TMS Offers Hope
Life-Changing Depression Treatment Comes to KMHS
When Kay first heard about Transcranial Magnetic Stimulation (TMS), she was skeptical. But after less than two weeks of treatment at Kitsap Mental Health Services’ Neil S. Hirsch TMS Clinic, she started to notice subtle differences. She brushed her teeth without overthinking it. She made small talk and struck up casual friendships. She started to plan for the future.
“Now, I’m taking care of myself for the first time in a long time”
“Now, I’m taking care of myself for the first time in a long time,” she reflected. “I think a part of depression makes you hate yourself, but TMS has allowed me to like myself again.”
During the first six months, 60% of clients experienced significant improvement and 48% achieved remission.
Bringing TMS to KMHS
TMS is a non-invasive treatment for medication-resistant depression that uses a series of magnetic pulses to stimulate and strengthen connections in the brain. It has few side effects and is about six times as effective as antidepressants in people who have tried multiple medications without success.
The treatment has been available in the Kitsap region for almost a decade, but until now it hasn’t been accessible for people on Medicaid or the uninsured. KMHS opened its clinic in June 2024 after receiving a grant from the Foundation for the Advancement of Clinical TMS (FACTMS), with support from the Neil S. Hirsch Foundation, and Magstim, which donated a state-of-the-art TMS device.
KMHS was chosen as the first FACTMS-sponsored clinic, as part of the organization’s mission to bring TMS to underserved communities. The KMHS clinic will serve as a model for expanding TMS to other community mental health centers around the world, and was featured at the organization’s June 2024 conference in London.
“We have all seen how amazing this treatment is and how it can transform lives,” Dr. Mo Abdelghani, chairman of the FACTMS Clinic Expansion Committee, said at the clinic opening. “We had more than 50 applications from around the world, but we couldn’t find anyone better than Kitsap. We’re impressed by the facilities you’ve got, the services you provide, and above all, the outstanding staff and leadership you have in this organization.”
KMHS Chief Medical Officer Dr. James Hughes oversees the clinic. His expertise – he was one of the first three people in the Pacific Northwest to use TMS when he was in private practice – is one of the reasons KMHS won the FACTMS grant, which includes start-up and operating expenses for one year.
Promising Early Results
During the first six months, the clinic treated 36 people and attained results comparable to those in the medical literature, with 60 percent of clients experiencing significant improvements in their symptoms, and 48 percent achieving remission. Remission means they’re no longer clinically depressed.
“It’s such a pleasure to see people get better, especially when you know these are people who have struggled with this for years and have all but given up,” said Dr. Hughes.
There have also been challenges. KMHS clients often live with a complex web of mental health and substance use disorders. When their depression improves after TMS treatment, their other conditions may come to the forefront. Said Dr. Hughes: “They’re not depressed anymore, so now all of a sudden they’re faced with dealing with their trauma.”
Clients also struggle with showing up for six weeks of daily treatments, both because of the severity of their illness and because of a lack of access to transportation. The FACTMS grant has helped cover transportation costs for clients, providing bus passes, gas cards and cab rides when needed, and the clinic hopes to be able to continue that support after the grant funding ends.
Clients’ challenges underscore the healthcare inequities that the FACTMS grant is helping to address, said KMHS CEO Monica Bernhard.
“In a world where people of means have access to cutting edge treatment and people without means often do not, this powerful and life-changing gift is helping us create a legacy of hope for years to come.”
Ed, 43
What is it like to live with severe depression?
The precise and polar opposite of fun. It’s like walking around with a millstone around your neck.
If I said I have tried out on the order of over a dozen medications over the years, I’m low. Those are just the ones I can remember.
How did TMS help?
The changes I noted were subtle at first. It’s not something where you go into the chair, you get zapped and then bam, everything’s better. No, it’s over time, it’s cumulative and the changes can be subtle.
For my part, having completed the treatment, my symptoms are significantly reduced.
I had a tendency to shame spiral, and I don’t really do that anymore… I gained the ability to control those spirals or pull myself out of them rather than be locked in for hours and in some cases, days.
What else do you want people to know?
TMS has certainly helped me and it may have a good chance of helping you with reducing your symptoms, and helping you get back into a functional, livable place, whether it’s with or without medication.
Kay, 30
What is it like to live with severe depression?
It was hard to care for myself. It was hard to bathe, brush my hair. I’m still dealing with dental issues because of it.
How did TMS help?
It’s like being starving and then being finally able to sit down and eat a meal.
I have moments where it’s hard, like, I can feel the depression and everything. It’s there, but I don’t have to interact with it anymore. I don’t have to be consumed by it. I have that choice, and a couple of months ago I didn’t have that choice.
What else do you want people to know?
It just feels good to have options again. With the depression, it feels like branches are cut off at every opportunity, just at any inconvenience… You just pick the thing that your brain says is the least worst thing. But now I don’t have to pick the least worst thing. Now I get to pick anything that I want to do.
Eric, 41
What is it like to live with severe depression?
Before the treatment, I would get home from work, the days that I made it to work…I don’t know how many days I would just get home, sit on the couch doing nothing, and then all of the sudden it’s just dark again. And then when I looked at the clock, I didn’t realize that I just sat there doing nothing and staring into nothingness for probably 4 or 5 hours.
How did TMS help?
The best way I can describe it is it’s this feeling of being a teenager, of all the possibilities of what could happen with your life, and you have the enthusiasm to look forward to it.
What else do you want people to know?
I used to say that depression was a rich people’s problem because most people couldn’t afford to be depressed. But it is an actual problem that does not differentiate based on creed or nothing, and you don’t have to feel bad about it, you just have to do something about it.
If you feel you have lost joy, look for help.
