Grace Liestman, a Community Psychiatry technician in San Jose, CA discusses the TMS patient journey and when the average patient starts to be experience results.
Grace Liestman, a Transcranial Magnetic Stimulation (TMS) technician, gets asked a lot of questions by the patients she treats in Community Psychiatry’s San Jose office.
But the one she gets the most is how people feel after completing TMS treatment. For many, it’s hard to imagine ever feeling “normal” again.
“Some people actually forget what it’s like to not be depressed,” she said.
It’s natural for people to have a lot of questions or even skepticism when they first start TMS. After all, they’ve likely tried psychotherapy and numerous trials of antidepressants, all with little to no effect on their treatment-resistant depression.
But for two-thirds of people who’ve undergone treatment, TMS is a safe, non-invasive procedure that has resulted in full remission or noticeable improvements of their depression symptoms.
TMS works by delivering highly focused magnetic fields to stimulate underactive nerve cells in the brain and relieve depression symptoms. Treatment includes roughly 36 20-minute sessions scheduled over nine weeks.
For the technicians who treat patients on a daily basis, tracking these changes – both emotionally and physically – is one of the most rewarding aspects of their job.
“They start talking and smiling and laughing. It’s so cool to watch,” said Liestman. “We are continuously grateful to be a witness to that and to participate in the patient’s journey.”
Patients on the first day of treatment are often vastly different from the last day. In the beginning, their voices may be shaky, there’s little eye contact, they are nervous and anxious. Most of all, they are desperate for relief.
On average, most patients experience positive changes after about four weeks of treatment.
Monica Alcasid, a TMS technician in Community Psychiatry’s Calabasas office, recalled a woman with extreme depression who came in for treatment.
“She wasn’t super hopeful. It was hard for her to come in,” she said. Midway through her treatment series, Alcasid noticed the woman “started dressing better, she looked happier, she glowed more.”
For many patients, feeling like they have more energy is a welcomed experience.
“I’ve noticed with quite a few of our patients that they suddenly get more creative urges,” said Liestman. “It’s really cool to see some of their hobbies that our patients really loved doing start to become accessible again.”
Some patients will wake up one morning and know their symptoms have lifted. But for others, it can be hard to track its effects.
“Most of the time, the family members or friends will notice a change first,” said Steven Pomerantz, the TMS experience manager at Community Psychiatry’s Calabasas office.
Pomerantz described a patient who declined to walk the dog with her husband every evening. But midway through TMS treatment, she said yes, a simple change that astonished her husband and surprised herself.
Many technicians encourage patients to keep a journal during their TMS treatment to track even the smallest of changes.
“It’s good to see their results on a trajectory,” says Liestman.
It’s important to note that not everyone notices improvements after the four-week mark. Some are “late-responders” who don’t experience results until after the treatment series is complete.
While full remission of symptoms is the goal for TMS, some patients only experience improvements to their symptoms. And some, about one-third, do not experience any relief at all.
“Success is very personal for some people,” said Pomerantz. “Success doesn’t always mean that their depression is gone. Sometimes it’s about being able to get out of the house.”
It can be tempting to worry that TMS won’t work, but technicians caution that patients should be patient and take it one day at a time.
“Don’t worry about it so much. Just go in with an open mind and don’t have expectations,” said Pomerantz. “TMS will open the door and you just have to walk through it.”