For most of my adult life I have been depressed. Over the past few years, as my family and I have endured a seemingly endless cavalcade of pain and suffering, my depression has gotten steadily worse. My sister’s death, our infertility, the loss of my cousin to cancer… it all takes its mental and emotional toll. My depression was recently supplemented by a new diagnosis — prolonged grief disorder. The Butlers have always been pioneers in various ways, so I suppose I’m proud to be the first Butler to be sporting a DSM-5-recognized diagnosis! A dubious honor, but it did help make sense of some of the things I’ve been feeling.
I have not been alone in my fight against depression. My wife and family are with me. I have good mental health benefits which I take advantage of. I see a therapist. I also take medication, and the number and dosage of my medications have grown over the years as the fight has intensified. Sometimes it feels like I have to work incredibly hard just to stay afloat, let alone make any positive progress. I took three months of leave last year to try to get on top of it, and it helped. I’m glad I did it! But I’m still not in good shape.
Which is what brought me to another treatment that sounds like hogwash but is real: treating depression with high-powered magnets. That’s basically what repetitive transcranial magnetic stimulation (rTMS) is. High-powered magnetic pulses are shot into my brain, where they induce a small electric current and help form new neural pathways. Pathways which, if all goes to plan, will help my brain better cope with the realities of depression. My goal is not to get off medication entirely, though that would of course be welcome. Rather, I just hope to reduce the need for so many meds, or make the meds more effective.
What it’s like
The science behind rTMS is pretty cool, and you can read more about it, but what you might not be able to find is a description of what the treatments are like. That’s what I hope this helps with. And note that I said treatments. This is not a one-time thing. rTMS is 8 weeks of 20-minute treatments at an office in Seattle. With the commute it’s about 80–90 minutes of commitment, every weekday. It’s a lot.
Fortunately, the treatments aren’t uncomfortable for the most part. I don’t have to be strapped down or anything, but I do have to wear a skullcap that makes me look a little like a Mercury astronaut. Then the machine fits over my head and my head gets anchored in place. Having your head anchored to a beam isn’t really that bad as long as you don’t start to slouch or move your head too much. Then it becomes very apparent that your head is relatively immobile.
Each session consists of three-second pulses of the magnet, spaced 20–30 seconds apart, for 20 minutes total. The pulses themselves are like a jackhammer — well, that implies pain, and it’s not really painful. So maybe a woodpecker? And it doesn’t feel like it’s hitting your skull directly. It’s more like it’s tapping on a helmet.
There is an electric current being induced, though, and the pulses are going into my right forehead, so each pulse causes the right side of my face to seize up and my jaw to clench. The techs tell me that I am getting a relatively low power (which is good, because it means fewer side effects) and that some folks need to use a mouth guard because of the clenching. It sounds a lot worse than it is.
At my first session, they also did a test where a single pulse was sent and they watched for movement in my thumb. They then adjusted the power of the magnet accordingly. This means that the first time you experience the magnet it’s not the full three-second woodpecker that is the standard experience.
Trying to read without my glasses for 20 minutes is more annoying than the treatments themselves.
Effects and side effects
The biggest side effect I’ve had with rTMS is fatigue. They tell me that the treatments are essentially a brain workout, similar to a long night of hard studying. I get the treatments mid-afternoon because anything else would completely blow up my schedule, and afterwards it is often hard for me to get a lot done for the rest of the day. But I am an early riser anyway, and do my best work in the morning, so I manage OK. And one never grows too old to enjoy an afternoon nap!
So far I haven’t noticed any miraculous healing or anything. Mental health rarely has quick fixes. That said, there are some signs that the dense fog of malaise is lifting. I have been enjoying video games to some extent again. Hades II and Outer Worlds 2 so far, but I am excited about Ocarina of Time as well. I have a little more natural curiosity about things, especially work-related things, than I have had in some time. I continue to work on a variety of side projects. All of this bodes well. If the trend continues, I should feel much better in a few months, and hopefully with less medication.