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Two weeks after celebrating her 12th birthday, Mary Beth* received what she stills considers “the best Christmas present ever”: a charcoal gray Welsh pony with a black mane and tail that she aptly named Smokey.
“Oh, my gosh, he was beautiful,” Mary Beth remembers. “And he was so calm. He had a great temperament, so he was the perfect horse for me to learn to ride, which was all I wanted to do when I was 12 years old. That was my thing, riding horses.”
Mary Beth rode Smokey for almost 10 years until she went away to graduate school, where her attempts to earn a master’s degree in business law were eventually derailed by a bout with depression and anxiety that she continues to fight today.
“I also had a couple of physical issues I was dealing with, but the depression made me feel as if I didn’t want to do much of anything,” Mary Beth explains. “I wound up procrastinating a lot and didn’t take care of the things I needed to and isolated a lot.
“That was a really dark time for me because I had no desire to do anything, and I felt fatigued all the time, so I just slept a lot. And when I was up and out of bed, I just kind of played games on my computer instead of doing important things like schoolwork.”
Mary Beth fell into such a rut during that time that she dropped out of graduate school and returned home. Soon after, her parents encouraged her to seek medical attention, which she did.
“That was when I was officially diagnosed with depression,” she says. “Since then, I’ve been to three practitioners, and each one has put me on a different medication, so I’ve been on PROZAC® (fluoxetine), WELLBUTRIN® (bupropion), REMERON® (mirtazaine) – I feel like I’ve pretty much tried them all.
“The problem is that, at best, the medications were only marginally effective. I might get little spells where I’d feel pretty good from them, but that was it. Because of that, depression continued to be a big part of my life story.”
To rewrite that story, Mary Beth recently reached out to a fourth practitioner, Faizi Ahmed, MD, of The Neuropsychiatry & TMS Group, which specializes in transcranial magnetic stimulation therapy.
“I’d heard about TMS in passing and decided to read up on it,” Mary Beth offers. “The more I read, the more I thought, Maybe this is something I should try. So, I looked around for a practice that offered TMS and chose Dr. Ahmed.”
Safe and Effective
Approved by the Food and Drug Administration in 2008, TMS is a noninvasive therapy for people with depression who have not achieved satisfactory improvement through the use of antidepressants.
With TMS, short magnetic pulses are emitted through a paddle-shaped device that is placed on the forehead in the area of the brain’s left prefrontal cortex.
The prefrontal cortex is associated with mood regulation and cognitive function. Scientists have determined it is often underactive in people with depression. However, research shows that this area can be stimulated by the magnetic pulses delivered intermittently in a precise computer-generated sequence during TMS therapy.
TMS is considered safe and easy on the body, with the most common side effects being headaches and nausea during the treatment period, which takes place as the patient reclines comfortably in a chair like that found in a dentist’s office.
Treatments last 19 minutes, and a typical regimen calls for 36 sessions over a seven-week period. That, Dr. Ahmed explains, is one of the few drawbacks associated with TMS therapy.
“TMS is not a one-and-done treatment,” he explains. “It actually requires 36 individual treatments to get the effect. And the biggest downside is that somebody can go through that entire course of treatment and have what is called a nonresponse.
“That happens with 40 percent of the patients. But the good news is that another 40 percent will experience what we call remission from depression, where the depression essentially resolves completely.
“And an additional 20 percent of patients receiving TMS therapy will experience what we call a response. That means they will get between 50 and 90 percent improvement in their symptoms while retaining some residual symptoms that prevent them from meeting the criteria for remission.”
Studies show that most patients who experience remission from TMS therapy will remain in remission for about a year, while 50 percent of those who receive a response will retain the effects for about a year.
“And for those who do have a relapse, durability studies shows that 84 percent will respond to treatment again,” Dr. Ahmed says. “Unfortunately, those who do not experience a response or remission are unlikely to respond to a second course of treatment.
“But the bigger problem is that we just don’t know who will and won’t respond to TMS treatment. A plethora of studies have been done to determine the characteristics of those who do respond, but nothing has been found to be a true indicator.”
Depression in Remission
Hopeful that the odds were in her favor, Mary Beth first went to see Dr. Ahmed last summer. Following an initial evaluation and review of her condition and medications, the doctor deemed her a good candidate for TMS, which she began in July.
“I completed my treatment in September, and the only side effect I felt, if you can even call it that, was a little headache that would come on but then go away after a few minutes,” Mary Beth reports. “Other than that, I had no adverse effects, and I feel great.
“I used to always have this overriding feeling of dread that I could never really shake. It just kind of hung with me, but that has pretty much been lifted off my shoulders since I received the TMS treatments. My whole outlook on life is better now.”
Dr. Ahmed refers to Mary Beth’s response as “remission,” and in the months since, she says she has become far less isolated than before. As a result, she’s engaging with family and friends more and reaching out to others more regularly.
“I no longer spend my days sleeping or hanging around the house playing games on my computer,” she says. “I actually get up and do things, so I’m volunteering a lot and I’m actually excited most days to get out and engage with people and help them.
“TMS therapy has made a huge impact on my life. It’s definitely allowing me to live a better life, so I am very thankful that I sought help from Dr. Ahmed, and I really can’t say enough great things about him.
-Mary Beth
“He’s very personable, very optimistic and he really puts you at ease. The best thing is, he seems genuinely interested in his patient’s well-being.
“One thing I know for sure is that he really believes in TMS therapy because he knows it works. And it definitely worked for me.”
* Patient’s name changed at her request
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