Defying Disability, Generating Hope

Nonmedicinal therapy lifts fog of depression, clears pressure of brain injury.

 Jennifer Haywood doing wood engraving in her kitchen.

Jennifer is enjoying the benefits of TMS therapy

For 12 years, Jennifer Haywood was a prosperous massage therapist in Kentucky, with professional athletes among her clientele. She was the sole practitioner in her area, so her services were in high demand. Appointments with Jennifer were booked four weeks out.

Her career ended abruptly in 2010, however, after the car she was driving was T-boned by another vehicle and struck yet again by a third car. The impact caused Jennifer’s brain to slam against the inside of her skull, resulting in a traumatic injury.

“It was just enough to disable me,” Jennifer shares. “I temporarily lost the use of my left leg and right arm, which I now have intermittent use of. Their function comes and goes.

“I also get migraines, something I never had before the accident. I had one that lasted for nine days once, and I ended up in the hospital. When I try to work or do anything physical, I get this intense skull-splitting pain in my head. On a scale of one to 10, it’s 100. There’s so much pressure in my head all the time.”

As a result of her injuries, Jennifer couldn’t care for herself without help. She returned to her native Florida to be closer to family and friends who could lend a hand. But Jennifer’s physical and emotional symptoms intensified and eventually overwhelmed her.

“My memory got bad,” she relates. “I was having difficulty concentrating and trouble with my vocabulary and speech coordination. I felt stupid when I knew a word but couldn’t get it out. I was never sedentary before, I became absolutely sedentary because I couldn’t work. That and my limited movement wound up affecting my mental health.

“It finally reached a point that I had a breakdown because things in my brain were so strange and I couldn’t make sense of them. I felt like a stranger in my own brain and in my own body. I knew someone who was a patient of Dr. Noonan and he helped her, so even though his office is far from my Zephyrhills home, I traveled to see him.”

Troy Noonan, MD, is a psychiatrist at TMS of Central Florida in Brandon. He initially evaluated Jennifer in August 2013 and has treated her consistently since then.

“Jennifer suffered a traumatic brain injury and was experiencing secondary depression and anxiety symptoms that were impacting her life,” Dr. Noonan recalls. “Over the years, we tried multiple antidepressant medications and combinations of medications but never realized the results we hoped to achieve.

“Last December, we discussed alternative treatments. Jennifer was interested in ketamine therapy. Ketamine is a fairly new medication for depression. I wasn’t comfortable with the results I’ve seen so far on its effectiveness, and ketamine has a negative side effect profile, so I didn’t recommend it.”

Jennifer and Dr. Noonan also discussed vagus nerve stimulation, an FDA-approved treatment for depression that involves applying electrical impulses to the vagus nerve. But that requires an invasive procedure to surgically place the stimulator device.
“We agreed that was too extreme, so I decided that Jennifer’s best option was TMS therapy.”

Changing the Brain

TMS, or transcranial magnetic stimulation, was approved by the FDA in 2008 for use in people with treatment-resistant depression. It uses magnetic pulses to stimulate the parts of the brain that are insufficiently active in people with depression.

“TMS stimulates blood flow to the brain’s frontal lobes, which is where the emotional regulatory centers are located,” explains Charles DeVine, MD, at TMS of Central Florida. “By increasing that blood flow, the brain is stimulated to more effectively regulate its own blood sugar, which is what we’re trying to target with medications.

“At its core, TMS is a noninvasive, nonmedicinal therapy that produces a genuine anatomical change, which in terms of regulating blood sugar is different than insulin. While insulin helps regulate blood sugar, people need to keep taking insulin to keep it regulated. That’s not the case with TMS.

“When TMS is successful, there is a true anatomical and physiological change within the brain. The anatomical change is the increased blood flow. The physiological change is the improved regulation of blood sugar and brain chemistry that produces a result where people can either come off their medication altogether or function better with it.”

“Nothing has cleared my thoughts or eased the pressure in my skull like TMS therapy.” – Jennifer

TMS is far different than electroconvulsive therapy, or ECT, which uses an electric stimulus, Dr. Noonan assures.

“TMS uses magnetic stimulation and is administered in the doctor’s office. It is considered safe and easy on the body,” the doctor stresses. “The most common side effect is mild to moderate scalp discomfort at the application site.”

“The TMS treatment feels like Woody Woodpecker is on your forehead,” Jennifer describes. “Of course, it’s not as forceful as a pointy beak hitting your head. And if I had a migraine the day before a treatment, the technician puts down a little pad so the tapping sensation is even less intense.”

TMS treatments last for 18 minutes, 45 seconds, with patients usually receiving a total of 36 treatments, Monday through Friday, over an eight-week period. The magnetic pulses are delivered through a cup-shaped device that is placed on the prefrontal cortex while the patient rests comfortably in a chair similar to a dentist’s chair.

Snowballing Improvement

The amount of time it takes for patients to begin feeling the effects of TMS varies. Jennifer felt a difference after her second week of therapy.

“I noticed that my brain wasn’t as foggy, and I could access my vocabulary,” she details. “That’s important to me because I’m a creative person. I like to write and draw. Things just snowballed from there. Soon, I was talking better, and my head was clearer. Nothing has cleared my thoughts or eased the pressure in my skull like TMS therapy.

“And I’m not sleeping as much now. With a brain injury, your brain gets tired really fast. In the beginning, I had to sleep a lot, but now I don’t need to take naps during the day. But I sleep well at night, which is amazing because brain injuries affect your sleep switchboard and mess everything up.”

Jennifer still gets migraines, but they’re not as disabling.

“The medicine I take for my migraines is helping now; it didn’t before,” she reports. “I think my brain is receiving the medicine better because I recover quicker. I’m not down as long when I get a migraine.

“It’s been a long, hard road, but TMS therapy has really cleared the fog. I’m probably 60 to 70 percent better. I’m considering another round of therapy. I figure if I feel this good now, how good will I feel after another 36 treatments? It’s foolish not to go for it because TMS therapy makes me feel hopeful and happy.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
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    • TMS of Central Florida

      TMS Therapy is a proven, effective treatment for debilitating depression. TMS Therapy system uses short pulses of magnetic fields to stimulate the area of the brain that is thought to function abnormally in patients with depression. ... Read More

    • Charles Devine, MD

      Charles Devine, MD, specializes in psychiatry and neurology and has been in practice for more than 20 years. He earned his medical degree from the University of South Florida College of Medicine in 1995 and later performed his residency at the... Read More

    • Troy Noonan, MD

      Troy Noonan, MD, specializes in general psychiatry, and child and adolescent psychiatry. He earned his medical degree from the Chicago Medical School at Rosalind Franklin University in Chicago, Illinois in 1996 and has been in practice for mo... Read More