I recently started a procedure called TMS, or Transcranial Magnetic Stimulation, which is touted as an amazing treatment that reduces depression in 80% of its patients and completely cures depression in 50% of those who find success. It seemed almost too good to be true. My research revealed only positive feedback: most people felt happier and less anxious after the procedure, with minimal side effects—just a slight headache that fades over time. However, most doctors and therapists I spoke to had never heard of TMS because it has only been around for about 20 years, a relatively short period in the medical world. Unfortunately, the medical community does not always keep up with the latest developments or technologies, so TMS is often only available through private practices. Nevertheless, it is FDA-approved and covered by insurance, unlike many therapies and depression treatments, which are often expensive and poorly covered. For me, TMS only required a copay. Although each session needed a copay of $25, and TMS involves 36 sessions, my FSA card covered it, so I proceeded.
I reached out to a reputable private practice known for TMS, where I consulted with a highly experienced doctor. This doctor assured me that side effects were minimal, mostly limited to a slight headache, which not everyone experiences. I was hopeful that I might never need antidepressants again after this treatment. When I attended my first appointment, they did a test of my reflexes to determine the optimal placement on my head. I was surprised that the sensation was neither barely noticeable nor painless as advertised; it felt quite uncomfortable, like someone flicking me hard on the head. The staff explained that the initial discomfort is due to the unfamiliar sensation, but once we started the treatment, it became more manageable. What began as a pain level of 5-6 decreased to a 1-2, making it almost tolerable. The doctors had mentioned that many people initially find the procedure bothersome, but over time, they get used to it and even find it easy to fall asleep. However, you must stay awake during the treatment to activate your brain.
During the procedure, a device is placed on the dorsolateral prefrontal cortex, delivering approximately 3,000 magnetic pulses over 18 minutes. I was told the process was short, painless, and had negligible side effects, making it feasible to do during my lunch break from work, they said many people do this. I arranged with my employer for an extended lunch hour to accommodate the drive, the treatment, and the return trip. I thought it would be perfect, but I was mistaken.
One crucial detail not mentioned until after I started was that the treatment doesn’t have a noticeable effect until about 20 sessions in. You need to attend sessions five days a week, making 20 sessions roughly equivalent to four weeks out of a total of about 7-8 weeks. This requires perseverance. If everything else they told me about having no side effects were true, this would be manageable. Unfortunately, I discovered that not only was this not the case, but it appears to be common for doctors performing TMS to understate the symptoms. I found a TMS subreddit early on and learned that many people experience symptoms beyond just a slight headache. For instance, most people feel fatigued after the treatment, which is essential to know since I was advised I could drive myself there and back and return to work afterward. I often felt the need to nap and struggled to resume work. Additionally, many people experience increased anxiety at the start, something my practitioner did not mention until I brought it up. Along with anxiety, I faced significant frustration, anger, and mood swings. Research indicates that these symptoms might be a sign that the treatment is working. I shared this information with my TMS clinic, but they had never encountered these symptoms before. I was willing to tolerate these effects, but unfortunately, that wasn’t all.
The intensity of the pulses increases with each session. To ensure effective treatment, there is a threshold that must be reached. The treatment starts at 50% of that threshold and gradually increasing by 5-10% per session to help you get used to the sensation (read pain). The first five sessions were relatively bearable, initially feeling a bit uncomfortable, but ending with minimal pain. However, after the first week, I noticed pain in my neck around my throat that did not subside.
In the second week, I reported the neck pain to the practitioner, who adjusted my position and re-evaluated my assessment to lower the pulse level slightly. They reduced the intensity by about 5 points, but the pulses remained intense. The pain, which started at a level 3, became a level 5-6. Despite this, I was willing to endure the pain for the 18-minute sessions in hopes of a better life free from depression. Unfortunately, the pain did not end there. When I returned home, I experienced severe headaches and a sore neck, as if I had been punched in the throat. I suspected that the constant pain during the treatment was causing muscle tension in my neck. However, the pain persisted for hours and even the next day. I began taking 2-3 ibuprofen before each session, but it didn’t alleviate the pain. I had to take additional ibuprofen to manage the headaches afterward.
Things took a turn for the worse after my 9th session. I was relieved to have the weekend to recover, but I fell ill with fatigue and soreness, though without other symptoms. My husband had been feeling unwell the previous day and was already feeling back to normal, so I thought it was a minor virus that would pass. I felt better within a day and returned for my 10th session. However, that night, I developed a fever and continued to have nightly fevers. My head and neck ached so intensely that I couldn’t sleep, despite taking ibuprofen, cold medicine, and melatonin. I started using ice packs on my head and neck for relief. I felt sore and fatigued throughout the day and missed a week of work and TMS sessions. I thought I must have covid because this is such weird, yet intense virus, but I tested negative for COVID and strep throat at home and at the doctor’s office. After 9 days of persistent fevers and pain, I visited urgent care. There, tests revealed I had an elevated heart rate of 140 at rest and an overproduction of T4 hormones by my thyroid.
I was relieved to understand the cause of my prolonged fever, but I was shocked. In the past I had blood work and it had always shown normal hormone levels, with no thyroid issues. I eat healthy, I'm in the normal bmi/weight range and I exercise fairly often so this seemed so weird. The urgent care doctor advised me to start heart medication to lower my heart rate and see an endocrinologist as soon as possible. A week later, the endocrinologist diagnosed me with Thyroiditis, which she explained was an inflammation of the thyroid triggered by a virus. She said it should heal on its own within six weeks, though I might need steroids if it doesn’t improve.
I have some knowledge of thyroid issues, and I understand that stress can disrupt thyroid function and contribute to depression. I had previously explored thyroid hormones as a potential cause of my depression but found no issues. It seems oddly coincidental that, after ten painful and stressful TMS sessions, I developed Thyroiditis from a minor virus that my husband recovered from in two days. I believe the stress from TMS on my head and neck triggered the thyroid problem.
I found four studies mentioning that TMS procedures can raise or otherwise affect thyroid hormones. I shared these studies with my doctor, who dismissed the idea that TMS could affect the thyroid. They also seemed unaware of potential fatigue, mood changes, or pain. My conclusion is that while TMS may be beneficial for some or even most, it can have negative effects for a significant minority. There are numerous horror stories online from people experiencing prolonged negative effects, often with doctors denying these possibilities. It appears that the medical community might focus on success stories while ignoring contrary evidence when it comes to TMS.
This experience has been a stark reminder that no medical procedure is without potential side effects. If anyone tells you otherwise, even if they are a doctor, be skeptical.
For now, I will not return to TMS. My depression has actual temporarily improved because I’ve realized how much worse my life could be if my health were worse as it is now. Having felt like I was dying and now just dealing with daily pain and fatigue has given me a new perspective on my depression. Although I still lack clarity, a feeling of motivation and focus, I am managing daily tasks despite these feelings. The negative emotions seem less intense now. Whether it’s the slight success of TMS or the realization that things could always be worse, I am determined to actually do what stuff I can with my life because my health is not a gurantee.
I am not willing to endure TMS again anytime soon. If I can't trust the doctors to tell me what can be expected, then really anything can happen. I can't risk the health of my thyroid again. I recommend anyone going into TMS do research online and just pay attention to how it makes you feel. I wouldn't say just skip it all together because it seems like it really works well for some. My practioner told me she went through TMS and found it painless and effective. I would just say if you try it be willing to speak up for yourself and tell those doctors to take the intensity down, and if its just too painful maybe its not for you. I would defintiely recommend taking 3-4 hours off work or even getting FMLA and taking the full treatment time off work, or having someone drive you. Do not let the doctor trick you into thinking its gonna be a quick easy thing to do during your lunch break. If you have to, stay in a hotel near the doctors office for the duration of the treatment and make it a vacation. Do whatever you have to if you want to try this method. Save up money to take the time off work or do whatever you need to, to make it as stress free as possible. Don't fool yourself into rushing during your lunch break and driving in traffic back and forth and pushing through the pain like I did. Your body will not thank you and you may end up with thryoiditis.
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