Wednesday, May 3, 2017

Looking to TMS, for now.

I'm having a lot of trouble focusing these days. I have resting-anxiety that’s higher than normal, and I can’t get enough sleep. I’ve changed my commute to work in order to walk more, and also to cut from a bus and two metro rides to just one long bus ride. This means I’m on a bus for about 45 minutes to an hour, so I nap twice a day nearly daily. It’s still not enough sleep. It also allows me to read or just sit quietly. Then, once in the city, I have a longer walk uphill so it's a nice start to the day.

Right now my mind is on TMS. I’m considering TMS, and I hope I’m a viable candidate for it. I need a change. I’m afraid and worried, but I’m also at a low point right now and I’m all out of ideas.

So right now, the focus is on TMS. If it’s a yes or a no, I can then move to the next thing, which may be microdosing.

I have an appointment tomorrow with my family doctor, Dr. Rishi. I sent him a letter last week (they don’t have an office e-mail, so I mail him things like a war-time bride) asking him to look up TMS and microdosing before my visit. TMS is offered at the neurology department of the McGill University Health Centre, so it’s an option.

A piece on NPR mentioned TMS being used for "treatment-refractory depression" - which is depression that does not respond to common treatment methods. That sounds like me. I am on a pretty high dosage of anti-depressants and I'm barely functional nonetheless.

I also read a piece in a psychology journal about recent findings:
A recent study presented at the 2016 Annual Meeting of the American Psychiatric Association (APA) in Atlanta, Georgia, investigated the effects of TMS on depressive symptoms in a private practice setting.3 The sample included 123 patients (67.5% female) with MDD who had not responded to an average of 3.9 treatment attempts with antidepressants. The mean number of TMS sessions that patients received was 40.8. 
Following the acute phase of treatment, patients demonstrated a 76.4 to 78.8 response to treatment as indicated by their Beck Depression Inventory (BDI-II) and Patient Health Questionnaire PHQ-9) depression scale scores, and no notable adverse effects occurred during or after treatment. Remission rates were between 52.5 and 72.4, and of these patients, an 80% long-term remission rate was observed among those available for follow-up assessments over a period of more than 4 years. “These findings further establish TMS as a safe, effective and durable treatment option, both acutely and on a continued basis, for those who suffer from a high degree of symptom severity and/or do not gain relief from antidepressant medications,” concluded the authors.
Those are encouraging findings, the article, Transcranial Magnetic Stimulation Effective for Major Depressive Disorder, Generalized Anxiety Disorder, ends by saying that 60% claimed remission and that 70% showed significant remission. Those numbers aren't nothing.

For now, I just have to wait until tomorrow, where I can talk to Dr. Rishi about it.

Until then.

Update: 

Musician streams TMS treatment live on Facebook.

Also, there's this bit on gut health and the brain and TMS. They seem to correlate TMS with gut-health and weight-loss, but I'd argue if you're less depressed shit gets better in general.

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