I have just been scheduled for Transcranial Magnetic Stimulation (TMS). It’s a six-week long, non-invasive neurological treatment for severe depression. I’ll begin in mid-April at London’s Parkwood Institute.
For those who know nothing about it, here is a very brief but useful primer:
How might TMS help in the context of my psychotherapy? DBT identifies several elements in an episode of anxiety or depression: vulnerabilities; a prompting event or “trigger”; an emotion-infused reaction in the body (e.g., increased heartbeat, clenching of muscles); and an interpretation which the reasoning mind creates in light of all this.
The most relevant element here are the vulnerabilities. They can be short-term or long-term. The former pertain especially to i) reduced sleep, ii) unhealthy diet, and iii) insufficient exercise. Sleep in particular is a very strong predictor of emotional fragility in my case. Long-term vulnerabilities lie in iv) psychological history (e.g., an abusive childhood or a catastrophic loss) and v) biomedical diagnoses, such as my own Bipolar Disorder Type II.
I can and do work constantly at reducing those short-term vulnerabilities: I’ve learned lots about sleep hygiene and a mind-wise diet (think Mediterranean), and I run all the time.
I can’t do much about (iv): history is what it is. My pre-adolescence was a traumatic domestic nightmare. And, after a devastating five years of surgeries, radiation, and chemo, I lost my first wife to cancer. She was 29, I was 28.
TMS comes in with respect to that fifth vulnerability. It helps approximately 50-60% of people suffering treatment resistant clinical depression.
It’s very, very important that I focus on this fact, viz., that TMS might very well help with number (v), but cannot “fix me”. For, anticipating that 30 days of brain stimulation will itself excise all my sadness and fear sets me up for disillusion and despair. It is self-defeating.
So, wish me luck. And remind me to manage my expectations.