I hear a lot of debate regarding which treatment people should choose. Let me start by saying I am not a medical professional. I am someone who has suffered from depression for a long time, and have personally undergone both TMS (transcranial magnetic stimulation) and ECT (electroconvulsive therapy).
Here I will share my experiences and opinions regarding both treatments.
What Does TMS Involve?
TMS, or transcranial magnetic stimulation is a way of stimulating the brain through the use of a large magnet. As far as treatments go, it is still relatively new compared to other treatments such as ECT.
A session of TMS will usually last 20-30 minutes, and will need to be repeated 3-5 times per week for 4-6 weeks. You can read a book or watch TV while undergoing your treatment (or play candy crush on your phone like I did!) and usually the worst thing you will feel is a non painful tapping on your head from the magnet doing its work to stimulate your brain. Sometimes I would feel tired or have a minor headache afterwards which is also fairly common.
Usually the treatment will need to be repeated every few months, so it can be quite a commitment to continue to receive TMS. On the other hand, if you are continuing treatment, it’s most likely because it has worked for you to some degree, so the commitment can be well worth the time.
For me personally, I found the first round of treatment had a small positive effect on my depression for a short period of time. I underwent a second round of treatment a couple of months later, which seemed to have no effect at all on me. After another break from TMS, we tried again at a different frequency level and on a different part of my brain. This also had no positive impact on my condition, so we abandoned TMS as a treatment option for me. It certainly wasn’t through a lack of trying however.
While in hospital I met many people who were undergoing a regular round of TMS and they found it to be very helpful, in conjunction with regular psychotherapy treatment.
What Does ECT Involve?
ECT, or electroconvulsive therapy is a lot more invasive than TMS. It requires the use of a general anesthetic and muscle relaxers. While you are under the anesthetic, electrical currents are passed through your brain which triggers a seizure. It’s like a reset of the brain. The entire procedure only takes 5-10 minutes and you will wake up in recovery shortly after. The procedure is repeated 2-3 times per week for around 3 or 4 weeks.
It has the effect of rapidly changing your brain chemistry and is often used as the go to treatment for those that are in a severely depressed state.
It is not uncommon for ECT treatment to be given on a regular basis if it is found to be effective for you. How regularly you have it will depend on what your doctor advises and the state of your mental health. Often people will feel much better after a course of ECT, but then after a few months the benefits have subsided and they need to return for another round of treatment, much the same as with TMS.
How Fast Does ECT Work?
Most people notice improvements with ECT after just a week or two. As far as depression treatments go, it works very fast. When you consider anti depressants can take weeks to work, you can see why ECT is often used when a patient is dangerously ill and waiting for an anti depressant to kick in would simply take too long.
How Fast Does TMS Work?
There is no clear cut answer to this question unfortunately. Some people will notice improvements in as little as a week or two, while others won’t notice improvements until after they have concluded their round of treatment.
TMS Side Effects
Although everyone is different and different people will have different side effects, I personally experienced very few side effects with TMS. I had a mild headache for the first few days of treatment which had minimal impact on my life. Headaches have been reported as a fairly common side effect. The other side effect I personally experienced was far less common which was my pulse rate dropped for a couple of hours immediately after treatment. This had no ill effects on me, but it happened after each session.
ECT Side Effects
The side effects from ECT were why I stopped the treatment early. It simply had too much impact on me for me to continue.
After waking up from the anesthesia, I would find myself confused and suffering from memory loss. At first, I wouldn’t know where I was, then that would quickly subside as the short term memories would come flooding back within a short time of waking up. The confusion was terrible and upsetting, to say the least. For the rest of the day I would walk around in a daze, not really functioning too well at all.
What I also found later on, which is far less common, is that a lot of memories simply never returned. For example there would be recipes I’d had in my head for years and had cooked many, many times, but after ECT they were just a blank. I knew that I used to know how to cook that particular dish, but I just had no clue how to do it anymore.
The same experience applied to several other areas of my life, where I simply could not remember how to do things that I had taken for granted before undergoing ECT. This had quite a negative impact on my self esteem and confidence as I would feel unsure of myself and second guessing my own abilities. Typically memory loss after ECT has completely subsided within a couple of months, but unfortunately for me a lot of memories simply never came back, even now after many years.
For that reason I personally will never try ECT again. That doesn’t mean you shouldn’t try it, as my experiences with it are my own and not the same as everyone else’s.
Other common side effects of ECT are muscle soreness, headache and jaw ache, as well as the confusion and memory loss mentioned above.
Pros and Cons
Typically no major side effects
No drugs are used for the treatment
Expensive (depending on where you live)
May require hospitalization (depending on where you live)
Requires several (20-30 usually) sessions at a time, as well as needing regular top up treatments.
Extensive track record and proven history
Typically results are seen quickly
Memory loss, confusion and other side effects
Requires hospitalization and there is a recovery period after each session
Which One Should I Choose?
Although I can share my personal experience with both ECT and TMS, ultimately I can’t tell you which treatment you should go with as I am not a medical professional and the results and side effects I had may not be the same for you. Consult your Psychiatrist as they will know your situation and can formulate a treatment plan specifically for you. They are the experts in the field, not me.