It’s eight in the morning and I’m half asleep. I’m sitting in a procedure chair; a medical recliner with an adjustable headrest and something called a coil. I’m pushed up and “clamped” into the coil’s head rack. It’s kind of tight, and makes me want to scrunch down like a slouching kid at some boring event they’ve been forced to attend. Every ten seconds there’s a mechanical clicking as the electromagnetic coil shoots quick bursts of electricity into my brain’s “underactive” nerve cells. Causing an annoying sensation deep inside my skull. Antagonizing my sinuses, and thumping my gray matter into submission. Four seconds and then a ten second reprieve. Three thousand zaps per seventeen-minute session. The coil blasts away again. It seems to be tugging at my scalp. But I could just be imagining that.
This is such bullshit. What the fuck am I doing here?
After numerous consultations with my psychiatrist. Her suggesting. Me resisting. I’ve finally agreed to undergo this oddly bizarre procedure known as TMS (Transcranial Magnetic Stimulation). A so-called “noninvasive” therapy—noninvasive meaning they’re not actually hacking into my brain via surgery—which, understandably, is my preferred alternative.
In theory, the objective here is to change my brain’s activity, specifically my depression, by zapping my ne’er-do-well nerve cells, coaxing them to kick down a few more neurons they seem to be holding back. The fact that I’ve actually put myself in this chair, is testament to just how bad my mental state has deteriorated. When I start opting for an “alternative” treatment, you know it’s become a shit-show of major proportions.
I didn’t really know anything about TMS before I started. Other than some of my clients have gone through it. But they were always the ones adverse to taking psych meds and a little “different” to begin with. It’s not what one would call a “normal” mainstream treatment. But it’s not an Ayahuasca three-day “spiritual” bender in the jungle with a tattooed septum ring wearing “shaman” either.
TMS therapy isn’t just some new thing, trotted out for the masses to try, and let’s just sort of see what happens. It has been kicking around the scientific and medical research community for a long time. But in the long-term strategy of such therapeutic procedures—the FDA only approved it as a viable therapy for depression eighteen years ago—it’s taken a while for it to come into widespread use. Yet, even with the FDA’s accreditation, it’s still not the go-to front runner for treating depression. The stated protocol is one should have exhausted repeated unsuccessful attempts with various antidepressants, labeling said depression as medication-resistant, before turning to TMS. In the scheme of alternative treatment, it’s either this or Ketamine and I’m no longer a fan of treating my mental health with narcotics. I did that for the majority of my life and it nearly destroyed me.
Not that I’m opposed to taking a pill or two. But a year ago, the antidepressant I’d been taking for over a decade just stopped working. I went from doing okay to feeling unhappy and dissatisfied with everything in my life. As if in a response to my overall despair, the antidepressant started causing a deep-seated-internal rage in my brain. It got so bad that the potential for acting out violently scared me, and I had to discontinue using it.
Over the following eight months, under the care of my psychiatrist, I meandered through the ever-expanding world of the latest antidepressants. But to no avail. Nothing worked. All of the medications had detrimental side effects; fatigue, nausea, low to nil libido, obsessive and/or intrusive thoughts, psychotic dreams, profusely sweating at the slightest exertion, and much, much, more. In the meantime, my anxiety went through the roof. But it all came screeching to a halt when the last medication made me suicidal. And I’ve never been suicidal. I was hitting the skids and it wasn’t pretty.
The coil clicks on again. I anticipate the jolt and feel pressure as the electric pulse zaps my prefrontal cortex. This whole procedure is more than just a little weird. Part of me is silently screaming this is all bullshit. Stuff like this reeks of new age holistic healing. Homeopathic sea moss munching whack jobs, jumping on the next trend, trying to grasp one more second of enlightenment, as their lives fleetingly slip by. But I can’t deal with this debilitating depression. So here I am.
Enough already. Are we done yet?
The doctor, who looks like a kid fresh out of high school, explained TMS and the subsequent procedures in our initial “brain mapping” session. He and the technician made calculations of my head size, marking my forehead with an erasable sharpie, and fitting me for the coil. Once I was centered and secured into the headrest, they tried some test blasts, to determine my baseline for magnetic intensity. The doctor had me hold my hand up, and when he shot a blast into the left side of my brain, my fingers twitched. A few more blasts, dialing in the intensity, calibrating my motor threshold—the minimum power needed to cause finger movement. My baseline was 15. Which is in the lower range of sensitivity. Some people have higher thresholds and require a more intense treatment.
“You’re a good candidate for TMS,” said the doctor as he went on to explain they’d be starting out at 80% of my baseline, increasing it in increments, until I was at the therapeutic level of 120%. “If you can tolerate that we’ll stay there for the course of treatment.”
These are just numbers that mean very little to me. Is this shit going to work, or what?
The “course of treatment” is six weeks, five days a week, with weekends off. I arrange with my work to come in late the days I’m in the office. I’m on week three and I’m at 120%. Which borders on “uncomfortable” and wondering how the hell am I going to last through three more weeks of this shit.
This morning I was apprehensive about going in. Something was making me anxious. Although the anxiety soon dissipated once I was in the chair. Most days I actually feel better after the session. Only once have I felt an adverse effect. I left tense and stayed that way for most of the day.
The doctor said some people feel the benefits immediately. But that might just be a placebo effect, our minds finding solace in being given a solution. Like drug trials when the one test group is given sugar pills and does just as well as the group getting the real thing. Proving that my mind, the one that is getting zapped right now, could actually cure me. I just don’t know how to make it do that. On the two days off over the weekend, I waited for the depression to come creeping back in. So far it hasn’t.
For the majority of my life, I’ve been depressed. It’s something I’m accustomed to and at times, even feels familiar. But now, as I am aging out to oblivion, my body has started to produce less and less of the needed chemicals that keep such things at bay. Where I used to generate a decent amount of serotonin, dopamine, and norepinephrine, my waning brain neuron receptors and transmitters are pitching and catching less, causing the depression to be that much greater.
The coil clicks on again, tugging at my scalp, seemingly anything but noninvasive. At 120% I can really feel the pulse. Although it isn’t “electrical” in the way it feels, it’s definitely a peculiar sensation. Visions of black and white films documenting electroshock therapy flash through my mind. The patient strapped into a gurney, electrodes on either side of their head, a rubber wad stuffed into their mouth, so they don’t bite off their tongue. The body convulses as the electricity jolts their brain.
I hate getting shocked. When I worked in the music industry, breaking down gear after a show, on a beer and sweat soaked stage, it was a nightly occurrence. Grab a cord to an ungrounded amp, I’m basically standing in water, and wham-o, a jolt would go through me, and I’d shudder and curse. I couldn’t imagine being sentenced to death by the electric chair.
Another blast from the coil and those antiquated images of electroshock therapy morph into the eye-clamping scene in A Clockwork Orange. Malcom McDowell strapped into a chair with metal speculums prying his eyelids open. Forced to watch horrific imagery as part of the mind-altering aversion therapy. TMS is of course, nothing like that. This is just where my mind goes. I am constantly amazed that the brain that allows me to be creative is also the brain that tortures me.
A chime sounds somewhere behind me, signaling the session is done. I step out of the chair, pick up my phone, and thank the technician.
“See you tomorrow,” I say.
This better fuckin’ work…