An Appleton hospital is treating depression by delivering magnetic pulses to the brain – Post-Crescent

APPLETON - Waking up each morning and preparing for the day used to feel as difficult as climbing a mountain for Erin Johnson.

The depression she lived with for years made it a struggle to get to her job as a physician assistant, work on thehobby farm she owns with her husband in Greenville and care for her two young children.

She'd been on and off medications to treat her condition since she was a teenager, Johnsonsaid. None produced the results she was looking for, and some brought on unpleasant side effects, like nausea and sweating, that made it hardto continue taking them.

"You think, 'Oh, you can't just deal with sweating?'" Johnson said."But ... you think about sweating, and you sweat. Or you wake up in the middle of the night in a pool of sweat."

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When she heard a presentation at work last year about a new treatment being offered to tackle depression like hers, she wanted to give it a try.

Every weekday for a month and a half, she reported to Ascension St. Elizabeth Hospital, where a machine delivered small magnetic pulses to her brain for about 20 minutes. When the treatment ended, her depression symptoms had disappeared.

Transcranial magnetic stimulation, or TMS, has been around for awhile but is less commonly found outside of Wisconsin's urban centers. In the Fox Valley, St. Elizabeth began to offer it in May 2021, and Prevea followed later in the year.

TMS is meant for people like Johnsonwhose clinical depression isn't responding to medication or talk therapy. Patients sit in what looks like a dentist's chair and a magnetic instrument stimulatesthe brain's dorsolateral prefrontal cortex, which regulates mood. The pulses help release chemicals like serotonin, norepinephrine and dopamine, correcting theimbalance that's thought to cause depression.

Johnson described the feeling as "an interesting sensation" that's not quite painful, though she did have some scalp tenderness and a slight headache after her first few visits.

Transcranial magnetic stimulation at St. Elizabeth hospital

Erin Johnson, of Greenville, receives transcranial magnetic stimulation treatment for depression at Ascension St. Elizabeth Hospital in Appleton.

Courtesy of Erin Johnson

Most other TMS patients at St. Elizabethare seeing the same positive results that Johnson did. Of the 46 patients whohave undergone treatment since the program began, 84% have seen their depression symptoms clear, said Dr. Thomas Rowell, an Ascension psychiatrist who oversees TMS at the hospital.

Many insurance providers will cover the treatment, provided the patient proves they'vetried medications and other forms of therapy without relief. At that point, Rowell said, the people he's seeing are "almost at their wit's end."

"They come to us pretty depressed ... they've tried a lot, and they're hoping this is the thing that's going to help them," Rowell said.

Each time a patient comes in for treatment, they fill out a questionnaire about their depression symptoms, he said, rating how often they're experiencingthings like hopelessness, appetite loss, poor sleep, loss of interest in activities and suicidal thoughts. Over the course of treatment, Rowell said, the frequency of those decline "dramatically."

After about three weeks, Johnson said she realized she was able to get up in the morning with ease. She felt more social at workand said her coworkers and family members noticed.

There isn't a definitive answer to how long TMS keeps people's depression at bay. One 2013 study found that, after a year, 68% of people who received the treatment were still experiencing improved symptoms and 45% were in complete remission.

At St. Elizabeth, a TMS patient coordinatorwill follow up with people after their treatment to see how they'refeeling, Rowell said, and may recommend a few more visits if their depression has returned. No one has reported that yet.

Depression can be passed down genetically or be triggered by environmental factors, like trauma or severe stress. TMS works well forpeople whose depression was likely passed down through their family, Rowell said, and it works best when it's paired with an antidepressant.

Rowell was in residency when the treatment was first approved by the Federal Food and Drug Administration in 2008. Hesaid it was met with skepticism because doctors thought the data on its efficacy wasn't up to par.

He forgot about it for years, then spoke with a salesperson for the machine who showed him newer, better research results. Within 18 months, St. Elizabethwas able to start offering it.

The treatment is still a new frontier, Rowellsaid. Although research is limited, doctors have begun to examine how it could be used to treat anxiety as well as depression by sending the magnetic pulses to another part of the brain.

Scientists are hoping a new type of TMS, called Stanford neuromodulation therapy, could be approved by the FDA by the end of this year. In that type of treatment, patients receive the magnetic pulses for longer periods of time per day but complete treatment within five days, as opposed to six weeks.

Johnson said one hesitation before starting treatment in October was that she wouldn't be able to commit to going daily if work and life got in the way.

But in the end, she said, six weeks was an easy sacrifice to make for having her symptoms go away.

"It's hard to explain. You feel I don't want to say normal, because what is normal, really?" Johnson said. "But you feel better."

Contact reporter Madeline Heim at 920-996-7266 or mheim@gannett.com. Follow her on Twitter at @madeline_heim.

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An Appleton hospital is treating depression by delivering magnetic pulses to the brain - Post-Crescent