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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.
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
-gColeen,
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,
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,
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.
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, 9 months ago by
gandolfication.
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/
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/
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.
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.
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.
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..
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
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.
Best,
-gThanks 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…..
That makes sense. Thanks for the info. The Pinterest page is good.
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.Thanks.
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.
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This reply was modified 9 years, 9 months ago by
