TMS Take II

The word remission brings with it a hope that few who have not fought a life-threatening illness would understand.

Remission means that the light at the end of the tunnel is not an oncoming train. That for the time being, you will live. It’s also not generally used for mental illness. Folks think of mental illness as permanent and ongoing. The impact of dTMS on my life was so profound that I used the term remission when I told people I was in recovery because it was the only way to get them to realize just how free I suddenly was from that crippling illness. 

For those who do not know about the crippling illness part of my story, you can find that here, and here. 

Did you read up? Well … I’m going to proceed as if you had. 

In my essay, Learning to be Myself, I’d mentioned that in May, 2022 I had one foot in the grave. I talked about how TMS changed my life; it gave me back the life I thought was over. 

So, what have I been doing with my second chance? 

My wife and I set about rebuilding the life we had before depression took me from her. That was my first and most important task. It took months for her to move past the role of caretaker and back to the role of partner. It took me months to realize just how deep depression has hurt us both. Today, we are every bit as in love as we have ever been. Our bond is stronger for the illness that nearly claimed me. There is still fear. Whenever the shadows return to my eyes, I can see the fear grow in hers. But my Good/Bad brain has been able to fight in ways it never could before TMS. Good/Bad brain, a term my wife lifted from Alie Ward, is how we  refer to the whole mess inside my head, and it’s perfect. 

The rest of 2022 was a litany of repairing relationships or ending them with people who had walked away while I was ill. My boys were quick to jump back into old habits and for that, I love them even more. The extended family was stunned by my sudden return to them, but they, too, were quick to embrace my recovery as genuine. My brothers and I have made a point of spending more time together, and that’s been wonderful.  

I did some of the best teaching of my career. I’ve been more organized and efficient since TMS than at any other time in my 33 years in the classroom. It’s not even close. I’m current on grades at the end of each week. My Good/Bad brain works the way brains are supposed to work, and it’s apparent to all who knew before that something has changed. I can stay on task, keep track of multiple lines of thought, remember details, and think without the constant fog of depression and ADHD clouding my mind. 

Writing has been a joy. I’ve always been able to work on my current project in my mind and write it down later, but now I’m able to work on multiple projects and remember what I added when I sit down at my keyboard. This article, for example. It has been in the works for months and is just now finding its way to my fingers and onto the page. I have updated my camera equipment and I’m creating on that front as well. 

In short, I’ve returned to the life I lived and loved before depression with renewed passion. 

Triggers, Triggers, Triggers

The thing is, I still have depression and ADHD. I still have all of my learning disabilities, and I still have to fight daily to keep the shadow at bay. In the past, I had a handful of meds to dull the constant thoughts of self-loathing, to numb me to the imposter syndrome that said I was unworthy of love and respect. 

After my first series of dTMS treatments, my psychologist and I decided I needed to end my use of meds and we set about doing that. It took months to wean me off them all. Those meds might have kept me alive, but they took a heavy toll as well. My liver function is not what it should be, in part due to the meds. I’ve got nerve damage in the dermis of my arms from meds as well. I was bitter for the first year, but I have moved past that … mostly. 

So, when I started the 23/24 school year, it was without a net. Nothing was there to catch me if I fell off the tightrope that TMS had provided me. Sure enough, the same old triggers did their thing, and I slipped. Standardized testing has done more damage to education than anything else I can think of, except perhaps smart phones. What’s crazy is that standardized testing is no longer about whether the kids pass. We got very good at getting them to pass. So politicians and testing companies came up with “value added” and pushed it to measure individual teacher impact on individual students’ learning. 

The details are not important here, and I’ll be writing extensively about them in my book on teaching. What is important to this story is the impact these scores have on individual teachers. Specifically, those of us who battle mental illness. These test scores are used to judge us and our effectiveness. Understand, there is no attempt to control the dozens of variables that impact the education of a student during the year. None. The benchmark score students are given to judge how much they should grow is based on a previous test and often different subject material, but we do not know because the algorithms are proprietary to the testing companies. Kids have this target we are supposed to get them to and then they are given one single test to measure whether we got them there. This is supposed to measure our contribution to their learning. 

It ignores the reality of modern education. It ignores smartphones, Covid trauma, constant change of schedules, lack of teacher support, lack of materials to teach the content, daily disruptions, trauma at home, student hunger, constant change of administration and the quick-sand of innovation that never lets teachers master a program before it’s gone and we are on to the next thing. 

These scores are held up to the world and teachers are told that we are the only variable if students do not hit this magic target. Understand, teachers with low value added, but high passage rates are put on improvement plans based on these scores. To a teacher with impostor syndrome and severe mental illness, that’s enough to start a spiral that could end their lives. These scores come out every fall, and teachers are hammered with them over and over. 

It’s this cycle that started my last severe depressive episode in the fall of 2018. In 2023, I faced the same trigger and ended up falling victim to mental illness yet again. This time I had the Good/Bad brain in place, and we acted to counter the darkness. This is where the importance of TMS maintenance needs to be addressed. 

TMS Maintenance

TMS is not a cure. There is currently no cure for depression. What TMS is, though, is a breakthrough treatment. I’ll include links at the end for folks who want to know more, but like the use of medication, TMS is not a one and done thing. It has to be reapplied at regular intervals. After my first series, we tried every couple months, then every month. That worked well until last fall, when I was triggered again. I was able to start more frequent treatments immediately and then, after insurance approved a new full round of 36 treatments, I started going three times a week. 

My first exposure to TMS was like shining a spotlight into a dark closet. It was dramatic and harsh and ripcord fast. I went from darkest night to brightest day in 24 hours. This new round of treatment was different.  It was as if the defenses were already in place against the shadows of depression and they just needed reinforcements. The recent rounds of TMS did that. In waves, they built up the walls of my stronghold stone by stone. I was able to keep working this time. I missed some days, but I could function. 

There were ideations, those whispered lies about ending the pain for good. They are terrifying when your brain is up and working. I used to sit and simmer in them for hours. Now, I did not want to die, despite the murmurs in my mind. I knew what they were and dismissed them as the voice of illness. Death’s sweet caress was not something I longed for and, in fact, was now whole enough to fear. 

So, in November 2023, I started TMS three times a week, and that continued until I finished the 36 session series in February. There were a few breaks due to school breaks. This time, I was able to keep working, even though there were many half-days and I still missed more school that I wished for. It was necessary. Having TMS three days a week was about perfect. My brain was in a constant state of recovery. Depression never grew roots.

This time, I was able to maintain my health through the mental health crisis with little or no disruption. But some things were already broken beyond repair. Relationships at school were all but irreparable. Too many years of depression brain, not talking to anyone but my students, skipping interactions with adults because they were always a horror show of triggers. There are consequences to living with and in spite of depression, and this is one of them. Isolation. It’s easier for some of the staff in my school to simply ignore me than to do what they would happily do for one of our students. That is, give grace, compassion, and understanding.

The hurricane of emotions that surrounds the fact that I’m a year from retirement and all but invisible to the younger teachers I work with is now my most significant obstacle. It’s also one that must be acknowledged as unresolvable. Depression silenced me for years, and so I lost the friends I had and did not make new ones. Add the insane turnover in a high school and you end up with my current situation.

My goal now is to reach retirement in February 2026 in one piece. I’ve got many years of writing and political activism left in me, but my teaching career is in its sunset and I am okay with that. I’ve always preferred a good Irish goodbye.bye.