KANSAS CITY, Mo. -- Nearly 7 percent of all adults in the US, roughly 16 million people, have suffered at least one major depressive episode.
Medication, therapy and sometimes even a combination of the two don't always work.
For some of the toughest cases of depression, there are few alternatives. Electro-convulsive therapy is one option. Another is transcranial magnetic stimulation -- using magnets to treat depression.
“Why did you use that pencil? Why didn't you use this pencil? Why didn't use that ink pen? Why did you throw that paper away? Are you sure you didn't need that paper?”
For years, Cora Dimitt said she used to hear those questions swirling in her brain, like a tornado. She said it was oppressive.
“There wasn't anything that was working,” Dimitt said. “It was coming to a point where I couldn't function. And I was the primary earner for my family, and I had a child. I needed to take care of my family, so I had to do something. I was at a point where I had to lose my job because I couldn't focus, I couldn't do my job effectively.”
She had tried everything else.
“Playing drug roulette isn't fun,” she said. “There's side effects to everything. When the miracle medication doesn't work, that's just one more nail in the coffin. So you spend the money.”
She spent money on genetic testing to see which medicines would work best. That’s when she discovered she had already tried the medicines that worked best for her, with horrible side effects -- hallucinations, sedation, thoughts of suicide.
There were few alternatives left.
“I really didn't want to do Electric Shock Therapy," she said.
So the old mailroom on the first floor of the office building at 8900 State Line Road was her last resort.
“It was a last ditch effort,” she said ruefully.
Four chairs all aimed towards a wall, each with its own TV screen and its own privacy screen are now what she considers a lifesaver. Literally.
“It saved my life,” she said emphatically.
“TMS stands for transcranial magnetic stimulation. It's an FDA-approved treatment for treatment-resistant depression,” said Dr. Ely Tamano, the medical director at Advanced Psychiatric Solutions of Kansas City.
Dimitt rhetorically asked, “How is putting some magnets against my head going to change something that I've been experiencing for 25, almost 30 years? What's this going to do that medicine hasn't already done?”
Dozens of TMS patients file into the room 11 hours a day, every day. Patients wear a personalized cap that denotes exactly where a magnet should stimulate the brain. For 37-and-a-half minutes, it's 26 seconds of silence, followed by 4 seconds of a loud metallic rapping.
As Dimitt described, “its not painful, per se. It’s really annoying and loud.”
The Advanced Pyschiatric Solutions of Kansas City is housed within Psychiatric Associates of Kansas City. PAKC operates one of the largest TMS practices, by volume, in the nation. It points to its 330 patients, and its more than 1,000 treatments.
TMS takes roughly an hour a day, five days a week, for six weeks.
But Tamano is quick to point out: “It's not a cure. It's a treatment.”
But he also said roughly 35 percent of TMS patients seen in his practice go into remission from their severe depression.
But even 40-45 percent of the rest see some relief from their symptoms.
“Remember, we're getting people back, functioning,” Tamano said. “Even if they're still depressed, they're getting out of bed. They're interacting with their family again. They're eating. They're sleeping better.”
Dimitt is one of them. Even when she became a widow this summer, she didn't fall back into the depression that once consumed her life.
“TMS has allowed my medication to work effctively,” she said.
Before, she wanted nothing more than to go back to bed.
“Now, I can pick out the information from the tornado," she said.
“I can focus on what I need to focus on, and everything else is background noise. I find the joy in the joy in the TV show, or my cat doing stupid stuff, or my kid coming home from school," she added.
“I can participate in life. I'm not just standing in a corner, wondering when I can go back to bed.”
Currently, TMS is only used for treating depression, though it was just approved for treating obsessive compulsive disorder. Doctors are hopeful it will be approved for use in bipolar disorder and adolescent major depression soon.