I'm having a consult for TMS soon. I'm depressed, in part, from having had several mild traumatic brain injuries and possibly from cptsd and my executive functioning stinks.
Did anyone notice a change in their abilities to plan, organize, stay focused, etc?
So in Australia we get 35 funded sessions (~36 in a lot of US protocols), and from what I've read that number seems to be a funding decision, not where the evidence says benefit stops. A few things I came across:
The standard research protocol was 30 sessions plus a taper.
One study found 15.7% only started responding after session 30.
A big registry (7,000+ patients) found benefit kept climbing past 36 with no plateau.
Among non-responders who continued past 36, over half eventually responded.
So for those who do this clinically: do you tell patients the funded course is a floor, not a ceiling? And how do you tell a likely late responder (worth extending) from someone who needs a protocol change?
Asking because I suspect a lot of people read a non-response as "TMS doesn't work for me" and stop — when for some it might just be under-dosing.
(Happy to link the studies.)
I’m almost done with 7 weeks of rTMS for depression, I just have 1 session left. I have seen zero improvement. In fact, I’ve only become more depressed. This week I saw a comment that said they do TMS on the right side for anxiety related symptoms and the left side for depression and mood related symptoms. So I did a google search and found results all saying the same thing. At my appointment yesterday I asked my TMS tech how do they decide which side to target and he said they always target the right side because “that’s where the neocortex is for serotonin and dopamine.” So now I’m confused. Are they doing it on the wrong side? Is that why it’s not working? Or is he right? What side did you guys get it on for depression?
I’m 2ish months post TMS (36 days) and I honestly
Feel no different than when I started. My psych said I could feel changes around this time if not earlier. I honestly don’t know what to expect now since that the window is closing. What’s everyone else’s experiences?
After 20 or so years of antidepressants and therapy, I was referred to TMS. Ran the whole course of treatment, felt successful, tapered of antidepressants.
Feeling big changes in temperament. Family says I’m more irritable, short tempered. I’d counter that I feel more “alive” , less fog, more like a participant and thus more inclined to push back when things cross me. As opposed to being rather passive and internally coping with frustrations.
I dunno. Anyone else having a similar experience? I would say I feel genuinely less depressed, my overall outlook on life has seriously improved. But now it also seems to have simply allowed other issues to surface that depression symptoms and antidepressants have maybe been masking?
Other issues in the brain chemistry cocktail include adhd and adderall, sleep apnea and a CPAP, daytime fatigue and exhaustion, yada yada.
Not looking for diagnosis or medical advice, just curious if anyone else had same sorta thing. Also some disappointment. Hoped for magic magnetic cure to all that ails me, and still have other issues and work to do.
Was wondering if anyone did the one day protocol with d-cycloserine and how long it took to get results.
I’m 3 weeks out and still depressed.
I am contemplating ending TMS due to copays. I calculated $1,800 in copays for 36 sessions. How is anyone coping with the copays?
Probably a tedious post but I’m a bit anxious about this. I had my 14th session today and have noticed no changes, good or bad. I thought this was relatively normal based on everything I read - but the doctor at my clinic is asking me PHQ-9 questions almost every (daily!) session and seems concerned that i’m not noticing anything yet. They added on a couple minutes to the right side for my anxiety, and today when I went in they switched up the pattern of the zaps because I’m not yet responding. Still nothing.
Does this mean it doesn’t or won’t work for me? For those who TMS DID work for, did you notice gradual improvement or did it come later? Starting to feel like my brain is truly broken.
hello! I finished the 36 session treatment last week and while I was getting them, I felt significant improvements. but now, I am feeling sad again and crying every day again. I’m wondering if this is normal and if it’ll get worse before it gets better or if it just only worked for me while I was actively getting zapped. any advice or kind words would be appreciated. thanks :)
I had my fifth session today and noticed a big increase in my anxiety this morning, so much that I had to take a lorazepam. Is an increase in anxiety common at the beginning? So far TMS has been for depression however tomorrow they are adding on for anxiety.
29F. Looking for advice.
Venlafaxine consistently works for me. It gets rid of my depression, severe social anxiety and binge eating. I tapered off it once, but within 7 months all those symptoms gradually returned, so I had to restart medication.
Since then I've tried venlafaxine IR 37.5 mg → desvenlafaxine ER 50 mg → now venlafaxine ER 75 mg.
The pattern has been identical every time. My mood becomes stable, anxiety is controlled, and I'm no longer depressed. But I still have almost no motivation, very low energy, excessive sleepiness and severe anhedonia. I barely function at work. I often end up working from bed and only push myself to meet deadlines or attend meetings. Outside of work, I'm almost always in bed because nothing feels rewarding or worth doing.
The downside is that venlafaxine/desvenlafaxine also seem to worsen my physical symptoms, especially TMJ, body aches, chronic tongue pain/burning, acid reflux, and poor sleep quality.
I've also failed sertraline, fluoxetine, escitalopram (gave severe mood fluctuations), and couldn't tolerate bupropion.
At this point, would you:
Increase venlafaxine to 112.5 mg (or eventually 150 mg)?
Switch to vortioxetine?
Consider TMS or esketamine?
My biggest goal is to improve motivation, energy, and the ability to enjoy life while keeping my depression under control and not making my physical symptoms worse.
I would really appreciate any recommendations in this situation. Thanks so much!
I had my 3rd session last Thursday and I feel my brain is fried and my emotional wellbeing being is not any better but worse. I am angrier and bitter. They are recommending 36 sessions and I know is early to.make an assessment, but i am going to stop it. I have been dealing with forgetfulness, headaches, and irritation is not getting any better. I just texted the medical assistant, I am going to stop this nonsense treatment. It is not only painful, but expensive. I think this is another medical shenanigan just to collect money.
Hey guys,
I’m writing here because I’m feeling very discouraged. To give you a little background on my story. I had healed from all my childhood trauma fully and truly loved myself. I never ever had mental issues. I’ve been living with my parents in the bachelor and they were very demanding. As hyper sensitive soul, I would always help them and be there for them even if I didn’t feel quite like it. During this time, I started suppressing myself constantly, my brother would come to the house and I would voice my mind, realized I was in a very toxic relationship that got me isolating from safe friends. I was going through a lot and isolated until my whole body went into hyper arousal, I fully dissociated and felt like I was going to die the whole time. My cortisol and adrenaline level were so high, I didn’t sleep for a month during that time I became crazy. I had to take two shots of SBG, did 2 treatments of ketamine. Calmed me for a bit but was still not in a safe space. After 2 months of fighting, I finally messaged friends and went to their house, now I have giving up the fight I was fighting for 2 months, told myself I’m dying. Now I’m at my friends with my perspective and seeing from the outside where I was and I’m not there anymore. I’m gone fully, zero dopamine, serotonin and no will to live. Everyday is a loop, social media or cigarettes don’t even give me a hit of dopamine. I’m considering rtms deep, anyone that did this treatment think that I will help me. I’ve hit a wall, I’ve lost my soul, my confidence, my self esteem, my dignity (due to hospital incident) everything is gone. This is very severe, and I’m really desperate for any kind of solution. It’s trauma for 60 days not one event but plenty! Day after day, screaming running and trying to explain my reality! I really thought I was going to die, and I didn’t so now I’m left with the feeling of death but I want to live. I truly lost everything, my business and everything around me. Is this treatment strong enough to give me some kind of hope?
I have pretty good health coverage, but it only applies to Kaiser permanente, so I have the opportunity to get TMS almost completely covered if I go through them. I already have the referral and I’m starting intake soon, but I understand that experiences can be very difficult between clinics. Has anyone gotten theirs at a Kaiser clinic? If so, how did it go? Any issues with the procedure or are they fairly trustworthy?
I'm halfway through my course and trying to get 7-9 hours of sleep each night during my TMS treatment. But some nights I only get about 5-6 hours. Could this mess with my progress?
I just like the pecking on my head like a little woodpecker. I definitely feel less depressed and I feel less anxious. I’ve also been implementing new routines for myself and i feel that it’s helped me with them but I rlly wish I could do the treatment for longer than just 36 sessions 😔 sigh… i know that it’s for the best but anyone else feel the same way? I know im not the only one lol
Hi
I'm going to be starting TMS soon and I wanted to know if the headache side effect is debilitating or not? To the point where you would not go to work/normal activities? (Ie driving, working out)
I know pain and tolerance thresholds are different. I work two jobs and cannot take significant time out unless I physically cannot move and have a note. Thank yall in advance 🥲
50 sessions in 5 days, what can I expect for each day? does it get easier/harder? any dips?
I'm posting this since I'll be going into my usual weekday sessions tomorrow (other than July 3rd) so anything folks can suggest that I should bring up to my TMS team and psychiatrist I'd like to hear now. And suggestions in general for this fatigue. I'm not upset it's a thing, I'm just annoyed that it's been going on for this long now. I'm at 120% by the way and that's been the case ever since the 8th or 9th session I believe.
I started my new job on June 15th and it's a full-time career track job where I work from 7 AM to 3:30 PM in the office and have one remote day a week too. Others in my post 8 days ago did mention how starting a new job is stressful, but this has been the opposite given how slow onboarding has gone for me, mostly due to the bureaucratic elements of getting tech requests resolved and a slew of issues with online systems not working on the system side of things properly until this past Friday. Even going into this week, I need to get my office phone number working since I need to legally use it to get information I need from certain hospitals. I've had a ton of unexpected free time as a result given how I'm a step removed at every corner so far it seems.
I also do my TMS sessions at 4 PM after work since that's the latest they could do for me. It doesn't hurt nearly as much as it used to thankfully, even though I slept a ton this weekend and ate meals too. I used to power nap for 30 minutes when I got back from my old job and was in my bedroom around 5:30 PM to 6 PM. However, even when I tried those so I could to bed by 9 PM at the latest, they weren't enough after the intensity reached 120.
Does this mean I'm responding as I should to TMS? What can I do to mitigate this fatigue? I'm going to ask tomorrow if the plan is to go 30 or 36 sessions with me before I'm discharged since they never told me the session maximum they're aiming for here. I was hoping to get it wrapped up at the end of next week since that's when I resume neurological rehabilitation and when I expect my workload to increase too.
Hello, everyone.
I got TMS around a year and a half ago with amazing results. I went from not being able to leave my room, to going out every day and even getting a job! It was all great until a few days ago when I suddenly started feeling my depression coming back. I contacted my psychiatrist and she said to do another round of TMS. Have any of you gotten TMS twice with the same results? Should I expect it to be as successful as it was the first time?
Looking forward to your replies.