After 24 of 30 TMS sessions with no meaningful improvement, I wrote the guide I needed: why failed treatment hurts, how to get through the next 72 hours, and what to ask your clinician now.
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Does TMS cause headaches or migraines? Yes, sometimes. This first-person guide explains the pain, how to tell TMS headache from migraine, and the relief tactics—dose ramping, coil adjustments, and other techniques—that helped me keep going.
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If you’re hooked on the show Yellowjackets, like me, then you’ll know that in season two, episode two, Yellowjackets showed an electroconvulsive therapy (ECT) scene (I believe it may be called “electroshock” in the show). In the scene, one character, Lottie, is forced onto a bed, an injection is given in her arm, a bite block is placed in her mouth, and she is shocked by electrodes on either side of her head. She violently convulses, clearly in nightmarish pain. Let’s talk about how the Yellowjackets‘ depiction of ECT is inaccurate and harms the mentally ill.
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Transcranial magnetic stimulation is an option for depression treatment and may be an alternative, for some, to electroconvulsive therapy. Transcranial magnetic stimulation (when used as a treatment for depression known as repetitive transcranial magnetic stimulation or rTMS) is actually similar to electroconvulsive therapy (ECT) in that it’s also a neuromodulation technique. It does differ, though, as rTMS is much less invasive and has a very favorable side effect profile, particularly when compared to ECT. There are reasons that people aren’t flocking to rTMS as a depression treatment, though.
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The pros and cons of electroconvulsive therapy (ECT) are actually quite numerous but in this post I will try to, unbiasedly, lay out the basic pros and cons for anyone considering ECT as a treatment. I am likely uniquely qualified to do this as I am very educated about ECT (Yes, I still have that book in the works. Did I mention I’m really busy?) and I’ve also had ECT. This does not mean it’s right for everyone, however. Do consider the pros and cons of electroconvulsive therapy carefully before you make your own mind up with the help of a doctor.
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Saturday, after sharing the story of someone who had been through electroconvulsive therapy (ECT). someone named Michele Montour left me this series of tweets (shortened words lengthened to improve readability):
Nothing will ever convince me that this barbaric, antiquated butchery is proper treatment. We know almost nada about the brain. Scientists admit very little known about our brain – even diagnoses are guessed. But zapping it and not REALLY knowing and irreversible!? I think ECT treats us like animals. Repackaged to remove ITS stigma. Let’s just go to the ice-pick lobotomy again! #disgusted
To this, I, admittedly shortly, responded:
That’s a convenient perspective when you’re not dying.
Well, Michele Montour did not like this response and it led to a bit of a diatribe on her part wherein she, among other things, called me a stupid and ignorant bitch.
I thought, perhaps, this stupid bitch could take a moment to explain her opinion.
Read MoreApparently I’m the only one that understands the concept and usage of healthcare statistics.
Recently a commenter got angry at me for saying this:
“. . . Are there people who have had a bad experience with ECT [electroconvulsive therapy]? Yes. Are there people who have had very bad experiences with ECT? Yes. But then, I was hit by a car, so things happen. It’s not really the car’s fault. . . ”
My point, of course, is that there are people who have bad experiences, I would never deny that. But there are people who have bad experiences with everything. That doesn’t mean it’s the typical experience. We work hard to reduce traffic deaths and injuries in North America and doctors work hard to try to implement ECT in the best way too.
But the commenter felt,
“. . . And you wonder why are people anti-psychiatry? Because they had horrible horrible experience and are consider “oooops” and downplayed number in statistic . . .”
Well, um, yes. That’s what statistics are.
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I have been known to lament that there’s nothing new under the sun when it comes to depression treatment, and thus, there is little hope for people with true treatment-resistant depression. (And by treatment-resistant depression I mean people who really have tried everything, and there are few in this category.)
But I forget how far we’ve come and how fast. It isn’t fair to say there aren’t new approaches to treatment-resistant depression because there are new approaches being researched and approved every year. Here are a few noted by Current Psychiatry article Innovative approaches to treatment-resistant depression:
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In the book I’m writing on electroconvulsive therapy (ECT) I’ve had to address the question as to how ECT works. However, in spite of the fact that ECT has been in use since the 1930s we really don’t know how ECT works.
But recently we may have gotten a bit closer to figuring it out.
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