Six medically backed treatments for depression – which make absolutely zero sense (part two!)

Earlier in the week, I published part one of this article – six medically backed treatments for depression which make absolutely zero sense. Here’s part two!

Warmth

According to a multiple studies, people suffering from severe depression found relief when their core body temperatures were raised. We’re not talking a fluffy blanket here, either: We’re talking a hardcore warm bath in temperatures reaching 104-degrees Fahrenheit. Incidentally, the more depressed someone was, the more likely they were to find relief, which could offer some hope for people who suffer from treatment-resistant depression.

Another study found that depressed individuals who had their body temperatures raised showed less depressive symptoms than those who had their body temperatures raised, but by a much lower amount. In other words, more heat made someone feel better. And the difference, according to the report’s write-up, was “dramatic” – not a word often used when describing depression treatment!

Does this mean warming up can cure all? No. Of course not. But it does show a promising potential cure, one that needs more study to be truly evaluated. But, there are more cures which are even more effective, such as….

Getting smashed in the head with an electro-magnet (Transcranial Magnetic Stimulation)

Allow me to introduce you to Transcranial Magnetic Stimulation, one of the goofiest (and potentially more effective) treatments for depression that there is.

Transcranial Magnetic Stimulation (TMS) is a type of therapy used for treatment resistant depression. What is it? Well, here:

In a nutshell, it involves being tapped in the head thousands of times (as many as forty over a ten second period) by an electromagenet. The electromagnet is supposed to wack you in the head in a region which corresponds to your brain’s center for mood control. As a result, your depression is supposed to increase.

Yes, this sounds terrible and painful, but it’s not, at all. I actually had TMS and absolutely noticed an improvement – one that decreased six months later, but is still there. Depending on a variety of factors (your own depression, insurance and availability), it’s a significant commitment. I had about 35 sessions over a seven week period. You sit down, get strapped in (again, not as bad as it sounds) and the tapping begins. The magnet hits you about 40 times over a four second period, then it rests for twelve seconds, and the cycle repeats for twenty minutes. Let me emphasize this: THIS IS NOT PAINFUL. I fell asleep repeatedly and texted my way through the other sessions. It’s kind of annoying and does take a session or two to get used to. It is also a time commitment: While you can miss a day or two, you can’t go on vacation in the middle of the session and expect it to still be effective.

Does it work? Yes. It did for me and I’m not crazy (well, I mean, I am, but that’s besides the point): Studies have found TMS having a success rate as high is 58% in terms of lessening symptoms, while other studies found that as 75% of people who had TMS reported that the benefits lasted for at least over a year.

That being said, if you’re looking for a treatment which smacks you less, allow me to direct you to our final item on this list….

Meditation

Breathe in. Breathe out. Focus on your navel. Feel better.

Really.

Meditation has gained a ton of prominence in recent years, and rightfully so: For as little as ten minutes a day, it’s been shown to reduce stress, lengthen your attention span, reduce memory loss and improve sleep, among many other positive changes.

And that works with depression too? Yep.

The most effective type of meditation for beating depression is mindfulness meditation, which is a specific type of meditation in which you sit still, calm down, and focus your mind on the present moment.

In a recent study of people with mild depression, people who underwent mindfulness meditation showed reduced rates of developing full-blown depression when compared to a control group.

Of course, that’s not all. A massive, systematic review of 18,573 citations on mindfulness meditation  showed that mindfulness meditation was moderately effective in treating pain and anxiety.

How does this work? Probably more than just one way. But, according to Dr. John Denninger of the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital, Meditation trains the brain to achieve sustained focus, and to return to that focus when negative thinking, emotions, and physical sensations intrude — which happens a lot when you feel stressed and anxious,”

I mean, when you think about this, it makes perfect sense. Meditation can help you calm down, focus your mind and avoid negative thoughts. This isn’t a matter of just sitting still and being chill. Depression changes your way of thinking. Meditation can help make it right again.

TMS Update: Is this what feeling better feels like?

So, it’s been about six weeks since I started Transcranial Magnetic Stimulation. As I type this, I’ve had about 26 sessions, with another ten or so to go.

How am I feeling? Is it working? Better. And yes. It is working. And I feel reasonably convinced at this point that it’s not just the placebo effect.

Let me discuss the second part of that question first, because I think it’s almost the most important. Why do I think it’s not a placebo effect? Because life is NOT perfect. I think – I don’t know, but I think – that if this was a mere placebo effect, I’d be sitting here, flying through the sky. Life would feel perfect. There would be birds and sunshine and candy everywhere and all that crap. Then, eventually, the effect would wear away, and I’d crash hard.

Simply put, that isn’t true. Everything doesn’t feel perfect. I’ve still gotten depressed about things, upset. Most of the time, it’s been normal life events. On a couple of days I’ve still woken up really down, but that feeling fades easier than it did before treatment. Simply put, things aren’t magical.

So then, let me tackle the question in the title: Is this what feeling better feels like? Maybe? I can’t answer that question definitively yet, because I don’t know . Look, I’ve been on anti-depressants and in treatment, as needed, since I was 18. I’m 35. Half my life. So I’m not quite sure what “normal” is.

Here’s what I do know. Since I started TMS and began to feel it’s positive impacts:

  • I’ve been enjoying things more. A lot more. A couple of examples:
    • As I’ve long since established I am a big computer game nerd. I play these games more, and I just like them more. I’ve had more fun playing them.
    • I was with my wife and my kids at a local food fair. I’m sitting there, eating this big ole Taco Salad. My son is leaning on me, eating Mac & Cheese. He’s snuggling in. I’ve got my little boy, good food, happy environment, great music. I felt good. I felt lucky. My phone was firmly in my pocket. I felt like I was in the moment. That didn’t happen before.
  • I wake up in the morning without this impending sense of dread. Without feeling like there’s a ceiling over my head, pressing down. It just feels like the world has less pressure. I still feel stressed, still feel overwhelmed. But the world doesn’t feel like it is filled with nearly as much darkness.
  • I’ve been less snappy. Less grouchy.
  • I’ve had an easier time concentrating and getting things done. My motivation is higher.
  • You know that myth about the depressed writer? Bull. Depression does help give you insight and experience for writing, but if it’s too severe, you ain’t writing. And I’ve had a much, much easier time writing lately.

Arguably the most important observation since this started has been from my wife. She was skeptical when TMS first started. She told me last week that she didn’t think it would work, and part of her almost wishes she didn’t know I was doing it so she wouldn’t risk being fooled by a placebo effect as well.

Why? Because she noticed the difference too. She told me the other day, unprompted, that she sees it’s working. She sees that I am happier. And my wife is smarter than me! So if she is noticing this, it makes me more convinced that this thing really is working.

Are things perfect? Hell no. They never will be.

But they are unquestionably better.

DISCLAIMER: First, again, I’m not a doctor or medical professional – I’m a damn politician and writer. I’m certainly doing my best to write an accurate description, but if you have any questions or concerns, please contact a medical professional. Second, this probably goes without saying, but I’m going through this treatment like any other normal person and paying with my insurance. I am not receiving any compensation or consideration whatsoever for sharing my experiences. However – and again, this is just me writing – I’ve had my TMS from the TMS Center of the Lehigh Valley. I am grateful for their skills, professionalism and willingness to work with my rather insane schedule. I highly, highly recommend them if you are local to the area.

TMS Update

Well, as I type this I am 10 sessions into the 30 session Transcranial Magnetic Stimulation sessions. 1/3 of the way there. Woohoo!

How’s it going so far? Well…maybe better? Honestly, yeah, starting at the beginning of the 2nd week, it did start to feel like I was feeling a bit better, but let me define what I mean. Birds did not start singing. The sky is not the bluest it has ever been. Depression is still there. Life is not perfect.

But, to some extent, I have to say, it does feel like things have gotten a bit better. My life hasn’t dramatically improved, but there does seem to be a bit less…pressure. Like, the ceiling of depression which pressured down on me seems a bit lighter. That’s the best way I think I can put it.

To be clear, this may be placebo. The readings that the Doctor gave me showed that depression probably wouldn’t start to improve until week four. When I mentioned this to him, he said some people did feel better in week two, but for many it was longer, and it is certainly possible that this is just placebo. So I guess we will see!

Some other notes:

  • For me, there are no side effects. Even the slight headaches that during the treatment have become more tolerable. I haven’t taken a Tylenol before a treatment since it started, and my head has not hurt a soon as the treatment has ended.
  • You really do build a resistance to the minor pain caused by the treatment. Of the ten times I’ve had it, I’ve fallen asleep three of them, which is kind of funny.
  • I went through the math in my head the other day. As I said in the last entry on this subject, the magnet taps your head for four seconds, then rests for twelve. During the four seconds in which you get tapped with the magnet, it makes contact 40 times. A session is twenty minutes, so you get tapped 3,200 times a session. Multiply that by the 30 sessions, and congratulations, you’re getting smacked by a magnet 96,000 time over six weeks!

Only 64,000 taps to go!

“A woodpecker on steroids” – My experience, so far, with Transcranial Magnetic Stimulation

So, for the first time in my multi-decade battle with depression, I’m trying a new type of therapy (other than talking and taking pills). It’s Transcranial Magnetic Stimulation (TMS), and I’ve written about it before.

Here’s the basic gist of how it works:

Transcranial magnetic stimulation (TMS) is a method whereby an electromagnet placed on a scalp transmits magnetic pulses or waves to a small portion of the brain. Repetitive transcranial magnetic stimulation (rTMS) delivered at a low frequency (once per second) has been shown to reduce the reactivity or excitability of the part of the brain stimulated and other brain regions functionally connected to the region stimulated.

I started it Monday, and it is time intensive – not so much in how long you have to sit there (my sessions are only twenty minutes), but in terms of how long you have to do it – for me, it’s six weeks, five days a week. I had to wait until vacation was over and for a break in my calendar to make it happen.

As for how it works: Honestly, it’s not hard. You sit there. You get yourself into a nice and comfy chair and they adjust a couple of things by your head. The right side of your head is lined up with a pad to keep your head still. The left side of your head is where the action is at – a magnet, enclosed in some equipment, is aligned in the right spot. It’s desired location is your frontal cortex, which is the area of your brain where depression apparently can be adjusted. They send one magnetic pulse into your head, and if your hand twitches, they have the right spot.

Once they have the right spot, they save the settings and that’s where you sit. If it’s aligned right, you may feel a little discomfort or pressure during the actual treatment. The actual treatment consists of your head being tapped with a magnet (not directly, but through padding) for four seconds, followed by a rest of twelve seconds. That continues for twenty minutes.

Is it painful? No. The first alignment can be – if it’s misaligned, it hits a nerve and OUCH. It just stings for a few seconds. They readjust, and then it’s fine. Now, is it comfortable? Nah. But you do build a resistance to it. I had a headache and took Tylenol the first three days. By days four and five I barely noticed. They also give you earplugs. Those are optional, but if a Doctor gives you ear plugs, use them, okay?

It’s a strange experience, described to me by the nurse as being hit by a woodpecker on steroids. I love that description, and it’s accurate. I mean, you’re basically getting tapped by a magnet or roughly 30 times over four seconds. It’s weird, but not painful. I’ll putz on my phone, close my eyes and chill, whatever. Honestly, its not that bad. The session ends and you go back to work. There are no after effects, except for maybe a slight headache that Tylenol can bop right out. You can drive, think, function, etc. I’ve left therapy sessions where I’ve been more disoriented.

When am I supposed to see results? The literature I read said week four. They said they thought they had seen some people get more depressed as the placebo effect wore away in week two. I’m hoping I don’t go through that, because I have no illusions that this will work until at least week four.

So, one week down, five to go. Here’s to hoping.

As always, I’d love to hear your thoughts and experiences, and as the process goes on I’ll share more, including some pics. Let us know about your TMS experiences below!

SIDE NOTE: First, again, I’m not a doctor or medical professional – I’m a damn politician and writer. I’m certainly doing my best to write an accurate description, but if you have any questions or concerns, please contact a medical professional. Second, this probably goes without saying, but I’m going through this treatment like any other normal person and paying with my insurance. I am not receiving any compensation or consideration whatsoever for sharing my experiences.

Transcranial Magnetic Stimulation?

You know, you first hear about something like this, and you think it sounds like some sort of witchcraft nonsense. Magnets? To help depression?

Apparently. And it’s scientific based.

I write about this now because I had an appointment last week to explore this as a treatment possibility, and it is likely something I’m going to pursue. Here are the basics, per the Mayo Clinic:

During a TMS session, an electromagnetic coil is placed against your scalp near your forehead. The electromagnet painlessly delivers a magnetic pulse that stimulates nerve cells in the region of your brain involved in mood control and depression. And it may activate regions of the brain that have decreased activity in people with depression.

 Though the biology of why rTMS works isn’t completely understood, the stimulation appears to affect how this part of the brain is working, which in turn seems to ease depression symptoms and improve mood.

The most important question, of course, is this: Does it work? According to the evidence I have seen, yes, and that’s in tests involving a placebo. More research is needed, but this appears to work.

Thankfully, the side effects are very mild, per the Mayo clinic.

Side effects are generally mild to moderate and improve shortly after an individual session and decrease over time with additional sessions. They may include:

  • Headache

  • Scalp discomfort at the site of stimulation

  • Tingling, spasms or twitching of facial muscles

  • Light headedness

The biggest drawback, as best I can tell? The Doctor I spoke with told me its most effective to do it every single day, for 4-6 weeks. Session, I think, are 30-45 minutes. That’s a heck of a time commitment. That being said, sucks for me. It’s not the Doctor’s fault that this is the way the brain works, but it’s certainly a challenge with my schedule – going to Harrisburg and vacation means I won’t have that kind of time until August.

So, let me conclude by asking you for your experiences. Have any of you out there had TMS? Any experiences to share? I’d love to hear them!