Profile for User: Martha Rhodes

Dear Lasthope97,
I did my first round of TMS (6 weeks) in 2010 and was what I call “a shell of a woman”. No hope, complete darkness and anger that my doctors couldn’t help me with medications. (I had just come off of a suicide attempt.) Needless to say, when I found TMS as a pathway to climb out of the darkness, I had renewed hope. Expectations weren’t high, but hope prevailed.

Soooo….. when after my first 10-13 treatments I suddenly found myself feeling WORSE than I had when I’d started, I completely freaked out. I was certain TMS wasn’t going to work for me, especially since my TMS doctor and treating nurse had warned me that TMS isn’t a quick fix and that it doesn’t work for everyone although the response/remission rates were pretty darn good. I asked what percentage of patients at my clinic DIDN’T respond and she said, “10% — but that’s because they didn’t come for the full six weeks.” I assumed I’d be part of that 10%, even though I had the determination to do the full 30-36 treatments. So I spent the next 7 treatments sitting in a puddle of tears, wishing I was dead, and having NO confidence in TMS whatsoever. It is THE WORST place to be as I’m assuming you’re feeling right now. Do NOT give up!!! The Dip has become almost a regular thing with patients, although it doesn’t happen to everyone. By treatment #20 for me I woke up one morning and the disgusting UGGGHHHH feeling had lifted (which is why I call it my “TMS Lift”).

There’s no clinical data explaining why this Dip phenomenon occurs, but my instinct tells me it’s just a sign that the brain is waking up. The TMS process is a cumulative one that starts at the outermost part of the brain. As it wakes up the neurons in the prefrontal cortex, which is where executive function and mood neurons perform, I think that a variety of emotions are activated, increased sadness being one of them. So I look at the Dip as a good thing. Kind of like that old adage, “It’s always darkest before the dawn.”

Since that time, I’ve used TMS for seven years for maintenance and it has allowed me to remain medication free. Last Fall my doctor recommended I do another “full course – 30 treatments – because she had redone my Motor Threshold and it had increased. Since I had been on TMS for so long, she also felt a full course would make the once-a-month maintenance treatments either more effective or maybe I wouldn’t have to come so often for them.

Well, lo and behold — the exact same response trajectory occurred. I found myself in another Dip in the second week of treatment and didn’t even realize it was the same timeframe as the first time around! It lasted about 10-14 days, and then voila! — The Lift! So at least I was consistent, right?

Please hang in there and know that you’re doing a good thing for your brain. The response/remission rates are excellent and as long as you are doing your part as colleencasey so astutely pointed out in her post to you (exercise, sleep and eat well, stay away from stressful situations and toxic people, surround yourself with support, etc.) you are following the right path. Please stay in touch and ask more questions, let us know how you’re doing and don’t give up on TMS or on yourself!

YES, I think TMS can really help many people, but something we’ve all got to remind ourselves of is that we have a chronic illness that has no cure, but there ARE tools in the doctor’s toolkit to help manage them — and TMS is one of the newest, very effective tools. Don’t expect TMS to get you of of Depression Jail, however. It’s going to relieve symptoms and give you a sense of lightness that will make you feel like you can manage life in general. But you’ve got to monitor your expectations and not think TMS is a silver bullet or cure. Again, it’s your TOOL to live life with vitality, not dread, gloom and doom.

I also noticed that when TMS actually worked for me, it was so subtle that I could have missed the “lightness” that came with my remission until I realized what was missing: that horrible, disgusting “ughhhh” feeling I woke up with every morning. There was no dramatic, grand “AHA” moment that clinched it for me which, at first, was something I sort of expected. I just noticed that the little things in my life were the indicators that TMS was working. For example, I started listening to music again, answered phone call messages, I felt OK to go to the store or to the movies again, listened to what people were actually saying to me instead of zoning them out as I did when I was really depressed. So it’s important to look for little things in your day-to-day existence when you’ve reached about #18-#20 or longer during your 6 weeks of TMS treatment.

Just checking in with you Greg — I hope all is going well and you’re feeling The Lift more and more each day. Just a reminder that it’s the little things that are going to prove you’re on the upswing with this depression episode. No marching band will show up at your door, nor will there be angels opening the heavens with a Hallelujah Chorus. But based on your recent posts, especially about how you’re handling work these days, it seems like you’re doing well.

Be sure to discuss a maintenance plan with your doctor. I didn’t need one right away, but after 6 to 8 months I went back for single treatments and continue to do so every month now. Btw, I’ll be enjoying my FIFTH year anniversary of starting TMS this May, and although I’ve had a couple of brief relapses, I’m grateful that I have this wonderful tool to keep me medication-free and feeling as if I’m “in charge” of my depression.

Thanks Colleen, and congratulations on your magnificent interview I just found on NYTV. I created a Good News chat posting and I hope others will go to it to see your very personal, inspiring story. I’ll post the link here now with hopes others will see it here as well:
http://wnyt.com/article/stories/s3681189.shtml

Hi Greg,
I just left you another note on the “Hi” chat page before I saw this one. I’m sooooo happy for you! And you’re right, no one can possibly understand what this illness feels like unless they’ve experience it for themselves. One thing I want to support you with is the process of TMS. It’s cumulative, and you may find just the relief of getting through the red tape of insurance, etc. and finally getting into that first TMS week very uplifting. Then the second week you realize that you really DO have to get to that appointment every day, but you don’t see any results because it’s a cumulative process that starts at the outermost part of your brain and the stimulation needs several consecutive treatments to start affecting deeper parts of your brain. Just HANG IN THERE! Most people won’t feel The TMS Lift as I call it, until the fourth week. AND–not that this will definitely happen to you–but I felt WORSE before I felt better during my third week of treatment because I guess my brain was waking up and reconnoitering itself. I call this phenomenon The TMS Dip. Mine only lasted bout 3 or 4 days. Then the morning after my 19th session I woke up and the entire world felt different. It wasn’t a dramatic, “Woo Hoo” feeling, but I definitely felt as if a dark cloud had been lifted and my feeling was, “Oh, I can do this life thing. I can get out of bed and do today.”

I also recommend you keep a small book to journal each day during your six weeks treatment. It doesn’t have to be loonnnggg journal entries. Even if it’s one sentence, or one word or a number on a scale of 1 to 10 so you can look back on your entries and see your magnificent progress.

Keep us posted as to how you’re doing and please rely on us for support!

More Good News! There’s a new Transcranial Magnetic Stimulation coverage policy with United Healthcare, effective February 1, 2015. This coverage decision will now provide access to TMS for approximately 63 million members in United States. Members with United Healthcare living outside of the country may also have benefits for Transcranial Magnetic Stimulation. BIG NOTE HERE: Be sure to check with your health care benefits administrator, although there are many times that the person on the other end of the phone hasn’t received the “memo” regrading TMS coverage updates, so make sure your healthcare provider confers with either Neuronetics’s or Brainsway’s reimbursement folks.

I also think it’s really important to start noticing your depression symptoms and/or a pattern of them. Mine are feelings of constant, persistent weepiness and agitation that occur simultaneously. I get a pulling feeling in my throat and chest that causes a sense of dread. And the other tip off that I’m in need of a TMS treatment is that I start ruminating incessantly about people who have died. All this tells me that I need to get to my TMS center for a single treatment. Then I also notice that I don’t feel relief immediately. It usually takes 24-36 hours for the lightness to return. So If I go for treatment on a Friday, by Sunday afternoon I feel fine.

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!

My doctor and TMS coordinator told me from the very first treatment that TMS isn’t a quick fix—and they were right. It took about two and a half to three weeks before I started to notice an improvement (session 19 or 20). At the 12th or 13th appointment I was actually feeling worse, and when I asked my doctor if any other patients had seen a dip in their mood, she said they hadn’t. The only report was that patients felt increased anxiety for a few days midway through the six weeks.

However, since that time there have been others who have reported this “dip” that lasts only a few days, and then they started to feel much better right after that, just as I had. Not everyone has this, however. In many cases this period requires more patience and trust. The main thing is to remember the original commitment to not give up on the six-week process.

When TMS does start to take effect, it is subtle but unmistakable. I woke up one morning to notice that something was just a little different. The disgusting “I wish I were dead” feeling had vanished. It was just a discreet awareness that the horrible dread feeling was gone. Slowly but surely I felt better from that day forward. I’ve also heard of patients who felt no improvement after their initial six weeks, but a week or two later they ultimately experienced the positive effect from TMS.

I’ve looked into this quite a bit as I was concerned the two would be similar. This is just my take on the two based on my research into it:

Although TMS and ECT may seem as if they are the same, there’s a big difference between them. TMS is based on magnetic pulses that penetrate a specific, quarter-sized area of the skull. The magnetic stimulation to the brain creates a gentle electric impulse that awakens the neural pathways only in the area of the brain that pertains to depression.

On the other hand, electroconvulsive therapy is precisely that—electricity that is delivered to the entire brain and causes a controlled seizure. The seizure induces the brain to produce the deficient neurotransmitters, thus improving the neural activity. This process can be effective in severely depressed patients and people who suffer from psychosis.

Studies have been done comparing the efficacy of both therapies and, so far, they seem to be on a par with each other. However, side effects and logistics are factors to consider.

ECT may result in mild confusion and short-term memory loss after treatment. Other than a remote risk of seizure, TMS has no reported side effects. However, there may be some discomfort at the site of the magnetic pulse coil on the scalp, but most patients find relief by taking an over-the-counter analgesic and/or having the TMS coordinator adjust the coil to a more comfortable position.

As for logistics, an ECT patient is required to have someone drive him or her to and from treatments because it requires general anesthesia in a hospital setting with a monitored recovery period. A TMS patient can drive to and from a TMS practice office for a treatment that lasts less than an hour. In my experience, a manicure/pedicure takes more time than a TMS treatment.

I didn’t experience any side effects from TMS at any time whatsoever. I didn’t feel dizzy, headache, nauseous, or tired after my treatments. The only challenge I had to deal with during the first week was the intense tapping that required some getting used to. It felt like a small woodpecker tapping on the left side of my head in the front above the temple.

The tapping was very quick for four seconds and then it was off for twenty-six seconds and then on again for four seconds. This sequence lasted for the thirty-seven minute session. It “smarted” only for those four seconds. I was a bit of a wimp about it, and because I was so fragile and depressed, it made me feel even more pitiful.

But it’s like anything else, you get used to it—sort of like buying a pair of shoes you absolutely adore but they hurt your feet for the first week or so until you break them in. Then you feel like you could walk a mile and back in them. The same thing happened with getting through the adjustment to the tapping. Eventually I hardly noticed it.

For me, My treatment was a far away. At first it seemed like making the ninety-minute drive every day would be nearly impossible. But I created a few tactics that made the distance and time go by so fast that I was surprised when it was over.

A severely depressed person may not be able to do these things to begin with and shouldn’t feel discouraged. Just know that the more effort one makes during the process, the easier, more pleasant and faster it goes.

My psychiatrist prescribed TMS therapy for me, this is the case for most people I think.

For me, the only challenge I had to deal with during the first week was the intense tapping that required some getting used to. It felt like a small woodpecker tapping on the left side of my head in the front above the temple. The tapping was very quick for four seconds and then it was off for twenty-six seconds and then on again for four seconds. This sequence lasted for the thirty-seven minute session. It “smarted” only for those four seconds. I was a bit of a wimp about it, and because I was so fragile and depressed, it made me feel even more pitiful. But it’s like anything else, you get used to it—sort of like buying a pair of shoes you absolutely adore but they hurt your feet for the first week or so until you break them in. Then you feel like you could walk a mile and back in them. The same thing happened with getting through the adjustment to the tapping. Eventually I hardly noticed it.