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Re: How Come More People aren't Doing TMS!

Posted by PCB on June 12, 2020, at 8:13:32

In reply to Re: How Come More People aren't Doing TMS!, posted by linkadge on June 12, 2020, at 7:13:43

> The problem with TMS is that it's not rocket science.
> For some depression, the prefrontal cortex is overactive. For others, it is underactive. For some, there is hemispheric asymmetry (one hemisphere is more active than the other) and vice versa.
> I would imagine that future TMS would be paired with fMRI to see which regions would benefit from stimulation.
> Linkadge

Really good point Linkage. I wonder if also comes down to degree of illness. I was surprise to hear my mother and other people say when their depression is at its worst (like they come off an effective medication and try a newer newer medication with less side effects) it is hard and they have to hide their depression at work and with friends. Well first, when I am at my best, I have very few acquaintances. At my worse, I lose weight, bedridden with fatigue and anxiety, have leaded paralysis and my cognition drops tremendously.

So I wonder if it is the majority of patients with mild depression like my mother that a mild treatment like an SSRI or TMS helps. My father had bipolar and my mother is unipolar so I think thats is why I may only respond to big guns like MAOIs and ECT.

I apologized for canceling to the secretary and she said, "not to worry, people do it all the time. Things come up with weddings and vacations." Even at my best I struggle to go to weddings and vacations. How can this people with depression needing TMS which is for TRD be jetting off to weddings and vacations. I think once again it is the degree of depression. They might be mildly depressed, dysthemic or just experiencing adjustment disorder. I live in NYC, so I hear many "wallstreet banker" or "high end lawyer" have moments of stress due to there job, multimillion dollar homes, kids going to ivy league school and their doctors telling them they have major depression. The TMS staff tells me alot of these affluent people "stop by" once a month for a TMS treatment. That is an adjustment disorder, not major depression. And they deserve treatment and to be happy, but I think it skews the the studies results when these patients are included. Of course many of these patients are going to responds to TMS, SSRI, therapy. But what are the respond rates to patient like me whom have several neurovegative symptoms ... much lower I presume. SSRI, SNRI, lithium, depakate, etc have not put a dent in my depression. Only nardil and ECT ... and I thank god these medication are available.

Sorry I am being a whiner. But I agree these modalities probable work. I just wonder if they work for several neurovegative affect disorders.




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