physically. I’ve also since learned that just refraining from negative thinking is not enough- I actually have to “get in shape” by thinking positively. You know how when we sit on the couch and eat junk food we start to get overweight and flabby and lose muscle mass etc? So we have to get up and exercise. The same goes for our minds mentally- we have to “work out” by re-training our minds to think, live, breathe, eat, drink positive thoughts. Mental happy exercises are a must for me if I want to feel any better. So what I do is actually make myself think about specific times or events in the past that trigger happy memories for me. I actually try to visualize using imagery and tricking myself into feeling that way again. Then I also try to force myself to imagine how I’m gonna feel those good feelings again WHEN this depression eases up. Like when Spring comes through and I can go outside and let the sunshine bathe me in a euphoric bath. I try to do whatever I can to trigger good sensations and memories. I’ve done a lot of mindful meditation like you mentioned. Music is a good trigger of pleasant memories too. And I make myself think about the hope of possibilities- training oneself to think positively takes time and effort but at least if I’m too depressed to get out of bed I can still lie in bed and work on positive thinking and hope! This is what I’ve found helps me lately so I just wanted to share. I’d welcome anyone else’s suggestions too though! And don’t forget to be kind to yourself- no putting yourself down…;-) As I said before, you have accomplished a lot that you should be proud of. Both of you have done TMS- that’s impressive itself. Feel proud that just y’all communicating here on this site helps. I know it encourages me and I’m SO grateful for that- you have NO idea! What a great feeling to know you’ve helped and inspired someone else who appreciates it, right? It’s support within a group of others who suffer with the same affliction. And that is just what depression is- a terrible affliction. Just like diabetes or M.S. It afflicts people. It’s not a choice and it doesn’t result from weakness or laziness. I hate that stigma of mental illness. We are all fighting it and there is a lot to be said for that! I say these things to remind myself and any others who maybe need to hear it also so they can keep fighting the good fight! 🙂 …and y’all please keep sharing! Thank you!!!Anyone else feel like maybe our spirits will lift a little once Spring gets here and thaws out our “frozen” souls? Winter is always so brutal for depression!
Back to the TMS though- greg and gandolfication- did y’all notice ANY difference in how you felt after the treatments- both physically and/or mentally? I don’t just mean as in better or worse- just different. And how does TMS actually work to treat? From what I’ve read it seems like while ECT uses electricity to get the brain chemistry back on track, TMS uses magnetic stimulation to do that. Is that correct? I’ve read about it but I still find I need a “dumbed down” version of the facts… (And let me just say I understand this is NOT in place of a physician’s consult- I’m just wondering from the perspective of someone who’s actually undergone the treatments.) And last, in general, does insurance ever cover any of the cost of TMS treatments? Thank you.
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This reply was modified 9 years, 2 months ago by
claire.
PS- I wasn’t trying to sound all preachy about the depression but rather I get all excited when I feel like the lightbulb goes off above my head and I feel like I’ve learned something new so like to share it aloud…so really it’s more for my own benefit that I put thoughts out there. I don’t mean to insult anyone’s intelligence or talk down to anyone by telling them what to do. I find myself many times marinating in negative thoughts so also want to help others who may be suffering from the same problem. I wasn’t aiming at anyone but rather trying to add to the discussion… It would be cool to compile other people’s thoughts as well to provide any kind of enlightenment on how to cope with and fight depression. I learn so much from other people so I’m always grateful for any useful tools.
Claire:
Your post spoke to me. I cannot tell you how much I relate to your words and what I interpret the meaning to be behind them. What I would like to say is continue doing what you are doing! You are speaking to all of us in one way or another. It is helpful, inspiring and confirming to me personally and I am sure to others. My process is similar to what I am reading in your post. It was encouraging to me and I am sure to others who process in a similar fashion. I love to learn and am motivated by others too. For those of us that advocate for TMS or other issues in the Mental Health arena, it keeps us in touch with our depression history and inspires us to keep working for all of us who have and/or are suffering from depression. I am glad you found this forum and look forward to your continued contribution.Thank you
Claire,
I also appreciate your posts and certainly know what you mean when you said we marinate in our own negative thoughts.These thoughts seem to build on each other and put us in a hole that is hard to get out of.
To answer your question about TMS in your earlier post.I just had my 25th treatment yesterday.
While I struggled in the first month of treatment with thoughts like this isn’t going to work for me and they are not doing this right.For the first time in years I am starting to feel better and can see that these thoughts were just part of my sickness.
Your knowledge while working in the “mental health industry” is very interesting and I think it can be very helpful to people who are looking at their options for treatment.
I also suffer from chronic pain due to several failed spinal operations and I know that can cause depression and is probably a big part of my disease.Thanks again for your insight and I do enjoy reading what you have to say.
Claire,
In my first week to 10 days, I noticed a modest uptick in mood, and more precisely, in vitality.
I had gone into the procedure with the idea that a) this held real promise, b) that it was somewhat of a last-ditch effort; and c) that therefore I was going to do everything I could to help make it work. Also the time and expense kind of made this obvious.I had recently come off of completing my first DBT group (and individual) therapy course.
So I made a very conscious and concerted effort to be doing other things that I know help me, especially getting good sleep, getting up early in the morning and exercising. And I will say that I really enjoyed and I’m sure benefitted from talking to the very thoughtful technician (getting his masters in psychology) for 45 minutes, 5 days per week,
So those were my circumstances and my experience.
And in the first week to 10 days, I thought, ‘hey, I am feeling a very subtle but also noticeable and thus decisive uptick in vitality and mood,’ even a little hope. Now this would be somewhat unusual in that not too many people report improvement or changes this early. And I tried to be cautious about it.
Looking back I try not to judge it, but it does seem to me like this may well have been a product of placebo and of my own actions I was taking.The actions part is not to be minimized – it reminds me again that the line between feeling and doing very badly versus making small changes and doing little things that will result in my feeling better, is very small, even if very difficult.
Regarding how ECT and TMS works, you can read more authoritative descriptions than this, but essentially this.
They operate on the same biological-electrochemical theory of depression, that antidepressants do. That is they seek to modify–even if slightly–the electrochemical reactions that take place in the brain, especially in the prefrontal cortex and are thought to largely control or impact mood (serotonin, norepinephrine, dopamine, oxytocin and others). Antidepressants do this by seeking to stimulate and retain these chemicals. ECT does so by seeking to influence the electrical activity in the brain. TMS is thought to do so by stimulating the brain with a magnetic field or pulse. If you think about what the brain is, it is a biological organ, full of reactions that are electrochemical – that is it contains chemicals and electricity. Going right back to Michael Faraday–who discovered the electromagnetic field–when you pass a magnet through and electrical current, the forces interact. I am honestly not sure if anyone truly understands a whole lot more about exactly what the electromagnetic field or spectrum is – I get the sense that this still relatively young field of science is a bit mysterious, and if you notice, almost invariably, even the most strident claims about TMS are usually appropriately couched in terms of what it is “thought to do” or how it is “thought to work,” an honest even if disquieting admission which psychiatrists also usually make about antidepressants.I may write about this eventually on a blog I started as a creative outlet https://onbeingnow.wordpress.com/
Claire,
I wanted to add that I liked your post above and thought there was a lot of good stuff in it, especially what you described about visualizing past happy experiences – I had just been thinking about it. You know, with depression and the anxious, ‘mindless’ ruminating thinking, it is so hard to do something like this for me. Someone recently said to me that “forcing yourself to face what IS, right here and NOW, and even to be alone with oneself is something that most people find very difficult and aren’t terribly interested in doing.
“…make myself think about specific times or events in the past that trigger happy memories for me. I actually try to visualize using imagery and tricking myself into feeling that way again. Then I also try to force myself to imagine how I’m gonna feel those good feelings again WHEN this depression eases up.”
So with that in mind, I’m going to practice that.
Oh, Btw, there are a couple pretty good and lengthy threads on the DepressionForum.org (great site) dealing with peoples’ experiences with TMS – I found them helpful when deciding whether to try it.
These are all password-protected and anonymous so I am sharing them here in case they help people.
http://www.depressionforums.org/forums/topic/92804-transcranial-magnetic-stimulation-tms/
I have chronicled a lot of my TMS experience under this thread: http://www.depressionforums.org/forums/topic/104275-experiences-with-dialectical-behavioral-therapy-dbt/
Gandolification,
I appreciate you posting that thread as I certainly learned a lot from it.
You have a way with words my friend and your tenacity to fight this horrible disease is inspiring.
Maybe you could write a book with your incredible writing skills?
Love the idea of going back into your positive memories and living in that feeling today.Great stuff!
My thoughts and prayers are with you in your fight.How are things going for you?
Thanks Greg,
Yah, I’d really like to do that. I started writing a blog here recently, and as one topic at least, I intend to write about depression (and hopefully recovery) in time.
I am okay today – just feeling tired, which is extremely good for a monday (and well explained by late bedtime and early morning). How are you?
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This reply was modified 9 years, 2 months ago by
gandolfication.
Thank you Colleen- I appreciate your reply. I am encouraged as well by yours and every other response here on this site so am grateful to have been able to connect with others who also suffer with depression. Just being able to communicate with other people who understand is so therapeutic. I’m also glad to be able to learn more about TMS since I really didn’t know much about it except things I’ve read online. I’ve never talked to anyone with experience with it so I’m glad to get some exposure to it. Thank you and good luck with your process too!
Greg- my heart goes out to you for having to live in chronic pain and deal with spinal cord surgeries. I’ve read about how painful that is and yes, it will certainly contribute to depression in a major way. Living in pain definitely takes a toll on a person but I think the worst part is all the pain meds they give people in pain. For me those have been like poison in my depressed brain. I’m so glad your TMS treatments have helped you. Do you think they help any with the physical pain- directly or indirectly?
Gandolfication- whoever told you that it is basically difficult to face the here and now was absolutely right. That is so true- I find it so much easier and way more pleasant to just sit and imagine the past rather than face the present. Thank goodness for pleasant memories that allow me to transport myself back to times when I felt joy, serenity and peace. Being alone and facing the present is definitely tough. Thanks also for the references. And yes you should write some self help things for people to refer to when looking for tips on battling depression. All the things you mention are helpful. What do you think about natural herbal remedies? I took St. John’s wort several years ago and found it to be helpful but figured it might have been more of a placebo. It seemed to lose effectiveness later after the novelty wore off. Now I’m interested in looking into the B vitamins to see if those would help. I also think there is some value in prescribing stimulants for severe depression. I believe Ritalin is sometimes used for that. I took Adderall myself for a bit to see if that helped and I think it did but my doctor got nervous when my blood pressure went up so took me off.
Claire,
Thanks.
I have tried some, not a lot of herbal or homeopathic supplements. I have never really noticed any difference in mood or vitality from any combination of vitamins, supplements, etc. I’m not opposed to them. Actually, even from the loooong litany of antidepressants I have tried (including either off-label or meds for other only somewhat related conditions, including Adderall), I have rarely noticed any positive outcome or benefit. Some of the stronger anti-anxiety meds like Klonopin, I did feel more sedate, but that is about it. And, feeling more sedate is not how I want to feel and not even ultimately productive for me.Once or twice I think Prozac probably helped with an uptick in vitality/energy and mood – I went off at least once because at the time, we thought I was manic depressive (I really am not or if I am, the mania was limited to 1 episode during a perfect storm and then perhaps to high-energy during creative periods like 4 years of college or 3 of law school). Prozac also tends to give me relatively bad night sweats. I have kept a chart with notes on effects of all the meds I have taken because my memory has deteriorated as I have gotten older with cronic stress and depression. The couple things (unfortunately) that I did find provided great temporary relief, relaxation, lowered anxiety and even euphoria were marijuana, which I used for about a year, and alcohol (which I used for a few, and it alcohol was the much poorer of the too). Since I knew I was using these expressly to escape and alter reality, I progressed from having never touched either up until age 34, and thus came to the conclusion that they were not healthy – and of course doctors and therapists have said the same.
I am open to anything, meds or not – anything that works. I simply haven’t found it in chemicals or pharmaceutics at all. And this has caused me to think that for me, it just may be mostly behavioral/circumstantial, and that perhaps to the extent my depression could ever be improved by putting any chemical or substance into my body, neither I nor a doctor, currently knows what that is.
Claire,
Pain is certainly a factor for sure.
I also agree about the pain medication as I though that this was causing my depression.So I did go two years with out them and it became impossible to do simple tasks to help my family.Working was almost impossible with out them.
So I am stuck taking them.I try to get by on the least possible amount.It seems that the TMS treatments have helped with pain somewhat.
Gandolification
Living on good memories is something that I have been trying since it was mentioned here and it does seems to help.
I think the Beatles put it best in “Yesterday” one of my favorite songs.Speaking of supplements, Sam E is something that I have tried that seemed to work pretty good but for some reason I couldn’t tolerate it due to gastrointestinal issues.
As far as TMS is going I just had my 27th session this morning and despite having a panic attack this morning It has definitely raised my mood and to put it bluntly,has stopped my thoughts of suicide.
I just hope it holds.
Thinking of you both.
Greg,
I’m very glad to hear you seem to be feeling better after the TMS treatments. I know what those dark thoughts feel like all too well – and it is very gratifying hearing that they have subsided for you even if for now (every experience in life is temporary so we should enjoy the present as often as possible).
I love the song Yesterday. Yah, I think of remembering happy memories not so much as ‘living in the past’ (by which I am almost always referring to regrets negative experiences). Rather what I found in the last few days when actually practicing this consciously was that remember those good things–even though I don’t have and am not actually experiencing them now–the brain doesn’t know the difference. So when I really enter in and recall the sensory experience of things I have enjoyed in my life, it is very similar to if I did have them now, and in fact I am enjoying their experience again now – something our depressed minds do very naturally by finding the path of least resistance to remembering painful and negative experiences.
I also have been adding an affirmation that “I will have things like this or have positive experiences similar to this again”…and surprisingly not objecting or doubting.
We are conditioned to ‘be tough on ourselves’ as a means of motivating, pushing, etc. and also to be always obsessed with what is now and next, but the truth is that our minds only know what they are experiencing right now.
Claire, you are welcome. I agree communicating with others having similar experiences is quite therapeutic. Depression is an under estimated challenge no doubt and takes self-motivation, extensive research and trial and error to manage.
It is difficult when you are looking into treatment options and there are few if any peers available to consult with who have experienced it. I found that to be an additional frustration before deciding to engage in TMS.
After treatment, I have found it difficult to not have peers to talk with about the unexpected challenges and unknowns of recovery. This site provides a community for us all to communicate with, explore and be supported in all of our endeavors with depression no matter what stage of illness or recovery we are in.
I am continually on guard for signs of depression and am always open to and trying any healthy suggestions that are offered to manage depression because every May my depression creeps back into my life. I return to the doctor for two maintenance treatments and then I am set for a year. Depression is only a minute away.
I attend NAMI meetings and two Saturdays past, I attended their conference, “Hope and Healing. It was a series of speakers who have found ways to manage their mental illnesses. They offered several suggestions for their individual programs. What I came away feeling is that open societal discussions about depression and other mental illnesses are becoming more commonplace. There is more sharing and support available than ever before. The main speaker was very inspiring and I have included his website. You may find it interesting and helpful in some way. Jason Paden is the gentleman and his presentation is fascinating.
If you have questions about TMS I am open. I may not be able to answer them all, but Martha and other contributors to this site may or we may offer resources to obtain the info you need; we would do our best.
Thanks
Thank you, Colleen, for the reference- I will check out. I have heard lots of positive things about the NAMI meetings. I have never attended but would like to for sure.
Greg- I too have to live on pain meds. Initially they were necessary for the pain but have since become necessary just to function, though not happily, since I believe they are the worst possible thing for an already depressed mood. I’ve noticed a direct correlation between my intake of pain pills and my depressed mood/subsequent suicidal thoughts. Many times I’ve had to remind myself that it was the medication causing the dark and scary feelings. Opiates and especially benzodiazepines can “trick” my mind into really believing in the validity of those thoughts and I’ve gotten very scared at times. I’ve mentioned before how powerful the mind can be when left alone to its own devices and certain meds can act sort of like steroids getting that deviant mind all revved up… For me the only thing worse than my idle mind is my idle mind on painkillers! It becomes a breeding ground for negative self talk that leads to negative thoughts that lead to negative feelings that lead to possibly negative actions/behavior. I just wish I could find an effective way to deal with the obsessing in my head. It feels like I’m going insane and even becomes physically painful- not just emotionally agonizing. It’s not so much my own negative thoughts as it is my mind replaying the negative things others have said to me or about me or what I’ve perceived them to have said about me that bothers me. I can’t seem to let go of those things and it just sends my already low self-esteem plummeting even further. Don’t know how to help myself there…? That’s one reason I guess I wouldn’t mind having some memory loss from ECT! ;-/ …Anyway, I am glad you mentioned Sam-E cause I’ve wanted to try that. My doctor also wants me to get a light lamp. I thought sitting in the sun would be enough but apparently not.
The Sun the Sun
The Sun does wonders for me.Since I live in Connecticut it is going to be a while until I get out in it.
You are so right about the pain meds and benzozs.
Trying to wean down from 1mg of klonipin since last week.From what I hear you have to very slow.
I hate taking them but it was the only thing that gave me any relief for the past couple of years.
The TMS has definitely taken my suicide thoughts away for now.
It seems I have a couple good days then get hit with a bad one.I had my 28th treatment this morning.
Colleen,
Thanks for the web site.I am especially interested the part about diet,can’t really exercise.
Praying for all of you!Your welcome Greg.
I am hopeful for you and supportive of your HOPE! It is quite an experience to realize that you have spent an hour, a 1/2 day or even a day not feeling suicidal. Such a feeling isn’t it?
When I was depressed I unfortunately did not tune into this aspect of the illness – What diet and exercise could do to enhance management of my depression. But a year ago I started really working at it and I have lost 90 lbs and feel better than I have in my life. I cannot exercise at the moment with bone spurs in my foot, but before I was. I changed my eating a little, as I have been on a good plan, to affect my metabolism to see if I could continue to lose without the exercise and it has worked. Much slower but still making progress. I added the cider vinegar/honey drink that Jason talks about on his website in the morning and I am feeling great. (And actually it is quite pleasant) So depression management is like a puzzle with many pieces.
Looking forward to your posts about the continuation of your journey!
Coleen,
That’s inspiring to hear….and I needed that today.
cider vinegar/honey drink – (that sounds awful to me 🙂 – it’s good and it makes you feel better?
I like the puzzle metaphor – good description.
I feel a bit less comfortable commenting on this site than the depressionforum.org (which is both anonymous generally and behind a members’ password-protected firewall). I am pretty open about depression with most other friends and even colleagues and have been for some time. And yet, I still don’t really want to admit to myself that I have this phenomenological condition, that it’s real and that I can’t just transcend it through effort and introspection. I’ve heard it said (in 12 step rooms especially) that you’re as sick as you’re secrets. I suppose this still represents for me a resisting of a reality that is undeniable – and I guess a rejection / non-acceptance of an important part of myself.
Greg- yes, benzos and opiates and maybe any drug that you are weaning off of should probably be done slowly and under dr’s care. However, I think if you find something (anything) that helps you feel better than that’s worth a lot. I would have continued taking Ativan if it had helped- however, I found it contributed to my depression and made my anxiety/panic attacks worse. As do opiates, but for now I have to keep taking them and try to wean down slowly and then see if I can function off them. I have weaned down off opiates three times now since my pancreas surgery seven years ago and the longest I went off them was about nine months. My depression got so bad that I had to go back on them just to be able to function. Now it is sort of like Odysseus trying to sail between Scylla and Caribdus- I have to take just enough to avoid withdrawal depression but not too much to cause worsening side effect depression. Frustrating and difficult! Anyway, I wish you luck and safety in weaning should you choose to do that.
Gandolfication:
I hear your reluctance or resistance to accepting some of the realities of depression. I have been through many reality acceptance challenges. Two things come to mind. For many years my therapist has, several times, reassured me and walked with me through my resistance to reality and slowly and methodically encouraged its confrontation. I have found the harder battle is the battle we wage resisting. This is not to say that confrontation is easy. It is painful, challenging and sometimes exhausting – however it is temporary. Resistance can be life long if we so choose. This has been a difficult but invaluable lesson. I am much more willing now to fight the shorter fight, to accept reality as it is, in order to get to the other side, which by the way is freeing and I have found in the long run, much less painful and energy draining. The caution is to be ready for each step of reality acceptance. It sounds like your work with this illness is diligent, conscientious, and intentional. Just speaking of the issue is a step forward, I am sure you are aware of that.
The second thing is that when harsh reality is the disappointment, there is no further to fall so the only way is up. On the other hand, when we live in fantasy, whether positive or negative, when the inevitable reality is knocking at our doorstep we have to accept our state of delusion before we can accept the facts of reality. Consequently we are dealing with two disappointments. This is so much more work. It’s all a process. Timing, confrontation, acceptance, healing – the steps are interconnected and should be experienced with respect for the process and for us individually as we endure, learn from and grow with the process.
Each day, each effort, each conversation, each acceptance brings more light and knowledge from which we can make our decisions as to how to manage our lives, our illness and our challenges.
I am with you regarding the sound of the cider vinegar/honey/warm water drink, but it tastes a lot like apple cider. It really is pleasant and I think the detoxification properties are working!
Inspiration is passing both ways. Your posts are informative, thought provoking, inspirational and articulate. Verbiage describing our individual efforts of persistence is something we all lean on. It is needed and helpful especially in our times of discouragement.
I am confident in the future of depression treatment and I believe with all of the scientific research in the neurological field right now, a clearer understanding and more effective treatments are on the horizon.
Keep writing. You are serving yourself and others well my friend.
Colleen,
Yah, I have experienced what you’re describing above. It feels overwhelming. Pride, ego, and the healthy desire to be the best that I can, all seem to build up resistance in me. I want to overcome, transcend, ‘see the problem, solve the problem’…of depression and so on. The language we use can be a bit confounding. I recall reading and hearing from DBT and elsewhere that acceptance, acknowledging what is–including one’s feelings, conditions of reality, being more aware etc., far from being a giving in or surrender (although again that word can be used), is the first and essential step that makes strength and change possible – which you’ve described above. It feels like defeat. A final humiliation. Not sure why I can’t see that it is actually a source of strength, hope and peace. Even when I can point to and identify it, I’m not sure I apply it very well. I don’t know, – I guess the many, many actions I’ve taken and things I have done to try to get help, hang in and create a life I want to live, are at least some positive application of admitting I need help. I don’t have any problem acknowledging generally that the human condition usually involves suffering, anxiety and even some depression. It is as it applies to ME (the ego no doubt), that it seems very difficult indeed.
Thanks
-gGandolfication- this is just something I wonder about with everyone in general (and I hope this does not come across as offensive b/c I do not mean it to be.) Do you think it’s possible that at times you’re “too smart” to be in your own head? I mean if a person is obviously very intelligent and focused and in touch with his or her thoughts/feelings/afflictions (as you are,) that will work towards recovery but too much can AT TIMES be detrimental too. For example, I was working with a patient several years ago teaching her to do CBT where she wrote down her negative thoughts and then wrote the distortion and then the positive counter thought. The next week she came in with dozens and dozens of negative thoughts, so many that the CBT clearly backfired. She had almost indulged in negative thinking. She was thriving on it but in a bad way. It’s hard to describe but it made me realize that even the most well-intentioned therapies can be overdone. I know I’ve tried to do all the “fixing” of myself that I can only to discover I was driving myself mad. I’ve learned to see depression as the common cold of mental illness- there is no cure for a cold- you can only treat its unpleasant symptoms. I realized that basically I was trying to rationalize an irrational illness. We know what needs to be done for depression- we do all the right things and they should ideally be working. And yet we still suffer from depression- we still don’t feel good, we feel bad. It’s frustrating. Do you think it’s possible that you are too hard on yourself- trying to “cure” this affliction by reasoning through the logistics all the time? I guess my suggestion is maybe just take a small break from it- like a day- and “get out of your head.” Try doing something mindless and silly- watch a funny movie or do something just for simple pleasure. Something that does not involve trying to solve the problem (or puzzle) of depression. I’m not discounting all that everyone has previously posted about accepting and all b/c all that is good stuff and I totally agree with everyone and everything already said. You are all right on. I just think sometimes it’s beneficial to (for lack of a better phrase) “get out of your head” every now and then. I hope this comes across the way I’m intending it to- I don’t think you are doing anything wrong. In fact, you are doing everything right. But doing this all the time can be exhausting. I read once that people who are intelligent and creative need to have an outlet for that intelligent creative energy and when they don’t have an adequate outlet it can cause anxiety and, I’m sure also, depression. Maybe you are channeling all your energy into curing yourself and it’s exhausting so you must cut yourself a break??? Not trying to judge- you know yourself well enough to decide on your own. I just know from experience that I sometimes get lost in my head and that can be bad at times. Just bringing it up in hopes that it helps… 🙂
Claire,
Thanks. I identify with the need to take a break, get out of my head and accept things as they are. For someone habituated to ruminating thoughts, this is easier said than done, but still, for me it starts with taking a breath, maybe a half-smile and being in the present moment – often I find it somewhat helpful to repeat something like this as an affirmation/reminder, “i’m right here, right now…things are as they are, there is only now” something to that effect.
I have observed and know that in general, a high percentage of people who suffer from depression (and addiction also) tend to be intelligent, intellectual, deep thinkers, have too many eyes, etc. Also empaths. I had always thought that I was somewhat like this. A lot of people have told me this more and more over the past few years as my depression has gotten worse. It feels odd – like a compliment of sorts, although one which the more I hear, the more I feel like an impostor. But I try to accept it for what it is, and anyway, if there is one thing I shouldn’t question about myself it is that I like to and engage endlessly in thinking about everything, over thinking etc. (Tolles views this as being from the ego, but it is also a natural part of being human – its when you can’t turn it off that is becomes an enormous problem). I also have a lot of anger built up about this because I somewhat inevitably feel angry at myself – that either I was given a good ability to think, write, etc. – and I am not able to channel it in a way that is either getting good use out of it or benefiting my family and me. Or that it is some grandiosity, an egomaniac with an inferiority complex – that I was always kidding myself and that my best thoughts are rubbish. It feels like a curse – and makes a person feel almost crazy half the time. I’m sure this is common, but it is very painful, and I don’t exactly now how to let it subside. One of the adages in the 12-step programs is that no one is too dumb to work the steps; but some people are too smart (about over-thinking, ego, and lack of surrender). I have tried to learn and apply what I’ve learned about mindfulness, being in the moment, and also serving others – these are the most effective things I’ve found for taking myself out of my own head.
Yah, I do try to unplug from it so to speak and engage in activities that require attention, presence with my kids, family, movies, books, etc. These are the things I enjoy.
Thanks.
You all amaze me with you intelligence and knowledge about depression.
Claire you hit it head on with this last post.I am learning so much and thank you for it.
Hi, Claire. TMS had no effects physically at all. Mentally I felt better after 36 treatments, but that lasted only a few months before I went down again. An additional 10 booster treaments helped me out again, but some months later back down. My last round of 10 treatments didn’t help. Because I was out of network my insurance–BCBS–only paid about 20% of the cost. Total cost was close to $15,000.
Camilo,
Sorry to hear about that.
Mind if I ask what you are doing now to treat your depression?
camilo- thank you for sharing about your experience. I’m glad you got some relief but sorry it did not last. When you say you felt better (and this is a question for Greg too) how much better would you say you felt? Like happy and “normal” again ie not depressed at all?? or 50% better? or like on a scale of 1-10 if 1 is the absolute worst you’ve ever felt and 10 is completely happy with not a trace of depression? How would you rate your depression before and after the treatments? I guess if it’s so expensive the healthcare industry must really think it’s a valid useful practice? It’s absurd that health insurance does not cover more for mental health care!!!
Gandolfication and Claire:
Your posts about thoughts, ruminating thoughts, taking a break from our thought processes – working so hard at issues that are confronting the way we make decisions (which can be excruciating at times), live our lives or even experience our process of living is – well I just took a deep breath and said, “I can so relate.” I wonder if our processes are just our processes whether we are depressed or not. Those patterns have definitely slowed most of the time since TMS has been successful for me, but oh there are times I still struggle.
I am refreshed that this topic is on the table for discussion. Thank you Claire for your direct and legitimate question about taking a break. So often I have thought, “I wish I had an off button in my brain.” Gandolfication, I relate to your response. It was like hearing my own brain talk!
I recently listened to NPR’s Podcast, Invisibilia, The Secret History of Thoughts, in which they were asking the question, “How important our the thoughts we have?” Because I am in a struggle with this right now because of a particular recent experience, I am legitimately exploring this idea of how I am contributing positively or negatively to the outcome or interfering with an outcome to this situation in lieu of my thought patterns.
I have had breaks in this continual cycle of perseverating thoughts since TMS so I have to, in response to Claire’s question, state that it is refreshing and renewing, creating space for innovation in the approaches I take to life, problem solving and in particular relationships with self and others.
Thank you to you both. This has been enlightening and enriching.
Camilo:
I am sorry that your efforts to undergo TMS treatments have ended the way they have. It is disheartening.
Have your doctors suggested alternative treatment options with you? Keep in touch because what others share may be of assistance to you or visa-versa. Earlier I posted a website of a speaker I heard, who had different but very challenging mental health issues, which describes his journey to finding ways and treatments to cope with his illness and is living a successful life, career too, and managing the many challenges of his illness. I can repost if you would like.I feel like 20 treatments is far too few to judge how well TMS will work for you. It took me over 70 to finally feel well enough to taper off. I’m lucky that my doctor only stops if he hasn’t seen any improvement by 45 treatments. I had some glimmers of wellness, so we kept going until it stuck.
GraffinLA:
This is the first time I have heard of the methodology behind the number of treatments you had. I find it fascinating. Would you mind sharing how you are doing now and how long ago you had the treatments? Do you need boosters?
This may be quite helpful to other patients. Thanks.Sure 🙂 I made a post about this elswhere: my mood is generally well, but I’m still struggling with fatigue and fog. I’ve been told by other patients that this can be a lingering symptom that goes away with time, which I’m curious to hear feedback on.
I noticed a pattern where I have a bit of a dip for a few days following a treatment, then come back up the further I get away from it. So I decided to stop, and that’s when the biggest improvements came. Last treatment had been before Christmas and January was pretty good. I’ve had two boosters since then with the usual dip, come back up in a few weeks pattern.
Still trying to figure out where my stability is, hopefully getting there. Back to the original point, I’m very grateful my doctor knew to keep going (and that my insurance covered so much of it).
Graffin:
Thanks for your response. The next seven months will be quite interesting. Sending good wishes for a continued upswing. The information you provide is very helpful.Claire, Colleen and Greg: After my first round of 36 treatments, on a scale of 1-10? Hard to say. I felt normal/vital again, the best that I could expect I think. However “normal” for me entails a lot of underlying chronic issues: compulsion to isolate, having great difficulty in sharing my life with people close to me, and commitment phobia. These are things that require help that I don’t believe any amount of TMS can solve; they are largely in the unconscious. That is why I am doing weekly therapy in addition to my recent current regimen of 100 mg of Pristiq and 15 mg of Mirtazapine (I have been on these for a week and, as of yet, no noticeable improvement with depression). I believe the goal of TMS is not necessarily to cure you, but to getting you to feel vital again; I don’t know if many of the underlying issues I have mentioned which accompany, and exacerbate, my depression can ever be eliminated by TMS. I would love to hear from people here that have had successful treatment what that “success” means to them.
I met with pdoc yesterday and asked him what he thought about my experience with TMS (36 treatments, followed by a total of 25 booster treatments) and he suggested it could me that I need more, although he acknowledged my frustration of not having lasting improvement after 60 total treatments over the past year. He mentioned a patient of his who had an initial 36 treatments which helped her for a short time; when she relapsed she had an additional 36, after which she have been in remission for the last 3 years. So, I am thinking of possibly doing 36 more treatments. I just don’t know.Camilo
Thanks for the info as that is good to know.
It sounds like it’s worth a shot if the additional 36 treatments worked for her.
We all respond so differently to treatment.Wishing you the best of luck with the new meds.
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