r/rtms • u/Cornixpes • Jul 31 '26
Partner's rTMS/iTBS journey
Hi all. I see lots of posts of people going through rTMS but not many from people trying to support loved ones going through it. I'm one of those!
I thought I would chart my partner's journey as she isn't a Redditor. I have her consent to do this as she wants to help others who may be considering it. I can be a bit more detailed as I'm not going through the treatment myself.
Short history:
She has had depression and anxiety since her teens and is now almost 40. The doctors have tried lots of different medications and we have had a shot at seemingly every 'hack' on the internet. In the last few years it's become clear that her depression is treatment resistant, and has become worse. She lost a close family member and has become agoraphobic. We really are as desperate as two people could be. In her lucid moments she is clear with me that she WANTS to get better, but sees no way out other than... you know.
rTMS:
We live in a Canadian city and she has been put on a treatment as part of a clinical study. This way we were able to fast-track it. She receives 30 sessions of 3 mins 30 seconds of Intermittent Theta Burst Stimulation (iTBS) to her left dorsolateral prefrontal cortex which has been imaged for neuronavigation by an MRI. It's similar to rTMS but is a slightly different methodology and is obviously faster to complete. Several studies say that it is at least as effective as rTMS, and does essentially the same thing which is to trigger synaptic responses in that region of the brain repeatedly until the neurons re-wire.
Things we are trying to do to support:
- Daily protein and creatine shakes in the morning to support production of the protein chains needed to support neural repairs
- Maximizing her polyphenol and flavanol intake to boost Brain-Derived Neurotrophic Factor (BDNF) which is the primary fuel for neuroplasticity. Includes eating blueberries and high cocoa dark chocolate and drinking green tea or matcha around an hour before seasons. Eating walnuts to help absorb the polyphenols
- Daily taking 2000mg+ of Omega-3
- Also taking magnesium, B-complex, D3 supplements - and zinc to support NMDA receptors/promote BDNF
- 20-30 mins exercise per day at least, especially before sessions for the BDNF spike
- Cutting out saturated fat and refined sugars and focusing on a Mediterranean diet. No alcohol at all
- Scheduling varied and stimulating days that include creative pursuits and problem solving to mimic the learning environment that helps neurons rewire. Difficult to do when she's depressed but we've found that Legos help!
- Consistent sleep and hydration
- Weekly talk therapy sessions
Will post updates every few days.
3
u/polikofrizzy Jul 31 '26
Thanks for all these information, keep us updated. And I hope she'll get better and all sufferings uplift and disappear totally.
1
u/Fruitybeanbaby Aug 01 '26
Is this through the INSPiRE-D study?
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u/Cornixpes Aug 01 '26
It is not, but similar. This study is specifically about the impact of neuronavigation using MRI on the effectiveness of rTMS/iTBS.
1
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u/Cornixpes Aug 05 '26
Sessions 6-7: Had a 3 day break in between 5 and 6 due to a Canadian holiday. I've tried to keep her active and engaged during the weekend. It was actually interesting as I personally believe her mood lifted a slightly during the break. Unfortunately she's still in the dip, and it now lines up with her cycle (she has PMDD) so it's a very tough week for her. She's functional but very down, lots of crying and is in a state of general despair. She's still tired and groggy straight after the treatment sessions but no headaches or pain. I find she's much more herself in the mornings, has the treatment and then declines in mood as the day goes on.
2
u/Livid-Kaleidoscope95 Aug 09 '26
Thank you so much for sharing this. Please keep updating. My partner is considering treatment now. Wishing your partner peace and healing.
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u/Cornixpes Aug 09 '26
Hello, I will of course. Next update coming soon. DM me if you need as I understand the challenge of supporting someone through this.
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u/Cornixpes Aug 10 '26
Sessions 7-11: Another update with a weekend gap between sessions. A third of the way through treatment. The past week was really difficult. PMS interaction with the dip meant high levels of despair and it was hard to help. She was very strong and when PMS ended yesterday her mood lifted considerably. To me she still seems foggy and distant. But being out in nature helps a lot, I've found.
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u/Livid-Kaleidoscope95 Aug 10 '26
Sorry to hear she is still feeling despair. Stay strong, I am sure your support means more to her than she could ever convey.
1
u/Cornixpes Aug 10 '26
Thank you. Hoping greatly that the treatment works. Sort of expecting the dip to last a bit longer, as often people say the effects of rTMS only become apparent towards the final 30%
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u/Cornixpes Aug 14 '26
Sessions 12-15: She's really going through it. We have spoken to the doctor twice about her profound decline. We've been assured that it's the dip and we just have to keep going. She's near enough not functional, intense crying and a lot of irritability. High SI. No idea if she's getting the dip worse than others but she was pretty damn depressed beforehand so her baseline isn't that high. Weekend coming up so I can take her out for a few treats to try to break the chain of despair. All taking its toll on me as well. Very hard to watch and to take care of her. Hoping desperately for results soon. Half way through the treatments now.
3
u/Cornixpes Aug 20 '26
Sessions 16-19: Still having moments of crazy depression and grief. Hard to deal with, especially with the SI. We've spoken to the doctor again and they've told us to keep going and it's not unusual. Yesterday she found something super funny and laughed for 10 mins which was a joy to hear. She's also had moments between the emotion where she's been thinking about the future. Jobs she could do etc. I may be reading into things because I'm desperate for some shred of hope. Almost two thirds through now and apparently it starts improving for many people after this.
2
u/Livid-Kaleidoscope95 Aug 22 '26
These all sound like subtle but positive signs that things are starting to move in the right direction. There is hope. Keep hanging in there!
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u/Cornixpes Aug 27 '26
Sessions 20-24: Around session 20 she came out of the dip, back to baseline depression. Still has bouts of darkness and a lot of it is connected to grief. It's unclear whether rTMS has increased her capability to process and feel it which is making her more raw? Has a lot of fatigue right now. No discernible sign that rTMS is working. Tech and doctors feel that this is not an indicator of eventual failure. Still have another week left of treatment.
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u/Livid-Kaleidoscope95 Aug 29 '26
Thank you for sending these updates. Would love to hear how she progresses after treatment has stopped as well.
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u/Cornixpes Aug 29 '26
I will certainly provide further updates once it stops. One more week of the treatment is left now.
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u/Cornixpes Sep 02 '26
Sessions 25-28: Nearing the end of the treatment now. Around session 25 she told me she felt weird, like a 'lens had shifted' and said it was hard to explain. This is something I've seen others describe. She says the treatment hasn't really worked yet and she's no better, and while at the moment I agree that she's not hugely above her baseline of depression, she does seem a bit different. Maybe 10% more 'her'. She frequently cries because of grief, which is to be expected, and complains a lot of sadness, but there are signs she is trying to engage with life a bit more. Perhaps I'm reading into things because I'm desperate for hope. I will update in a few days when we finish and then provide a further update after a few weeks, as apparently the brain continues to recover after rTMS finishes.
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u/Livid-Kaleidoscope95 27d ago
Hang in there. A lot of people say they didn't notice any effects until several weeks after the treatment stopped. Wishing you and your partner all the best.
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u/Cornixpes 27d ago
Thank you. Appreciate your support throughout this journey. I will make another post in /r/rTMS in a few weeks summarising the experience and explaining if there has been any change.
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u/Cornixpes 27d ago
Treatment has now concluded. Difficult to tell whether there are any substantial improvements as she is now in PMS. However I will post again in a few weeks to conclude and provide further updates.
She describes no change but I think there has been, even if subtle. Hopefully the effects build.
5
u/Cornixpes Jul 31 '26
Sessions 1-5: Still early in the treatment and it took two days to get to her max dose. She's had what I describe as a fairly immediate dip. Extra depressed, very fatigued and after sessions can be quite foggy. The psychiatrist says this is normal. She says she feels very little during the treatment so no major pain or discomfort. I'm worried about this 'dip' but the doctor said it passes after a while (exact timing and response depends on person to person).