My TMS Adventure [UPDATED]

I mentioned in a post yesterday that last year, trying desperate measures to deal with my lifelong chronic depression, I’d looked into ECT (electroconvulsive therapy), and while researching it, found out about a newer, less harsh treatment called Neurostar transcranial magnetic stimulation (TMS).

TMS seemed very promising. A sort of less powerful electro-shock which uses a targeted electromagnetic charge (about as strong as an MRI) to stimulate an area in the prefrontal lobe of the brain that controls mood, it lacked the potentially dire side effects of ECT, such as memory loss. It was a simple in-patient procedure that didn’t require anesthesia every time, as ECT does, so you don’t pay for an anesthesiologist and have to have someone drive you home every day because you’re so out of it. And the claims for its results, and the longevity of its effectiveness, sounded very appealing.

The biggest downside to trying it: insurance doesn’t cover it. It’s only been FDA-okayed for treatment of major depression since 2008 and insurance companies, always leery of paying for anything, haven’t accepted its use yet.

Still, it sounded promising, and nothing else had worked to any significant degree, and I was quite leery of ECT (which insurance does cover). So I decided to go for it.

There were a couple of places in Atlanta I could go, and I opted to be treated by Dr. Brian Teliho because he was the less expensive option. The course of treatment was a session every day Monday through Friday for 4-6 weeks, depending on how the patient responded.

Each session cost $300, so I was paying $1500 a week. This is a lot of fucking money for me, as it would be for most people.

But, I was desperate.

For six weeks from August to September, I dragged myself halfway across town every weekday to Dr. Teliho’s Buckhead office. His extremely nice assistant would help me get situated in the chair, strap my head into place, and press the big electromagnet into place against my scalp on the forward left side of my head.

For about 40 minutes the device would send thousands of pulses into my brain in a 4 seconds on/20 seconds off cycle. When it fired, there was a rapid woodpecker noise and a feeling of tapping on my head (though there was no actual physical tap), and the upper part of my face on the left felt like a slight charge was going through the skin.

The first week, I seemed to be benefiting from the treatment. When a session ended, my mood was elevated and I felt more energetic as I drove home. Of course, that could have been a placebo effect from my hopeful optimism that this was going to change my life, or it might have been a simple result of getting my ass out of my apartment and doing something new, it was hard to say at that point.

The second week, my therapist had made a very slight change in my meds, and Dr. Teliho recalibrated the machine’s settings because changes in meds can cause changes in brain chemistry. Immediately the slight boost I felt at the end of my sessions ceased. Again it was hard to say what the cause was, whether it was the changed settings or due to some acclimatization of my brain to the regular stimulation.

Dr. Teliho said it was common for people to plateau.

We went the full six weeks, the full $9,000. In the latter half of the course of treatment, I seemed to be getting nowhere, and possibly backsliding. Dr. Teliho seemed surprised, as he claimed that pretty much everyone he’d treated had improved to some degree.

After I repeatedly pointed out that my apparent results had stopped pretty much the time the settings were changed, he decided to use the original calibrations for the last few days. Immediately I started feeling a slight boost at session’s end.

The six weeks ended. I went home. That was mid-September. Whatever slight boost I may have had those final days was ephemeral. I had no lingering effects, positive or negative, except to my bank account, where the effect was overwhelmingly negative. In the four months since, there hasn’t been a single bit of follow-up by Dr. Teliho, not so much as a call to see how I’m doing.

There are a few possible conclusions I can draw from my experience:

  • TMS is snake oil and doesn’t actually do what it’s advertised to do. People who think they’re benefiting are actually experiencing a placebo effect.

Or,

  • TMS just doesn’t work for me.

Or,

  • TMS would have worked for me, had we used the original settings for at least most of the course of treatment. Which would mean I paid for six weeks and actually got only two weeks of effective treatment, split in half with four weeks of squat. This would be a real customer service disaster, since the doctor seemingly brushed the possibility aside and didn’t offer additional treatments to make up for the lapse.

Whatever the case, I wasted time and gas and hope on this treatment and I’m no better off than I was when I began. And I essentially wasted $9,000, which only deepened my despair and will likely impact my ability to pay rent down the line.

If you’re considering TMS, I clearly can’t recommend it. Take my experience into account, and explore all other options before committing to it. Hopefully, whatever you choose to do, you won’t wind up where I wound up after wasting all that time and money.

UPDATE: I ultimately resorted to ECT, electroconvulsive therapy, also known as shock treatments. It was far cheaper because it was covered by insurance, and it actually worked. It reduced my depression’s hold on me enough that I have been functioning on a much higher level ever since, and with little or no negative side effects. I’m glad I did ECT. I deeply regret wasting my time and money on TMS.

A further update: Though Dr. Teliho assured me I had an 80% chance of the insurance company reimbursing at least most of the money I spent, they ultimately reimbursed none.

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