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transcranial magnetic stimulation

Me crying, struggling with depression

A few years ago I posted an Instagram photo with me crying and a caption that said, “This is the face of depression. Be kind to others because you don’t know what they’re going through.” That photo upset some of my friends because I hadn’t really discussed my depression before in such an open way. To them I was happy and a goof ball. What most didn’t see was I was moody, miserable and even suicidal at times.

Though I was diagnosed with depression 17 years ago, it was after my babies were born that it really got bad — and scary. I had dealt with postpartum and post-weaning depression but had inadequate psychiatric care.

On the outside I was posting pics of my kids in cute outfits and everything online told a completely different story.

Many people mask their pain for different reasons. I had the idea that depression wasn’t talked about, that having depression makes you weak. That it was a matter of willpower. I didn’t want to be the depressed mom, I wanted to be the mom that does it all, which is a dangerous and unrealistic expectation for anyone. That stigma that I was buying into keeps a lot of people silent about their struggle. It can be especially hard in certain cultures, such as Asian cultures (read more about that here.)

There are definitely common misconceptions about what depression looks like. In my case, I’m not sad every minute of everyday. There are good and bad days, just like anyone else. Sometimes my depression manifests in other ways, such as overeating or binge eating; sleeping too much; having a short fuse; or partaking in other unhealthy behavior.

I was freed of the heavy weight depression holds when I admitted to all my friends and family that I went to a psychiatric hospital in 2019. I even wrote a forum piece about my experience for the local paper. It was not easy, in fact it was a little terrifying knowing that essentially the whole city knew my secret, but like I said, it set me free. I just didn’t care about anyone’s opinion anymore. I know it can be annoying when I plug my blogs or pieces in the paper but I’m hoping they will reach someone who needs to hear what I’m saying — that it’s OK having depression and there is no shame in it. Those who I’ve met who struggle with depression are the strongest people I know. We are fighters. We are survivors.

Ideally, everyone should be able to talk about their mental illness but I understand why people don’t. It’s terrifying being vulnerable, especially when there’s a chance someone will react negatively. But I urge everyone to reach out, even if it’s to one person. You’d be surprised how free it makes you feel, and by telling a friend or family member, you’re lightening your load. Your support system can help you carry that load, and you should take help where you can get it.

If you can’t reach out to someone, please know there are several online resources that can help. To learn more about depression or find resources visit the Substance Abuse and Mental Health Services Administration. They have a 24-hour helpline.

Other Misconceptions About Depression:

  1. “It’s all in your head.” – Depression is a psychological and biological disease. You have no control over it, so if someone tells you to “buck up” just know that the problem is not with you — it’s with them and their lack of understanding. You don’t have to pretend or fake it, just do you.
  2. Depression = being really sad. – Sure, you get sad when you’re depressed but someone equating it to “just being sad” is trivializing your feelings and your disease.
  3. Depression means you’re weak – I already touched on this but it’s worth repeating — I think people with depression are so strong. Depression can wreak havoc in all areas of your life. Some people deal with suicidal ideation daily and others have to tap into a reserve of strength and energy just to take a shower (me!) or go to work. Often that reserve is depleted.
  4. Depression is not treatable – There are a variety of medications that are safe and effective in treating depression. There might be side effects and it might take a while before finding the right combination, but (most of) patients feel better. There are also therapies you can try, such as talk therapy, TMS (Transcranial Magnetic Stimulation), ketamine infusion therapy, and my favorite, ECT (electroconvulsive therapy). Please consult your doctor before trying any medication or other treatments.

These myths are damaging, but again, please reach out if you are struggling. It gets better.

If you are suicidal, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit their site for chat support.

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One-year Anniversary

by Heather Loeb

A year ago this month I went to the Menninger Clinic for inpatient psychiatric care for six long weeks. The months leading up to my trip to Houston weren’t good ones. I was emotional, suicidal and so damn sad. I had been labeled with treatment resistant depression, thus none of my meds were working. I also had tried TMS and ketamine infusion treatments but it didn’t lighten my load at all.

I was scared. Mostly because I feared I wouldn’t be around to watch my kids grow up. My husband, therapist and psychiatrist all agreed Menninger was the next step. After going over my history, meds and different treatments, I was told I was a prime candidate for ECT (electroconvulsive therapy). It took weeks for me to wean off all my meds – an antidepressant, antipsychotic, benzodiazepines, anti seizure meds and Ambien.

While I was weaning off my meds, I underwent psychiatric testing and went to classes about how to deal with mental illness. I also had to go to the classes on addiction because I wasn’t great at taking the prescribed benzodiazepine the way I was supposed to, to put it mildly. When we weren’t taking classes, we were required to do therapy and meet with psychiatrists. The classes – and the teachers – were all very helpful. My diagnoses are Major Depressive Disorder, Generalized Anxiety Disorder, Dysthymia and Avoidant Personality Disorder.

I became close with a couple of patients who were in the same boat asI was. I still talk to them; sometimes it seems like they’re the only ones who understand what I went through since they were right there with me.

The facility was nice. It should be for how expensive it was, but hey, it did save my life. What stuck with me is that there were not rods to hang your clothes on, no drawers and no shower curtain rod – nothing a patient could try to hang himself from. At night we could shut our doors but the staff did checks every 15 minutes. The whole night. Every door leading outside was locked so patients couldn’t leave. We couldn’t have our phones but they offered cell phones for patients to use. We also had access to computers where all social media sites were blocked. It was a hard adjustment but it kind of made me feel safe, cocooned really. The girls had one wing, boys another and we all shared one common area with couches and a TV. On the weekends, we did movie nights and ordered food from outside the facility. Although it was scary and heart wrenching to be away from my family, I felt supported by the friends I made and never felt alone, despite my depression and anxiety.

When it was time to start ECT I don’t remember being scared, although it sounds scary to me now. I had three treatments a week for three weeks before starting a maintenance phase. At first, I got awful headaches after each treatment but those eventually subsided. By far, the worst side effect of the ECTs is the memory loss. Usually, it only affects patients around the time of treatment, meaning you might forget things that happened the day of treatment. But lucky me, my memory loss goes back years. I’ve forgotten people’s names, and sometimes, entire people. I still can’t remember how I met the majority of my Facebook friends. My short term memory has taken a hit, too. I can’t figure out how and what my brain is actually going to remember.

But as bad as memory loss sucks, the ECTs saved my life. And for that, I’m grateful. I relish in spending time with my kids and watching them grow. David and I enjoy each other more now, too. My mental illness takes a toll on him and I’m very thankful for his patience, love and support.

I won’t lie – there have been dark days in the past year and it hasn’t always been easy. My brain is not reliable and I have to remember during anxiety attacks or depressive episodes that it lies. It tells me I’m not good enough, that I should want to die, that there’s no way out. I ride out the pain best I can and turn to my support system – my doctor, therapist, best friends, parents and then to more ECT treatments. It’s not a perfect system but here I am.

I somehow learned when I was young that having mental illness made you weak, but after my experience I know that’s not true. It couldn’t be further than the truth but the stigma surrounding depression is certainly real. I could have easily overdosed on my meds or died any other way by suicide, but it was strength that saved me and what keeps me going now. I’ve been battling my brain for a long time – decades even – and I know I have more to go but I’m proud of the work I’ve done.

My brain has betrayed me (many times) but my dear, hardworking heart never will. Thank you to all who have supported me.

If you are suffering from depression and need help, the National Alliance on Mental Illness visit www.nami.org

If you are suicidal, please call the Suicide Lifeline at 1-800-273-8255.

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TMS: Session 24

by Heather Loeb

So it’s been awhile since I last updated my blog, my bad. I’ve also missed a couple of sessions of my TMS but am on session 24 and I’m feeling really good. It’s really helping – I have more energy, I no longer feel hopeless or depressed all day, and little chores that seemed impossible no longer do. I have 11 sessions of TMS to go.

I can’t wait to finish up in October, I should be feeling way better by then.

In other news, I stopped taking the Trintellix because it was just too expensive and went back to Zoloft. I haven’t noticed any changes – if anything, I’m doing better but it’s hard to tell because the TMS is so effective now.

I know this a short update but I don’t really have anything to report other than I’m doing great. Thanks for reading!

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Migrainepalooza

by Heather Loeb

Remember when I said my migraines were nearly non-existent a couple of blogs ago? Well, this week they came back with a vengeance. Usually I would go get a ketamine infusion, which keeps them at bay, but guess what? The ketamine clinic here – the only one in town – has closed. The closest clinic is two hours away.

person people woman hand

Photo by Public Domain Pictures on Pexels.com

Now what exacerbates my migraines is really anything but since I’m doing TMS and it feels like a woodpecker pecking the shit out of my head, it tends to make things worse. Good times.

This week I had to go to my neurologist for two injections. When my migraines get very bad and my abortive meds aren’t working I go to my doc and he gives me an injection of Nubain and some nausea meds. It worked for a little bit Tuesday but then the migraine was back in full force Thursday. I also had a less intense one on Friday but didn’t end up going back to the doc.

During the week I missed a board meeting, play date, didn’t get any chores done, barely saw my kids because they were either at after care at school or with my mother-in-law. And of course that all depressed me because 1. I felt like crap and 2. I felt useless because all I could do was lie down and take a massive amount of drugs that didn’t help.

My husband, who has picked up the slack for me this week, has decided to drive me to San Antonio for a ketamine infusion. Maybe he realized my job was too hard on top of his because I suggested getting an infusion before I started TMS to avoid this whole situation. Men, they never listen.

Last week I also talked about how good I was feeling and then I went a little downhill but with migraines three to four days a week it cant help but depress you. Chronic pain will do that to you, like I discussed in this blog.

I’ve now completed 10 TMS treatments and they say you’re supposed to feel a real difference by treatment 14 or so. I’m really hoping the ketamine will help my migraines, the TMS will start working better and then I can get my ass in gear. I do have two 5Ks coming up in the next four months and I haven’t exactly been running, unless it’s to the fridge for a Diet Coke (I needed the caffeine this week)….which I’m supposed to quit.

I’ll blog after my ketamine treatment and give an update on my TMS treatments next week. Wish my luck.

For more information on ketamine for chronic pain, go here.

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Whomp, whomp

by Heather Loeb

Once again, my brain is playing tricks on me. Last week I was flying high, going to the gym to run and eating healthy. These past two days I’ve felt myself going down the drain and it’s so frustrating because I haven’t done anything differently. I’ve been surrounding myself with positivity but now even that is hard to conjure up. The TMS technician did warn me that it’s a emotional roller coaster at first but I just wasn’t expecting such extreme mood changes. My anxiety is higher than it has been in weeks.

adult art conceptual dark

Photo by Pixabay on Pexels.com

Tomorrow I plan on eating a healthy breakfast, heading to the gym and continuing eating healthy throughout the day but there are knots in my stomach and fear that that won’t be the case tomorrow. And it’s already making me feel guilty. I’ve been reading all about showing up for yourself – not missing a workout or blowing your “diet” – and how it’s about integrity. Now I don’t feel like I have any integrity, which makes me feel even worse.

I’ve even regretting signing up for a 5K in November. I feel like I should’ve gone to the gym more last week, I should have run longer and farther. I’m scared that my depression will keep me from running more this week and then comes the guilt and fear again.

I know I’m in control. I know if I want to go to the gym tomorrow, I can go but there’s also that part of me that just wants to crawl in bed and ignore the world. I didn’t feel that way last week. I also know it’s all about getting uncomfortable and breaking habits but I’m just not sure I can be positive when all my brain is telling me is negative.

Stupid, asshole brain. It’s never easy with my brain.

Hopefully, it’ll get better as I’m approaching my 8th treatment and you’re supposed to feel better in about two weeks. I hope so. I really felt great last week.

It’s like being two different people at all times and that’s exhausting. Truly exhausting.

I feel weak, sad and worthless now. All I can do is pray for help and try to keep positive – fight all the horrible things my brain is saying and making me feel.

Here’s to tomorrow.

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I went back for the second TMS treatment yesterday so they could remap my brain and try to find that exact spot on my cortex where the magnet would be most effective. They searched and the searched and called corporate (Neurostar). Then the doc had an idea of moving the magnetic device back farther than it was or should be. It worked! My hand and eye were twitching, which is a sign they’re on the right spot.

The doctor then proceeded to tell me I have an anatomical variance – my brain isn’t the same as others so it was harder to find the right spot. Again, my brain is a real asshole and I’ve always known it was different but I didn’t think it was THAT different.

Anyway, once the found the right spot the treatment was started, lasting about 20 minutes again and this time it was less painful/uncomfortable. I can definitely make it thought 34 more sessions. Also, I didn’t get a migraine which is a huge plus. Hopefully, I wont have to worry about that in the next several weeks.

I’m not supposed to feel better until about 2.5 weeks in but I already feel better. Placebo affect, I guess, but I’ll take it. I’m still overeating (way too much) and getting anxious at night but I’m working hard to set goals for myself that will make me healthier.

Enter the Harbor Half. I signed up to do a 5k in November, one of the biggest runs in the city. I figure this is the best goal I can make right now because it forces me to train, fuel my body properly and gives me an exact date, or deadline I should say. I’m excited. I ran my first 5k last year but then stopped running so getting back into shape is going to be tough. I can do it though. I’ve done it before and I’m ready to get uncomfortable to make some major changes in my life.

That’s all for now. Thanks for reading.

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Day 1: TMS

by Heather Loeb

So, day 1 of TMS (transcranial magnetic stimulation) did not go according to plan. Since it was my first visit, the treatment operator and doctor had to adjust the magnet exactly right so it would stimulate a certain part of my brain. They figure this out by sending a signal to your brain and seeing if your hand or fingers twitch. They had a hard time finding the right spot but eventually they were happy with where it was and began treatment.

It was weird. Everyone says it’s like a woodpecker pecking your brain and that’s exactly how it felt. The magnet was placed near my temple so it made my eye twitch and water. The treatment lasted only 20 minutes long, and the good thing is that I didn’t get a migraine, thank god. It’s not exactly painful but it is uncomfortable and I have 35 treatments to go (I’ll go Monday-Friday).

So I’m thinking, “this isn’t so bad” but then I got a call from the doc later that night saying she wasn’t happy with the data and they were going to have to remap my brain to find the exact spot where treatment is needed. The doc said she’s never had this problem with anyone else, of course, and it makes sense that my meds don’t work. If worse comes to worse, the corporate guys will come out and help so there’s still hope.

My brain is a real asshole.

Anyway, I’ll keep updating the blog and let you know how I feel as the treatments progress. The doc said it would take about a week to start feeling different. Keep your fingers crossed for me.

 

 

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I don’t know about others with depression but I have a real problem when it comes to making plans. I usually make plans or commitments when I’m feeling good or whatever passes for good, and at that moment I’m truly looking forward to whatever plans I make.

But then, my depression overcomes my desire to socialize or perform whatever task I signed up for. I’ve taken to doing things last minute or being non-committal. It doesn’t impress my friends or social group to which I belong.

Even if it’s something I know I’ll have fun at (girls’ night, group workouts), I still have to summon up the energy to take a shower, put on a happy face and go. And by now, my friends have accepted that it’s just who I am. But I’m required to go out in public where friends and acquaintances don’t know where I’m coming from and I know I can come off rude or flaky. I hate that.

In the past it’s caused rifts and arguments with friends and definitely problems at work. I don’t know what I would do now if I were working outside the home. My depression has gotten much worse than before I was pregnant and working, I can’t imagine facing workplace obligations, not to mention the drama, again.

I also feel so burdened when I have an obligation hanging over me and I get anxious when I put off a friend because I just can’t even. I’m still supposed to set up a play date from 2-3 years ago. Sigh. Plus, there’s always the drama of coordinating schedules with the kids. That just adds to my problem, hence why I don’t have a lot of mom friends. I want them, I do, it’s just hard now.

Hopefully, the TMS that I’ll start next week will change things: I’ll have more energy, my anxiety will lesson and I’ll feel less encumbered.

Maybe going out and taking on more responsibility will be easy peasy. Who knows? I’d like to do more than barely get by with socializing and start cultivating my friendships.

Let’s just hope TMS really helps.

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I’m back and with news

by Heather Loeb

Vacation has ended and it’s back to life, back to reality. It has been awhile since I’ve blogged but my last blog talked about how I forgot my meds while on vacation. I was truly expecting a depression storm but actually I feel great. Maybe a little restart was what I needed. It was just three days without my total regimen, so it wasn’t too bad. No breakdowns, no withdrawal symptoms, nothing. I freaked myself out all for nothing.

And I’m still feeling great. It’s weird, but I’ll take it. Nothing has changed except the medicine hiccup. But I’m thankful.

In breaking news, I’ve decided to take the plunge and try transcranial magnetic stimulation or TMS. I was recently approved by insurance and while it sounds weird, I am hopeful it will improve my mood even more and I won’t have as many depressive episodes.

So, TMS. In a nutshell, you sit in a chair similar to a dentist’s. An electromagnetic coil is placed against your scalp near your forehead. Next the magnet delivers a magnetic pulse that stimulates nerve cells of your brain – the ones that involve mood control and depression. In people with depression, it’s thought to activate regions of the brain that have decreased activity. It’s not completely understand but TMS is known to greatly help those with depression and anxiety. People like me.

Because I’m treatment resistant and I have MDD, this is the next step. It has fewer side effects than ECT (electroconvulsive therapy), which is a big commitment. With TMS, you do have 30 or so treatments in a row Monday through Friday, but you’re able to drive yourself home and one of the most common side effects is headache. That worries me a bit with my migraines but I’m willing to give it a try.

One of my friends in Dallas is almost over with her sessions and she told me she can feel a real difference. She also said the electromagnet feels like a woodpecker tapping at your brain but doesn’t necessarily hurt.

I’m hopeful.

I start August 15, so think good thoughts for me.

 

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