I Tried Transcranial Magnetic Stimulation For Depression — Here’s What Happened

My depression is deep. Enough for me to find myself sitting in a chair with a helmet on my head, a magnet delivering electric pulses to my brain. The hope is that it will shock certain parts of my brain back to life and other parts into quiet submission. The magnet thuds against my skull and I close my eyes, counting the seconds until it’s over. In a group chat, my family jokes about what we call "brain zaps" and I don’t tell them that I cry in the bathroom between sessions. It hurts more than I was expecting. And then there’s the deeper, worse feeling: that perhaps there is something so wrong with my brain that it has to be zapped with magnetic stimulation. 

Transcranial magnetic stimulation, otherwise known as TMS, is a "noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain," according to the Mayo Clinic. TMS has been FDA-approved for treatment-resistant depression, obsessive compulsive disorder and smoking cessation, and it’s being studied for other conditions. The idea behind TMS feels deceptively simple when it’s explained by Dr Kristin Raj, a clinical associate professor at Stanford University. For people suffering from psychiatric conditions, their brains aren’t functioning optimally. In some conditions, like depression, that can mean a brain circuit is underperforming. In other conditions, such as obsessive compulsive disorder, a brain circuit can be overly engaged and firing too intensely. "The different patterns of the [TMS] magnetic pulses can help re-engage a circuit… or quiet it," Dr Raj said. "Over time, TMS helps cement the change of that circuit, allowing it to fire more optimally." According to Dr Raj, two-thirds of patients with treatment-resistant depression see at least a 50% improvement by the end of a traditional 30-session course of TMS, with around half of patients achieving remission of depression. Side effects — which can include headache and lightheadedness — tend to be minimal and improve soon after a session is finished, according to The Mayo Clinic. 

Dr Noah Philip, a professor of psychiatry at Brown University and psychiatrist at the VA Center for Neurorestoration and Neurotechnology, said TMS can affect people differently, like any kind of medical intervention. "Everyone’s brain is a little bit different. Everyone’s experience with depression is a little bit different," Dr Philip said. Some patients may experience "treatment-emergent anxiety" while undergoing TMS and others may feel that once the fog of their depression lifts, they can see the stressors in their life more clearly. Despite possible side effects, Dr Philip said TMS is a "very effective non-medication option" to treat depression. Though there are anecdotes among patients that TMS made their depression worse or was unbearably painful, that wasn’t my experience and the experts contacted for this story said it’s not a common reaction. 

Depression had once been a wave, knocking me off my feet, but by the time my doctors first suggested TMS as a treatment, it had gotten quieter. I had settled into the gray blanket of it. I swallowed my antidepressants dutifully most days, though I doubted whether they made a dent. I felt similarly hopeless about TMS. If nothing else had made a difference, how could this? It felt like magic, but not magic I could believe in — more like a cheap trick I would feel ashamed for buying into.

The first time I did TMS, in the winter of 2021, it was a six-week protocol (in the time since, a newly shortened protocol has been approved). My insurance didn’t cover the treatment then (though it does now) and I paid over $3,000 out of pocket for the six weeks. For the first half of my treatment, I didn’t feel any different. If anything, I felt irritated. Thanks to my chronic migraines, which make my head painfully sensitive and tender, I found the magnetic pulses painful enough to bring tears to my eyes. Each day after treatment, I would collapse into a dreamless sleep, rising only to eat a bland dinner before going back to bed. I was exhausted and sure it was all a waste of time.

Then, sometime toward the end of the third week of treatment, I opened my eyes and thought, I can’t wait to go make some coffee. If this sounds small to you then you have never been deeply depressed. It had been years since I had looked forward to anything, even a cup of coffee. As I drove to treatment that morning, I found myself playing music instead of an endless string of overly analytical podcasts meant to distract myself from my own thoughts. Slightly, quietly, moment by moment, the fog lifted. I was wild with small joys. I am listening to MUSIC again, I texted my mom. I am looking forward to MORNING COFFEE. In a book, I underlined the sentence: I wonder if this sense of awe is what it means to feel alive again. 

My sister tells me I was like a cartoon character who had been drawn in black and white and smudged grays and that with TMS, I was back to full color. After I finished the prescribed six weeks of treatment, I returned to my life but as someone closer to the self I thought I had lost. Nine months later, I felt the depression creeping into the edges of my vision and I returned for a marathon treatment of 10 sessions in one day (this time, the treatment was covered by insurance and I was only responsible for a $40 copay for each session). Sometimes I find myself judging a brain that requires maintenance like this to function. Most days, I am so deeply comforted by the idea that the treatment exists — that when the color begins to fade again, I won’t be alone in the dark.