Im lying back having rhythmic magnetic pulses sent into my brain.
Its a strange sensation. I feel a bit spaced out, but Im still making small talk with my psychiatrist about plans for the weekend and whats going on at work.
This brain zapping treatment, which Ive been having almost every day for six weeks, is meant to cure me of depression Ive been dealing with on and off since the age of 13.
You know what? Six months on, I think it might have worked.
I found out about RTMS, which stands for Repetitive Transcranial Magnetic Stimulation, when I was researching antidepressants, medication I was prescribed in January for the first time in around five years.
Although they did work, they werent as effective as Id hoped. Despite being on Escitalopram, an SSRI, for over two months, I was still depressed – just less depressed than before, and now with added side effects.
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I sought out consultant psychiatrist Dr Arghya Sarkhel at Living Mind to talk about a possible alternative to drugs. Apparently, after four to six weeks of having my brain zapped, I could stop taking antidepressants and I would be fine.
This seemed unlikely. After more than a decade of intermittent depressive episodes, I was apparently what you class as treatment resistant. AKA the type of person who is quite miserable as a baseline.
Depression to me feels physical, like theres pressure on my brain or a fog making it hard to concentrate or think. It could have me lying in bed for days, listening to cars go by or just sleeping to avoid reality. It makes basic decisions and small tasks like cooking or laundry feel beyond me. Its like having a bulb on the way out: You turn the switch, and the light flickers and flickers but doesnt come on properly.
This wasnt the first time Id seen a doctor for depression. From the age of 15 Id been on Seroxat, Fluoxetine (twice), Venlafaxine and Mirtazapine, as well as having art therapy, psychotherapy and CBT.
On several occasions it got so bad that I had to take months or years out of my education and life, dropping out of A Levels, retaking a year of university, and at one point ending up in hospital.
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That was 15 years – half my life – ago, when I was put on an IV and monitored for several days after taking an overdose that almost killed me. I remember the paramedics arriving at my house; I remember them asking Why would you do something stupid like that?, and then lying in an ambulance thinking I didnt care if I lived or died.
Once you know what its like to feel totally empty and outside of your own body, its hard to forget. The details become hazy but the feeling is still as sharp.
Thats not something many people know or would guess, and Ive been putting off writing this article because Im not sure how I feel about it being public knowledge.
After starting employment Id framed it all as a past life and convinced myself, with some clever Catch 22 reasoning, that because I wasnt having treatment, I must not be ill.
Actually, I was exhausting myself treading water when someone could have thrown me a life raft years before.
2018 began with a new years resolution to get over my depression, and thats how I ended up in a Harley Street clinic, wearing a white cap and feeling like Sylvia Plath in the Bell Jar.
Perhaps I did see RTMS as a quick fix, but wouldnt you want to be cured in a month if you could be?
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The treatment was approved for use on the NHS in 2015, but is rarely used because of its cost. At around £4,000 for a course, its not an option for everyone and is likely to be used in more severe cases.
To have the treatment, a magnetic pulse is passed into your brain generating a small electric current. Its meant to stimulate your neurones to pick things up a bit, and make new connections.
It does seem to work.
Im not totally sure what a normal brain is meant to feel like – if such a thing exists – but since the treatment Im (mostly) enjoying life and making plans. Thats a huge improvement from last year, when at times it felt like I had nothing to live for.
The first day I had the treatment was the only day I felt overwhelmed by it, while Dr Sarkhel was trying to find the correct threshold and gave me a higher dose than necessary.
That afternoon I went into work feeling so wired that I screamed at a grape rolling across the desk towards me, which looked like something alive in my peripheral vision. To my colleagues, it was very clearly a grape, and they found my reaction hilarious.
It seemed like progress to me though. After feeling like I was living underwater, I was ready to welcome my new life screaming at grapes.
That didnt happen again, though. I didnt react with shock to any other inanimate pieces of fruit. Instead, I felt generally more okay.
At the start of my treatment I said Id know I was better when getting words on the page didnt feel like trying to solve complex equations with GCSE level maths. I wanted to be able to work effectively again, and set that as the measure of my recovery.
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Part of me still hoped RTMS might super-charge me into becoming the kind of person Id never been before: very organised, very energetic, sleeping just four hours a night and frantically writing my novel, full of purpose and drive and with 100% confidence in my abilities.
That mostly didnt happen (although there was a little bit of that). Instead, I just started to feel like me on a good day.
When I was unwell, the days and months seeped into one another and all I could do was get through them.
Since starting the treatment, Ive arranged trips to Greenland, Greece and Antarctica and feel well enough to take up the opportunities life presents.
Others have described recovery from depression as a fog lifting, and thats as good a way to describe it as I can find myself. Its being able to live life without carrying a heavy weight, or having someone come and spray Windolene on the glass so you can see properly.
Its not that things suddenly became great. There have been times when I worry that the dazed feeling is coming back, and I still feel sad, angry or regretful quite a lot of the time.
RTMS cant change your personality, after all. Those emotions, though, are distinctly different from being clinically depressed, which had replaced the spectrum of emotion with what felt like a confused nothingness when I couldnt trust my own perceptions.
Six months after my first session, Im not taking medication and I dont feel like I need to.
Im starting to realise I could be (or even am) a pretty great person, and that theres a lot I can do in the world and give to it. Its quite a reversal from feeling like a worthless POS who will never amount to anything, and doesnt want to anyway because whats the point?
The treatment has made me feel stronger. Perhaps thats just a natural part of growing up, but for a lot of my life I felt like I couldnt manage in the world properly, which led to situations that werent right for me and that were difficult to change.
It hasnt always been easy. Ive had top-up sessions each month after ending my six week course of RTMS, and have another booked in next month.
I dont know whether Im really cured. A better term is probably in remission. Given my history with depression, Ill always have to be careful of it.
Its positive to know that if my symptoms do come back, there is something simple I can do to deal with them without having to go back on medication.
But Im hopeful that writing this article is a step further towards recovery, because breaking the habit of denial is hard.
Its scary to admit that you feel defective on some level, and to know that its out there for employers, dates, or people on Twitter to read and decide youre a liability, or too vulnerable to cope with normal life events.
On another level, though, acknowledging it and talking about it feels like a healthier thing to do than trying to hide the reality of anything being wrong.
I know talking about it is hardly a revolutionary concept in mental health. Of course telling people I”m depressed isnt enough on its own. But hearing how others have dealt with their issues has helped me, so hopefully this might help others too.
I could spend the next 15 years looking back on mistakes and hurt, wishing there was an opt-out button from life, or I could go forward trusting the best days are ahead – even if I dont have a map for the way forward.
I think thats a better option.
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