'I Had Crippling Depression—Until I Tried a New Treatment'

2022-09-16 20:58:34 By : Ms. Fiona Zhang

My heart thumped wildly as the doctor reclined my chair, dipping my head back while raising my feet. He was outside my field of vision, as my head and eyes were set dead ahead, courtesy of a long metal arm with a magnetic plate at the end of it, which he had attached snugly against my scalp. I was about to undergo a novel and emerging treatment for severe mental illness, called Transcranial Magnetic Stimulation (TMS).

"You'll feel a pulsing where the magnet is and a corresponding tapping sound," the doctor said. "Are you ready?"

I suppose my answer would have been just the same if he'd asked, "How desperate are you to be cured of your depression and anxiety?"

"I will do whatever it takes," I said.

I had despaired of ever escaping the deep, lonely, cylindrical death spiral I'd inhabited for the past four years. "Isolating" is the psychological term. Sure, I was still physically living with my husband and two young children in our home in L.A., but I was virtually unreachable on anything more than a surface level.

In the first year of my depression and anxiety, I'd lost my self-esteem and self-confidence, with my self-reliance not far behind; I dreaded going anywhere, especially alone. As the years passed with no real alleviation of my symptoms, I slipped into a deeper state of voluble self-loathing. I would have thoughts like: You have caused your own depression, by not meditating properly or exercising enough or eating mindfully. You lack character traits like courage, resilience, and strength to heal yourself. You are a revoltingly weak, worthless loser and you deserve this.

My mind was so loud, whirring with self-accusations and negative self-talk, that it was hard for me to speak over it. My husband noticed, but as my depression deepened, it became harder for him to reach me.

I attempted to negate the vicious thoughts inside my head by spending a month confined to a recovery house perched atop a Malibu cliff, to no avail. Later, my psychiatrist recommended a highly-regarded outpatient program at UCLA Medical Center. As a Phi Beta Kappa graduate of UCLA, where I was also a sorority girl, I hoped I might find healing at my beloved alma mater. I did find both purpose and camaraderie, attending the program. It gave me something to get out of bed for, and I enjoyed getting to know my fellow program participants, whose struggles mirrored my own.

Midway through the program, in a moment of insanity—or, arguably, sanity—I'd confessed to my social worker that I'd been lying on the Beck's Depression Inventory she gave me at our weekly check-ins. I actually did have suicidal ideations, and they were growing by the day.

She responded by marching me over to the Admissions Department at the Ronald Reagan Neuropsychiatric Hospital, which was conveniently just one building over. At the door of the inpatient psych ward, with its flashing light, security code and chain-linked padlock, I panicked. What had I done? I clutched my social worker like a scared toddler who doesn't want her mother to leave her at preschool. She carefully peeled my fingers off her arm and reminded me that I could leave as soon as I felt better, because I was a "voluntary admit."

My team of doctors at UCLA pronounced me treatment-resistant. I agreed, since it didn't seem to matter what kind of antidepressant or antipsychotic I was prescribed or how many therapy sessions I attended. I was not getting any better. My attending physician urgently recommended electroconvulsive therapy or ECT, commonly known as shock therapy, to get me out of what he labeled an "almost psychotic state." I did, indeed, undergo the invasive ECT treatments. Sadly, I experienced no relief in my symptoms.

It turns out, I was not alone in being treatment-resistant. One in five Americans suffers with mental illness, and up to 30 percent of those don't respond to the first line of treatment: antidepressants and psychotherapy.

About six months later, a dear friend told me she had secured an appointment for me with her psychiatrist, who had helped cure her postpartum depression. While I highly doubted that her psychiatrist could help me—coming, as he did, after a rather lengthy list of qualified medical professionals who'd already tried—I neither wanted to let my caring friend down, nor give up on myself.

My husband accompanied me to Dr. Sparago's office for the appointment and sat with me during his comprehensive review of the many meds I had been prescribed over the past few years. We both heard him mumble something about how I "seemed a candidate" and the words "new treatment option." Our eyes met on the couch. Hoping.

Dr. Sparago stood up and asked us to come with him to see the treatment room. It was small and windowless, with a reclining dental chair at its center. He leaned over and grabbed a brochure off a lucite holder and showed us what looked like a "Just Say No" ad. Two brains were pictured side-by-side, one dark with muted gray and blue blotches, the other one lit up with gold, red, and green. I expected the caption to say "This is your brain. This is your brain on drugs," but instead it said, "Normal brain" and "Depressed brain." The normal brain had lights on, like a cozy house after dark with people inside, while the depressed brain was gray, muted, and without light. Without hope.

I felt my thoughts drifting into their usual dark place and appreciated Dr. Sparago touching me on the shoulder, which brought me back to the present moment. He was explaining how TMS worked.

"TMS was approved in the U.S. in 2008 for use in treatment-resistant patients, like you," Dr. Sparago explained. "TMS uses a pulsed magnetic field—similar to that used in an MRI—to create an electrical current in the surface of the brain, which will reset your body's mood regulation system." Think of how turning your smartphone off and then restarting it will often "fix" a problem.

By the following Monday, I was able to confirm insurance coverage and begin the TMS protocol, which called for half-hour sessions five days a week for six weeks between October and November, 2018.

TMS did not hurt. But the tapping is fairly loud and rhythmic, and always followed by a time of silence. There was a TV to watch Netflix, positioned at eye level, which helped pass the time. I was also warned that I might get a slight headache after treatment, but I did not experience that.

While some TMS patients report a marked change in mood in just one week, my recovery came about more gradually. I had been living in almost complete emotional darkness, but as the days and then weeks of TMS went by, I began to see rays of light peeking in.

Soon, I found myself singing to my little girl as we played, making my son's favorite apple pie to celebrate his flag football victory, and looking forward to the time I could spend with my loving husband. As the new year approached, I continued to embrace life by reconnecting with friends and relaunching my PR consulting business.

Almost four years after I started treatment, I still do TMS once a month, to maintain my incredible progress. The psychiatrist suggested the maintenance as an option, but only if I wanted to. I know a woman who did TMS for her post-partum depression. She does not do maintenance and is still fine. But I will keep doing it monthly. It doesn't hurt, there are no side effects, and it only takes about 20 minutes. Insurance does not pay for maintenance, however, and I realize that I am privileged to be in a situation where I can afford to pay $75 per month for treatment.

I feel like my old self again—only better. Because I now know that mental health is rooted in the physical: in brain chemistry and circuitry. It was not my fault; it had never been my fault. And with depression the world's leading cause of disability, that knowledge is almost as vital as the cure.

Diana Daniele is a writer and publicist living in California. She is currently working on a memoir. To find out more please go to: dianadanieleauthor.com

All views expressed in this article are the author's own.

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