Hope for Depression

Revolutionary TMS therapy doing the job antidepressants haven’t.

Rebecca Coupe moved to Florida from Ohio in 1996 to escape the harsh Midwest winters. She planned to spend her days basking in the warm sunshine, but chronic back issues kept Rebecca from enjoying the subtropical lifestyle.

Her incessant back pain forced Rebecca to quit her job long before she had planned to and dramatically altered her lifestyle. Annoyed by the discomfort, she lost the desire to see or even talk to anyone and soon found herself confined to her home.

Rebecca Coupe was treated for major depression with TMS by Boris Kawliche, MD, at Brandon TMS & Psychiatry.

Rebecca has her life back after treatment.

“When I say I am retired, I was kind of forced into it,” she admits. “Physically, I couldn’t do anything because of the pain, so I had to retire. My back hurt almost every day, and I was irritable all the time. I just had no ambition or desire to do anything.”

Unable to afford surgery, Rebecca struggled through the pain and eventually fell into a deep depression. It wasn’t until she found something that motivated her to get out and interact with people again that she realized some relief.

“I started volunteering for the American Veterans [AMVETS] service organization. My son is in the US Army, and I enjoyed spending my time giving back to those who served so selflessly. It helped to take my mind off the pain and ease the depression.”

In 2013, Rebecca says, her daily life began to unravel again, this time as a result of a bout with double pneumonia. That, coupled with her ongoing back issues, left her weak and fragile and feeling unlike herself.

“I started to get depressed because I was on oxygen all the time and had a portable tank I had to drag behind me everywhere,” Rebecca recalls. “I never left the house. It was easier that way. I was cooped up. I was forced to stop volunteering because I was so sick.”

On the advice of her primary care physician, Rebecca sought help for her depression from Boris Kawliche, MD, at Brandon TMS & Psychiatry.

“Dr. Kawliche prescribed antidepressants, and they did work for a while. I felt better some days – good enough to at least be able to function with some normalcy day-to-day.”

But when her back pain magnified, Rebecca says she was forced to undergo surgery. That was when things took a turn for the worse.

“It was my fourth back surgery,” Rebecca informs. “Afterward, I felt about as low as a person could get mentally. I would get up at eleven in the morning, stay up until about two in the afternoon and then go back to bed.

“Then, I would get back up later and make dinner, crochet a little bit or read a book, and stay awake watching television until eleven at night and just repeat the same thing the next day. I used to be so active. Suddenly, all of that was gone, and I felt useless.”

During her recovery period following back surgery, Rebecca didn’t take any medication for her depression because of the potential interference with her pain medications. One day, when she was at her pain management doctor for a
follow-up visit, Rebecca was advised to go back to see Dr. Kawliche.

“My pain management doctor could see I was struggling mentally,” Rebecca shares. “That’s when I went back to see Dr. Kawliche, and he told me I was a strong candidate for transcranial magnetic stimulation, or TMS,” Rebecca confirms. “I discussed it with my husband, and he was on board with it.”

The TMS Era

A new chapter in depression treatment, TMS began in the 1980s when a researcher at the University of South Carolina discovered how magnetic pulses could stimulate part of the brain that is underactive in people with depression.

The Food and Drug Administration approved the noninvasive therapy in 2008 for people with treatment-resistant depression and those who can’t tolerate the side effects of antidepressants.

Once the patient is settled into a comfortable chair, a paddle-shaped device with a magnetic coil is placed on the prefrontal cortex. It emits a magnetic field, similar to that of an MRI, in short pulses to stimulate the brain. These magnetic pulses are delivered intermittently in a precise sequence that is computer-generated.

The magnetic pulses are precisely targeted to the prefrontal cortex, which is the part of the brain associated with mood regulation and cognitive functions. Research studies have shown this area can be underactive in depressed people.

TMS treatments last approximately 30 minutes, and patients typically receive a total of 36 treatments over a period of six to eight weeks. Patients are treated five times per week for the first six weeks and are gradually weaned off the treatment in the final weeks.

“Most people start to notice changes within two or three weeks after beginning treatment,” notes Dr. Kawliche. “They say, I have more energy. I’m thinking a little clearer. My motivation is better. I feel like doing things.

“As the treatments continue, the brain gets used to maintaining a higher level of functioning through the repetition of treatments. This helps create muscle memory and oxygen flow to parts of the brain that may have been weakened by the depression.

“This treatment is truly unique. Not only does it help alleviate symptoms of depression, it also regulates sleep and helps stimulate blood flow to the brain. And it’s a painless treatment that, for many patients, works far better than antidepressants.”

Antidepressant medications have become a common treatment, but a large percentage of people with depression fail to respond to the medications. Either that or they stop working after a while.

Statistics show that in patients who have tried three antidepressants that have either not worked or have stopped working, the chances of a fourth such medication working effectively are just seven percent.

“The chances of TMS working in those patients are much better,” Dr. Kawliche says. “For those patients, there is a much better chance that they will regain the function and enjoyment in life they had prior to their depressive episode, which is why TMS can be life-changing for these patients.”

Getting Her Life Back

“I had TMS treatments five days a week for six weeks, and started feeling better after about two weeks,” Rebecca reports. “It was a huge commitment, but I followed through with the entire treatment plan to the end, and I’m glad I did.

“By the end, I felt like I could get up and get moving every day. I wasn’t just lying around doing nothing all day the way I used to. I was slowly getting my life back because I felt rejuvenated.”

Rebecca says TMS was a life-changing treatment for her.

“I am back to my old self again now,” she says. “I am doing yard work again, volunteering again and enjoying all of the daily activities I had shelved for so long. I still see Dr. Kawliche every six weeks or so for follow-up care, but I feel great.

“I owe a lot to Dr. Kawliche,” Rebecca emphasizes. “TMS was a lifesaver for me because I had exhausted the use of antidepressant medications. This was kind of a lastresort effort, and it worked! I finally have my life back, and I could not be happier. I feel great!”

Print This Article