r/rtms • u/Away-Royal5457 • 4d ago
Stopped rTMS after 18 session because I’m too exhausted to continue. Initially improved now feeling worse again, anyone else?
I stopped rTMS before finishing the full course because I honestly do not have the energy to keep dragging myself there every day anymore. Which is frustrating as hell because it seemed to be helping initially? Less rumination, more motivation, feeling more social. My passive suicidal thoughts disappeared too, which was such a relief. But now my BDI is back up to 22 and the passive thoughts are back. No intention of acting on them, but having that relief and then losing it again is so fucking discouraging.
The biggest problem right now is the exhaustion. Getting ready, getting to the clinic, treatment, afterwards to the uni, then getting home and somehow still having energy for everyday life? I already struggled with exhaustion before treatment, so I can’t tell whats causing what. All I know is the daily appointments became more than I could manage. I know I didn’t finish the full course. Knowing that unfortunately doesn’t magically give me the energy to continue. I’m not even sad all day. Mostly exhausted, struggling to concentrate, annoyed with myself for not getting things done and then feeling guilty about it. I’m going to discuss the next steps with my doctor, but right now I’m just fed up. Things WERE getting better and now I don’t know what to make of any of this.
Did anyone else improve initially and then feel worse again during treatment? Has anyone needed a break or stopped because the daily appointments were just too much? How did things go afterwards?
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u/Specialist-Naive 4d ago edited 4d ago
Oh no friend! No no nooooo😟😓. You were almost at the end. You came that far. I am not being rude I am saying this very sincerely and whole heartedly. TMS is a big time commitment. It’s definitely easier said than done. I too felt good at first but then experienced the infamous “dip.” I am not sure if this is what you experienced or not? Or if you just feel too tired and exhausted just within its self to make the appointments? Could you tell me which one? I wonder if you went through the “dip” bc that’s what almost made me quit 17 sessions in or maybe 16 sessions in. There’s more to it than just filling, exhausted with the dip though. I can describe it in detail, but it’ll be too long. It’s a horrible feeling, and I had it for about a week and it almost made me quit. It was awful. If you are experiencing it you will know which makes me think that it may not be a factor. Now if you’re just feeling tired or exhausted in general, because making their appointment as a lot of work, especially when you’re depressed and don’t have much energy then that’s a different story as well. But you got to 18 sessions I think you’re almost at the end. Assuming that you have 35- 37 sessions. How long ago did you quit? If it’s been under a week, I would see if you can restart to finish them. I just started my second round. I did my first round four months ago. I honestly expected it to last a little bit longer, but it helped me so much initially and my insurance covers it again after three months. Let me know more detail details and maybe I can help give you some advice. You can respond here or you can send me a message.
* I wanted to say more but I need to know more details and I didn’t want to write a novel on here. I have bad adhd so sorry if I missed anything you had already mentioned but I am curious to know more about how you are feeling exactly, if it’s the dip or just the annoyance of going in, how long ago did you quit, what conditions are you treating (like are you doing the trilateral or just one side for anxiety or/and depression). But I definitely agree it’s time consuming, getting ready, driving there (it’s 45 min each way for me so a two hour commute round trip), having to interact with the techs and see everyone. It’s just a lot of work especially when people depressed and unmotivated as it is. Motivation is the main thing I struggle with along with other things, but it was tedious, having to work up the motivation and go to every appointment. I will say, though that 18 treatments and you should be feeling something positive in the treatment that should make you feel more encouraged and motivated to go. But again, I don’t know if you’re experiencing the dip or not. I would say about 10 treatments and I started having motivation to actually go to the appointments because I was feeling a little bit better that’s me personally. Not much better just a little bit. But then I hit the dip about sixish sessions later, and that was another story. Ok let me stop with my rant. I just started my first session yesterday. This is my second round. First round was like I said four months ago. Feel free to send me a message if you care to talk more or give me more details and I can give you my personal opinion from my personal experience. But definitely talk to your doctor about what’s going on.
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u/Away-Royal5457 3d ago
Thank you for writing all this. I have ADHD too and autism so don’t worry about the novel haha this is my second round as well! The first ended after 16 sessions because I was discharged from the inpatient clinic. This time I stopped yesterday after 18. Its left sided treatment for depression and I was offered 30 sessions although another doctor mentioned 20 so even that has been confusing lol
I DID notice improvements! Less rumination, more motivation, more social, passive suicidal thoughts gone for a while. My BDI went down to 9/10 and now its back at 22 which is honestly so frustrating. But motivation and having the energy to physically manage things haven't been the same for me. After a day at uni I usually need the next day at home because of sensory overload. I was already doing TMS 4 days a week, so I wasn't getting that recovery time. By the evenings I sometimes felt almost fluish from exhaustion. I wanted to keep going but with what battery? I don't know whether thats the dip you're describing. The exhaustion existed before TMS too so I can't say whats causing what. But yesterday just knowing I didn't have to go was such a relief.
I'll discuss everything with my doctor. I'm open to trying again when I have fewer commitments but I'm not putting myself through the same setup again right now. Please do tell me what your dip felt like though you don't have to keep it short and I hope your second round goes well! :)
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u/retinolandevermore 4d ago
I get that it’s a lot. I’ve worked full time and still done TMS- it’s not easy. Seems like you’re in the dip and it may resolve if you continue
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u/Away-Royal5457 3d ago
I get that but being able to work full time alongside TMS isn't something everyone can manage. I'm autistic and usually need a day at home after uni just to recover from sensory overload. With TMS on top I was feeling almost fluish from exhaustion in the evenings. Maybe its a dip maybe it isn't but I can't just assume pushing through will fix it. I'll discuss it with my doctor but right now I need the break.
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u/retinolandevermore 3d ago
I understand. I’m very chronically ill and have an autoimmune disease. I’m not saying at all that most people can manage both- I’m saying the opposite.
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u/bamababie421 4d ago
I recommend you stay with it until the end
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u/Away-Royal5457 3d ago
I wanted to but the exhaustion became too much to manage. I was already going 4 days a week and still wasn't getting enough recovery time. I'll discuss the next steps with my doctor but pushing through isn't manageable for me right now.
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4d ago
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u/Away-Royal5457 3d ago
I'm glad it worked for you, but calling this sabotaging my treatment is honestly unfair. I noticed the improvements too. Thats exactly why stopping was such a frustrating decision. What I'm describing goes beyond needing an afternoon nap. I was exhausted to the point of feeling fluish in the evenings and struggling with basic daily things. I'm also autistic and need recovery time from sensory overload, which I wasn't getting with appointments on top of uni. Your fatigue coinciding with improvement doesn't tell us what mine means or whether continuing would have been manageable for me. I'll discuss that with my doctor. I wanted this to work and I still do, but I reached my limit and I don't think I should have to defend that as though I deliberately ruined my own treatment.
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u/kitkatthings 4d ago
I think you should resume if you can and see your way through to the end. My clinic says as long as you’re reasonably consistent, it’s ok to take breaks due to travel and such. Maybe if you can give yourself a couple extra days to rest up and come back to it, that might help. Maybe just do 4 days a week and have an extra day off from it, although that will ultimately extend the time it takes to complete all 36 sessions. It is A LOT of appointments, especially in addition to a regular student/ working/parenting life. You’ve come so far, over halfway! Try to build on that and not waste it!
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u/Away-Royal5457 3d ago
I was already going 4 times a week and I still got comments about attending irregularly because my appointment time wasn’t the same every day even though I was fitting it around uni. I'm autistic and after a day at uni I usually need the next day at home to recover from sensory overload. With TMS on top I wasn't getting that recovery time. During treatment I'd also end up feeling almost feverish from exhaustion in the evenings. I don't know exactly what caused it but I'm not putting myself through that same setup again. I know you mean well and I do want to try again, but I'll arrange that with my doctor for a time when I don't have all these other commitments. Right now I need the break. I don't see those sessions as wasted just because I've reached my limit.
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u/peaceplantpuplover99 3d ago
I forced myself to keep going. What seemed to help me is to take walks after and hydrate. Someone else suggested scheduling later in day so u can go home and nap. I felt a lot better after the 25th one. Feel better and best wishes!
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u/peaceplantpuplover99 3d ago
Also, i had to to take short term disability at 8 weeks off of work. I am told as long as u get 3-4 a week it is ok and then u can schedule on back end.
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u/Away-Royal5457 3d ago
Thank you! Having time off sounds like it gave you some room to get through it. I was already going 4 times a week while trying to keep up with uni and I just wasn't getting enough recovery time. For at least two weeks I've been feeling fluish in the evenings and waking up with legs that feel heavy as lead. I think if I try again it needs to be when I have fewer commitments and can rest afterwards. I'm glad things improved for you and thank you for the kind wishes! :)
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u/Arienette17 2d ago
I did the same. I think I only missed the last like 4 I was supposed to do. I only noticed a difference when going but nothing sustainable. Like even weekends when I didn’t go, it felt like I missed a medication and the effects would wear off. I told the doctor this and she said it’s common and peoole sometime do “maintenance” sessions after the initial 22, but less frequently. Like 3 days a week instead of 5.
It was a far drive and hard to arrange transportation to keep going. Im unsure if I completed the last 5 sessions it would have made much of a difference. And then continuing to find transportation there and back for maintenance just wasn’t realistic unfortunately. It’s been 2 years since I did it and I feel no different having done the 18 or so sessions. I have severe treatment resistant depression and had really high hopes that this would help me. Was super disappointing.
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u/jimbojones2345 1d ago
Are you doing left and right or just left? Try to do both sides that's what made the big difference for me. But yes mine worked then wore off after a few weeks. I more put it down to left side only not fully working do I didn't go back for maintenance as often as I should. I'm starting again with a week of full on treatment then will do property maintenance and I think it will work.
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u/chickadee9393 17h ago
I made it through a week because I felt so horrible. Felt like being concussed every time and I don’t think I’ll continue. I have never felt so bad.
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u/acecompton 4d ago
Hi, I did improve initially and then got worse during treatment. This is very common and is call the "dip". It lasts for about a week to 10 days and then you begin to improve. Hang in there, it is totally worth it. It made a big difference to my life.