John Eline, a Gulf War veteran who left the U.S. Army in 2010 after a 24-year career, increasingly started to feel an uneasiness creep into his psyche, a foreboding that interfered with his ability to concentrate.
He could not quite put his finger on the lingering problem, but little things told him all was not right. A consultation with his doctor revealed he was suffering from depression, and he received a prescription for medication.
But the side effects proved unpleasant, and when the Transcranial Magnetic Stimulation Clinic was preparing to open in Waco, he signed up for a trial run. He agreed to allow powerful electromagnetic waves to stimulate targeted regions of his brain.
After leaving active duty, Eline, now 48, became a budget analyst at the Doris Miller Department of Veterans Affairs Medical Center in Waco, so he had a short walk to the new brain center at the VA dedicated to helping returning war veterans cope with mental health issues related to their service.
“I noticed the biggest change after my first session. I felt lighter,” Eline said. “I know that’s not a clinical term, but that’s the best way I can describe the sensation. I was more relaxed, not euphoric but lighter mentally. There definitely was a change.”
Eline said he wondered if he was experiencing a placebo effect, an improvement in mood simply because he believed the treatment could work, not because it was actually working.
“But the next day, my wife asked me if I had done something different, that I seemed better,” Eline said. “I told her that, in fact, I was involved in this new program. Then my kids also noticed, and that reinforced what I was thinking. And my improvement has persisted.”
Eline said he would highly recommend the therapy to other veterans who are concerned about the use of psychotropic drugs or who have suffered disappointing results from other treatments for depression.
“You come in, sit down and have a helmet strapped to your head,” he said. “There is no pain, no discomfort. You may have some muscle twitching in the face, but you don’t really feel anything but tingling of the scalp.”
Transcranial Magnetic Stimulation is an approach to treating depression approved by the Food and Drug Administration, said Dr. Richard Seim, spokesman for the VISN 17 Center of Excellence for Research on Returning War Veterans at the Waco VA. The facility sprawls across 53,000 square feet of Building 93 at the hospital on Memorial Drive and now includes the TMS Clinic that formally opened to veterans this week.
“Unlike electroconvulsive therapy, which induces an electric shock to the brain, TMS simply uses a mild magnetic wave,” Seim said. “Because of this, the treatment can be delivered without anesthesia, and there is no risk of memory loss.”
Seim said the treatment is available to veterans throughout Central Texas, including those from Austin, Temple and Waco. It is intended for veterans already receiving inpatient or outpatient depression treatment and can be offered at no cost if a doctor recommends it.
Three veterans took part in trials at the local clinic, which has some of the most advanced TMS equipment available, Seim said.
“It is a fairly new technology and fairly new in the VA system, something that was experimental for several years,” Seim said. “The FDA now has approved it for chronic depression, for re-stimulating certain parts of the brain during 20 to 30 sessions. Our machine, which is not found in most places, goes deeper into subcortical structures in its treatment of depression, which evidence has shown is a brain-based disorder. It’s not simply in someone’s head. It has a neurological correlate, and we try to address those issues and provide some relief.”
Seim said the machine is manufactured by Brainsway. According to the company’s website, TMS therapy is effective for Alzheimer’s disease, bipolar disorder, chronic pain, major depressive disorder, Parkinson’s disease, schizophrenia, post-traumatic stress disorder, multiple sclerosis, obsessive compulsive disorder, stroke rehabilitation and for smoking cessation.
“At the VA, the therapy has been FDA-approved only for treatment of depression,” said Dr. Geoffrey May, who directs the TMS Clinic in Waco. “It is not approved for use alone in treating post-traumatic stress disorder, which is co-morbid with depression.
“Research continues on whether it can be used all by itself, which includes the use of brain scans before and after treatment, and we hope to build a case for FDA consideration. If it does receive clearance, that opens up exciting possibilities.”
A VA report released last year shows between 11 and 20 percent of veterans who served in Operation Iraqi Freedom or Operation Enduring Freedom suffer from PTSD and about 12 percent of Gulf War veterans suffer PTSD.
Another VA study released last year shows an average of 20 veterans a day die by suicide and that the suicide rate among veterans is 22 percent higher than the country’s general adult population.