Transcranial Magnetic Stimulation

Losing hope for a solution, treatment lifts depression and leads to transformation 

Blanca Herrera, 49, began to experience a slew of debilitating health issues around age 30. She was diagnosed with endometriosis that resulted in a partial hysterectomy. She had such severe reflux disease that major surgery was required to repair her stomach and esophagus. She was later diagnosed with rheumatoid arthritis (RA) and fibromyalgia and suffered from chronic musculoskeletal pain.

“I began to have spells of sadness and was always so tired,” she says. “They would fix the physical issues, but mentally I was going downhill. The depression got worse. I tried suicide twice because I was just so tired of being sick and unable to take care of myself, my daughter and husband.”

After her first suicide attempt, Herrera was hospitalized on a 5150 hold, a California law that allows for the involuntary psychiatric evaluation and temporary detention (usually 72 hours) of a person experiencing a mental health crisis. This led to outpatient psychiatric care with two different professionals over the next 12 years. During this time, she was prescribed various antidepressant, antianxiety and antipsychotic medications as well as pain and sleeping pills.

“I was taking ten different medications a day, but nothing was working,” she says. “I felt like a zombie.”

Her psychiatrist at the time felt there was nothing more he could do for her and referred her to Eisenhower Behavioral Health, a program with a team of psychiatrists, psychologists, licensed clinical social workers, nurse practitioners and other staff who provide individualized outpatient care to patients ages 13 and older with mental health symptoms. The services offered include psychiatric evaluation and medication management, individual and group therapy and transcranial magnetic stimulation (TMS).

That referral was a turning point in Herrera’s mental health journey.

After a comprehensive evaluation by psychiatrist Peter Wagner, MD, she was deemed a candidate for TMS. This is an FDA-cleared, non-invasive medical treatment for patients diagnosed with treatment refractory depression.

“This is when someone has tried therapy and medications as initial treatment for depression but it’s not successful; their depression remains in the severe range and they need more support,” explains Dakota Carter, MD, EdD, Medical Director, Eisenhower Behavioral Health and Chair of Psychiatry. Dr. Carter is Board Certified in both General Adult Psychiatry and Child and Adolescent Psychiatry as well as Addiction Medicine.

“TMS uses magnets to stimulate the areas of the brain that regulate mood,” he continues. “The brain is one big electrical circuit and TMS creates more circuitry, opening up better pathways for medications to work.”

“Put another way, depression can feel like a traffic jam - and TMS builds more roads to get things moving,” he adds.

TMS is also a potential treatment for other mental health conditions, including anxiety, post-traumatic stress disorder, postpartum depression, obsessive-compulsive disorder and depression associated with Parkinson’s disease, multiple sclerosis or fibromyalgia.

During treatment, the patient sits in a comfortable chair, a magnetic coil is placed against the head, and magnetic pulses are sent to the front left side of the brain. The patient remains awake and alert during treatment and will hear clicking sounds and feel tapping on the forehead.  

Performed on an outpatient basis, TMS requires daily (Monday through Friday) treatment sessions for four to six weeks. Each session lasts less than 20 minutes and patients can immediately return to their regular activities after treatment. TMS has none of the side effects typically associated with antidepressant medications such as weight gain or sexual dysfunction.  

Most importantly, TMS works.

“While research reports that 50 to 60 percent of patients respond to TMS treatment - which are decent odds - here at Eisenhower, 90 percent of our patients have had resolution of their depression symptoms,” Dr. Carter says.

Herrera is among them.

“On my third day of treatment, I remember jumping out of the chair and hugging the staff,” she says. “I had lived most of my adult life in a fog and after just three treatments, that fog lifted. I was able to think clearly.”

It’s important to note that not everyone responds to TMS the same way. Some patients, like Herrera, may start to feel resolution of depression symptoms within the first week of treatment, while for others it may take several weeks or longer.  

“I completed my initial 36 sessions of treatment, then every six months or so I’d start feeling the depression again, so I’d return for another 36 sessions,” she continues. This went on for about four years, during which time she was weaned off most of her medications.

She also underwent testing that revealed she had an especially fast metabolism, a factor that had contributed to the ineffectiveness of the various medications she had taken. This meant that her body would clear the drugs very quickly so she couldn’t achieve the full therapeutic concentration of the medication in her system.    

Today, Herrera is a changed woman.

“I’ve been completely off all antidepressant and pain medications since April 2023,” she says, “and I haven’t needed TMS in over a year. I feel alive ... it’s amazing.”

The transformation in her mental health has also fueled a transformation in her physical health. She’s lost more than 65 pounds - working out four days a week at the gym, running three times a week and changing her eating habits. The inflammation in her body due to her RA dropped to nearly undetectable levels, along with her chronic pain. And, she became certified as a personal trainer in September 2024.

“I want to help others,” Herrera says. “Because of all I went through, I think I have a different perspective. I know the feeling of being stuck and not having the strength to dig out of it. And I couldn’t have done it with just medication.”

“TMS helped give me my life back after almost 20 years,” she continues. “If I could reach just one person with my story, I’ll have done something.”  

“We encounter so many patients like Mrs. Herrera who’ve gone years trying different medications and come to us as a last resort for resolution of their symptoms,” Dr. Carter adds. “To provide something like TMS to the community, it’s why I went into psychiatry, it’s why we’re all here. Because it helps.”

TMS is available to patients ages 15 and older. It is covered by Medicare and most private insurance plans. To learn more, call 760.837.8767.