“Our wounds are our very trophies!” – Julian of Norwich, English mystic
Healed wounds, though they may leave scars, bring trophies as well. I’m hoping to obtain a figurative trophy during the coming weeks thanks to transcranial magnetic stimulation treatments (TMS).
I am the first person to look at my life and recognize more blessings than I ever could begin to count. But even the most fortunate are unable to skate through life without incurring a wound here and there. My list includes seven broken noses, stitches to close a few deep cuts, a couple of emotional breakups with girls about whom I cared deeply, several other difficulties I will keep to myself and … oh yeah, my 14 years and counting living with a diagnosis of major depression.
The depression has brought a whole separate subset of wounds. I’ll be honest: I have hated every blasted moment of it. By the grace of God and the love of family, friends, doctors, therapists, many strangers and a cloud of praying saints, I still live to battle through another day. Perhaps as a way of thanks for that, I try to battle along with others and for others who have mental illnesses, people who deal with any type of imposing adversity.
Our wounds have enough common attributes that we understand we aren’t alone. Our “trophies” aren’t shiny or displayed prominently on our living room bookshelves, but they represent times when we beat a strong foe.
I have enough of those trophies. I really would like to get rid of the depression monkey that rides on my back wherever I go, along with the accompanying travel partner of anxiety. As soon as possible.
TMS is my most promising hope right now. Maybe others with depression and anxiety can fulfill their hope with the treatment as well.
Many people who have heard I am receiving this treatment are curious about it and fascinated as they hear some details. Here is the definition from www.mayoclinic.org:
TMS is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. Transcranial magnetic stimulation may be tried when other depression treatments haven’t worked. With TMS, a large electromagnetic coil is placed against your scalp near your forehead. The electromagnet used in TMS creates electric currents that stimulate nerve cells in the region of your brain involved in mood control and depression.
How TMS helps relieve depression isn’t completely understood. It’s thought that magnetic pulses stimulate nerve cells in the region of your brain involved in mood control. This stimulation appears to affect how this part of the brain is working, which in turn seems to ease depression symptoms and improve mood.
As it was explained to me – and knowing that something surely gets lost in the translation from the nurse to you through me – the neuro-transmitters in my brain are “asleep” rather than doing their job of carrying messages back and forth. TMS is supposed to wake them up, then retrain the body to keep them awake on its own. The process somewhat resembles what happens during electro-convulsive therapy – ECT, also known as shock treatment. The key advantage is that TMS doesn’t have the side effects of ECT, which can cause significant memory loss and confusion as the brain is sent into a seizure with electricity.
The TMS delivery machine consists of a comfortable chair that closely resembles a dentist chair, a magnetic device that is similar to the magnet used in a Magnetic Resonance Imaging test (MRI), and several other instruments that help guide the magnet to a specific spot on the patient’s head and then hold the magnet in place.
Basically, here’s what happens: At the first appointment, a physician and nurse “map” the patient’s head to find the optimal place for delivery of the magnetic pulses. They target the left frontal cortex. I underwent that mapping last Friday, a process that took less than an hour. Immediately after they located the right spot, I received my first treatment. That entails the magnet pulsing 10 times a second for four seconds, then resting for 26 seconds before repeating the process. A full treatment is 3,000 pulses and lasts a bit less than 40 seconds, though the nurse can adjust the dose to more or fewer pulses as well as the severity. A full round of treatments is considered 30, with one each day Monday through Friday for six weeks, followed by six rounds of once-a-week maintenance treatments.
I underwent ECT in 2006 and didn’t enjoy it, even though I was anesthetized during the procedure. Unable to drive or coherently interact for a while on days of treatment, I had to miss six weeks of work and still am unable to remember a few months before then as well as a few subsequent months. ECT didn’t really provide much relief from my depression but did seem to eliminate my severe anxiety.
Health insurance companies have covered ECT for many years in part because of a decent success rate – about 50 percent of the patients show improvement. Initial results from TMS, which has been used extensively in other countries, weren’t as good and kept American insurance companies from coverage. Some people paid out of their own pocket about $25,000 for a full round of TMS treatments. One machine is quite expensive, though, and few hospitals or doctors bought machines since the anticipated return on the investment wasn’t promising.
Several commercial health insurance plans started covering TMS a couple of years ago. Things have changed because there are a lot of boxes to check off in order to qualify for the treatment. Since it primarily is effective for depression and anxiety, most other mental illnesses don’t really merit qualification. An insurance company wants to see that a patient has exhausted all other treatments, including a history of trying many anti-depressants, receiving ECT and undergoing extensive one-on-one counseling sessions.
I checked all those boxes. I am covered.
So I’m in that chair every morning at 8 o’clock, letting the magnet peck ferociously at my head 3,000 times before I head off for work. The pulsing hurts a little at first, then is simply annoying. My head has hurt the rest of the day for the first three days, and I’m pretty tired all day. That is supposed to pass at the end of the first week. If things are going to improve, I should start getting a sense for that about halfway into treatments.
I’m trying to be optimistic while at the same time don’t want to set myself up for major disappointment. I am holding onto what I prayed during today’s Evening Prayer: Psalm 20
May he give you your heart’s desire and fulfill every one of your plans. May we ring out our joy at your victory and rejoice in the name of our God. May the Lord grant all your prayers.
I am sure now that the Lord will give victory to his anointed, will reply from his holy heaven with the mighty victory of his hand.
I’m praying this victory will provide a trophy that can serve as a beacon of hope for millions who have to live with depression and anxiety.