That’s a wrap. I’ve completed my last round of rTMS.
I reread my first post on TMS and the first paragraph is pretty rough, but it’s also still pretty accurate. Today I nearly aced the depression inventory (not in a good way) and my tremor has blown into a full body quake at times. It’s like shivering with anxiety. The staring into space actually hurts when my eyes dry out. I do realize I just came back from a long and exhausting trip, so I’m working on self care too.
I mentioned that I got a visitors badge every day at the hospital, and I just said “TMS” and they write it and hand it to me, then I use the required hand sanitizer. Which is prodigious. I used to slowly walk the 20 feet to the door so I could rub it all in/off, but in the end I usually just opened the door handle with disinfectant still all over my hands. I figured I was helping them sanitize the door. No charge. I also mentioned that I figured they would know me on sight and write my badge without my saying “TMS” but that it would probably happen on the last day. And I kid you not. It was the last day. I’ve done the math and over the last few months I’ve had 144,000 pulses of magnetic energy tapped into my head.
tldr:
Anxiety somewhat better, depression worse.
Bit more info:
Diagnosis: (still) Major Depressive Disorder, severe, recurrent episode without psychotic features
This means it’s pretty bad since they used the words “Major” and “severe” and it keeps coming back.
But I don’t have the psychotic features, which would be delusions, hallucinations, or both.
Depression Symptoms: depressed mood, sadness, anhedonia, fatigue, feelings of worthlessness/guilt, difficulty concentrating, hopelessness and suicidal ideation
The PHQ-9 is a depression inventory and rating system. The GAD7 is the same but for anxiety. I take both before pretty much every appointment with my Psychiatrists, so I’m pretty good at them. Just meaning I know how to take them, obviously.
My score on the PHQ9 for depression went up one point between starting and ending TMS. I wonder if that messes with their outcome statistics, since I got worse not better. On the GAD7 for anxiety, I’m down 6 points, which is an ok improvement. I think that takes me from severe to moderate. Anxiety is a lot more unpredictable than depression, as it comes and goes and varies in intensity. So it’s hard to inventory well.
Highlights from the official notes in my chart:
- He reports some noticeable improvement in anxiety, but no appreciable difference in depression
- Presents with appropriate and depressed affect
- He did not experience side effects with TMS
- He may be a candidate for future ECT treatments, as he had a better depression response to that, but he also had significant side effects with the ECT treatments
- It is possible that he may notice further improvements in depression after finishing with TMS, and if that is the case he may be a candidate for TMS treatments again in the future
- Overall, patient has not achieved greater than 50% improvement in depressive symptoms, throughout TMS series, as indicated in rating scales (that’s the diagnostic goal, at best cut the depression in half)
I have a feeling the little improvement I got in the anxiety is about as much as I will get. I don’t really want to get more memory issues, nor do I want to put my wife through the pain and hassle of getting me to and from ECT. Though I really enjoyed the peanut butter and jelly sandwiches she would bring me in the afternoon when I finally came out of the anesthetic haze.
I am currently between programs, having done a PHP and an IOT and now I’m starting another PHP on Friday with a different organization, just to mix it up. Also going through a lengthy intake process to get into a Treatment Resistant Depression clinic, and from what I’ve seen so far they really know their stuff.
Much like COVID, what we thought would be a few weeks has strung itself out into months. It was the anxiety that put me in this hole, it’s the depression that’s holding my head under water.
a Scarlet D 