TMS: Between No Longer and Not Yet

By Liz KochApril 15, 2024

I recently stood at the familiar crossroads of despair and resilience, grappling with the heavy burden of depression that had shadowed my life for as long as I could remember. That dense, unyielding fog had descended again, making each day feel like I was slogging through mud. As I stared out my kitchen window one sunny day late last summer, a new type of despair emerged—thoughts of suicide began to creep in for the first time. It was a cleaving moment that delineated my experience of depression up to that point, and I was terrified.

I took my first antidepressant at age 11, forever blurring the line between puberty and pharmaceutical intervention, and have dutifully swallowed them every day since. My first session with a gifted therapist when I was 19 turned into a decades-long therapeutic relationship that continues even now that I’m 45. Despite dedicating myself to the consistency of therapy and medication, depression would relentlessly return. I was in a perpetual spin cycle of hope and disappointment with each therapeutic breakthrough or medication change.

Over the years, depression cost me jobs, housing, relationships, and time—so much time. Once I married and had children, it began to take from my family the wife and mother who loved them more than anything.

Staring out the kitchen window that summer day, I realized there are certain moments when we are forced to confront our fate. Where we make a pivotal choice with the sudden understanding that the life we created can no longer continue on its current path. In that moment, between perception and reality, is a spark of who we really are behind everything we thought we’d never be. I chose to stand up within myself and ask for help. To actively choose healing and not just be a passenger in an experience I wouldn’t have opted for.

A New Treatment

After talking with my therapist, I decided to embark on a journey with a new treatment called Transcranial Magnetic Stimulation, or TMS for short. TMS is a non-invasive procedure that targets the prefrontal cortex, the part of the brain responsible for moods, and enhances neural activity through magnetic pulses. I was told that while studies have shown that up to 58% of people show significant improvement during treatment, the clinic offering TMS had anecdotally seen 83%. In contrast, only 10-15% of individuals experience improvement with antidepressants after attempting 2-3 medications without success. It was daunting to learn that there would be a total of thirty-six 30-minute sessions to be completed Monday through Friday. The timing was terrible. When I was approved for TMS through insurance, I was beginning a gauntlet of stresses and changes. My husband was leaving for a month-long international work trip, his first since before the pandemic. Both kids, neurodivergent with high support needs, were struggling immensely and only attending partial days as the school year began. I was profoundly depressed, and my Crohn’s Disease was beginning to flare.

So why did I decide just then to move forward with a new treatment that may or may not work? The temptation to stay crystalized in survival mode instead of figuring out how to move forward was strong. There was an impulse to stay in that small, familiar space because it felt like the walls were caving in. However, I remembered something that I’ve learned over the years about the story depression tells me: it so thoroughly convinces me that there is no exit from my suffering that I stop looking for one. Once I remembered that, I thought of all the other times I found an exit and felt a glimmer of hope. It eventually bloomed into a type of scrappy, defiant hope that helped me find the courage to begin inching toward healing.

This time around, the healing process began in what looked like a reclined dentist’s chair while a magnet rhythmically tapped the left side of my head. It worked in tandem with weekly therapy sessions and my medication regimen. I wish I could say it was an easy process, but it took precious effort to commit every day, especially when I had to sandwich appointments in between partial school day drop-offs and pick-ups at two different schools. Then there was what’s called the “TMS dip,” which some people experience as a short-term worsening of symptoms. My depression deepened, and I became uncharacteristically weepy. The theory is that dormant parts of your brain are waking up, and suddenly, you’re feeling a broader spectrum of emotions that had been buried beneath the gray blanket of depression. Instead of trying to resist or control the discomfort, I leaned into it, causing it to eventually shape-shift into a type of emotional sturdiness I had never experienced before.

During this time, I read a Nancy Levin quote shared on social media that felt especially resonant in the context of what I was going through:

“Honor the space between no longer and not yet…. This is the place where resilience, possibility and opportunity are born.”

There is such a human desire to dodge discomfort, and this quote made me wonder about the value of engaging with discomfort by finding a container to explore that distance between no longer and not yet. For me, therapy and writing make up that safe space to be less hostile toward it. I began to get curious about ways to creatively engage with my circumstances without being pollyanna-ish about it and without putting pressure on myself to find a silver lining. Maybe I could just explore it.

Beginning to Heal

So that’s what I found myself doing. By TMS session #24, I sat down to write for the first time in over a year. Sitting at the table facing the kitchen window with my laptop was a small, ordinary moment, but it meant everything. The words were raw and only for me, but I found agency in having a perspective on what was happening and beginning to connect with it through my writing. It was a way to show up and engage with what was happening that felt restorative and engaging. Instead of feeling like I was imprisoned by the stripped-down vulnerability demanded of healing, writing unlocked it and the world around me.

I found that when I get quiet and observant enough, I notice what other things appear in the periphery of depression’s numbing absence. I learned that there are new ways of living and coping, such as the granular gratitude I feel smelling my hot coffee in the quiet morning hours before everyone else awakens. That even when the walls cave in, I adapt and recognize I can handle it. That I am not the only one suffering, and when we dare to tell the unvarnished truth, whether it be in art, writing, or a conversation we realize again and again that we are more alike than different.

While TMS was not a magic cure, it was an undeniable turning point. The suicidal thoughts retreated along with the depression, and now, six months after completing the treatment, it feels like I’ve been given a second chance that I never thought was possible. Although there is no guarantee my depression will never come back, I find comfort in knowing that a treatment like TMS is available. That therapy and writing will continue to provide a soft place to land and a solid place to get back up. If a time comes when I find myself back at those familiar crossroads, I will not be alone and will have help finding my resilience once more, waiting inside me.

Depression has a way of making us feel incredibly isolated. We’re here to remind you of the truth that you are not alone. We encourage you to use TWLOHA’s FIND HELP Tool to locate professional help and to read more stories like this one here. If you reside outside of the US, please browse our growing International Resources database. You can also text TWLOHA to 741741 to be connected for free, 24/7 to a trained Crisis Text Line counselor. If it’s encouragement or a listening ear that you need, email our team at [email protected]

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Comments (2)

  1. Leticia

    Hi! Thank you so much for telling your story, and please know that you’re helping many people with it.
    I have a question to whoever can answer it. I’m a teenager and all my life I’ve been told by my parents that mental health does not matter, but lately I’ve been experiencing some signs of depression and I can’t help but believe that it’s just a teenage thing. My question is if there is a way of knowing if I have depression? preferably without my parents knowing. I live outside The USA (in Uruguay) so if you know about anything that could help, I really appreciate it. Thank you!

    Reply  |  
    1. TWLOHA

      Hi Leticia,

      We’re really glad you found the blog and that you took the time to comment about what you’re experiencing. We hope you know that we see you and that your feelings are absolutely valid. Mental health matters. Your mental health matters.

      One of the ways you can explore what you’re experiencing as it relates to possible depression, is by taking a free online screening offered by our friends at Mental Health America:,actions_a.

      Please know that we are here and you can reach out whenever by emailing us at [email protected].

      With Hope,

      Reply  |  
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