TMS – Increased anxiety after treatment

I have been looking for other people who have struggled with the after effects of TMS like I have. If TMS worked for you, I am nothing but happy for you. And envious. For myself, I completed two rounds of TMS. First was the summer of 2021, 36 treatments. I noticed an improvement in my depression (dealt with for years, cyclical severe bouts). I do not tolerate medications well (had a bad experience with Cymbalta, and seem very sensitive to all meds since). Tried multiple psychotropics, with some success but always major side effects. No psychotropics for 8+ years. Anyway. After the first round of TMS, my depression improved and although I felt different somehow, at first I was encouraged. However, my anxiety began to increase significantly, which brought back depressive symptoms. I have not normally had significant anxiety in the past, btw.

Things got bad enough I decided to start second round of TMS in December (because it had improved my depression and I thought maybe reducing the depression had brought the underlying anxiety to the forefront). Discussed with psychiatrist (he is very supportive, listens, takes all the time needed – he is great). Ended up doing nearly 50 sessions, but was not seeing a significant reduction in depression and saw a significant increase in anxiety. Stopped treatments because I simply could not continue. In this time I began wondering if the TMS was causing my anxiety….

The anxiety I experienced, and the subsequent depression is worse than any I have ever dealt with, and I have dealt with depression since I was a child (am 54 now). This anxiety/depression felt vicious and sharp and jagged. It became unbearable and I have been closer to suicide than I ever thought I could be – because it just hurts so damned much. I am now afraid of how black things can get, feeling hopeless and nihilistic. So not like myself. Although I have avoided and resisted medication since the cymbalta disaster, I ended up going on an anti anxiety medication, because I saw no other choice. Thankfully, it moderated the anxiety so that it is tolerable (but with the side effect of leaving me unmotivated and disconnected). I am currently on a minimum starting dose, because even the lowest dose made me so unmotivated it was significantly impacting my ability to work. This dose keeps me functional, with some breakthrough periods of anxiety that are brutal.

I do not know, I cannot prove, that TMS caused my anxiety, but I do know I have NEVER experienced anxiety (and resulting depression) like this in my entire life. Never. And nothing seems to work. I am a professional counselor – that is my training. I KNOW the skills and coping strategies and lifestyle choices that can help – but they no longer help. I have gotten back into my own therapy, but I no longer feel like myself and I’m not sure it is going to do any good.

In addition to the anxiety, my memory has gotten significantly worse in the past year. To the point that I am going to see a neurologist. I feel that I cannot remember how to be a counselor, like I no longer have access to my training and knowledge. If I could, I would go back to my depression as it was. It was difficult, but I understood it and could cope with it (as I have my whole life). The anxiety now? I have no frame of reference and no idea how to make it better or cope with it. I am fearful because I always tend to struggle more in the winter. I cannot increase the anti anxiety med because then my work performance suffers, but the anxiety can be debilitating too.

I truly believed that TMS was going to be the answer for me. That it would help fix some of what is wrong in my brain so I could live my life and be at peace. I wish someone could tell me that this place I find myself in is somehow my fault and that just a little more TMS will fix it. Because without TMS as an option, there are no other options, and the world I live in now is infinitely worse than the one I was in before I started treatment.

I know that TMS may work for other people, and not everyone will experience what I have. Some people see a benefit from psychotropic medications like Cymbalta, and for me it was traumatic (the withdrawal). Clearly some others have also experienced an increase in anxiety after tms. I wish someone would find us and study us to see why, maybe figure out a solution. I don’t know that I would tell someone els not to try TMS, anymore than I would tell people to never try psychotropic medication (though I would strongly encourage therapy and lifestyle change as the first option).

My doctor believes he has had great success with TMS, and I have to believe that he has, that it has helped people. But he does not believe that it could have caused my anxiety, and that is a blind spot that may keep him from recognizing the problem in myself and in others. It is hard not to feel like a failure that TMS did not work for me (when I so wanted it to) when it works for others.