I am really struggling today. My issue is terrible health anxiety triggered by the pandemic. I work as a massage therapist and was doing fine before the pandemic having one flare up in 2014 where I believed I had a contagious skin disease and was contaminating everyone.
Getting a good medical answer for that one and taking escitalopram permanently got rid of that particular issue and I was good for 5 years until the pandemic hit. Now I am really struggling with fear of spreading COVID.I rapid test almost every day and would love to just relax and not worry but the checklist for COVID is in my head like a magnifying glass.I am slowly able to tolerate the anxiety of not being sure after 1 year of effexor and two stays at residential mental health facilities and RTMS.
Just triggered today because my son is sick and I am a bit achey and have an itchy throat and then I have no idea for me whether I have what he has or if its combo allergies and sore muscles from my job. I don't want to lose clients and want to provide good care but this past few years has been a nightmare and I have lost 50% of my income. So frustrated to have a hard time distinguishing between my anxiety and my intuition and not being able to "know" when I am sick. I just want to get better!! So sick of always thinking everything may be a COVID symptom and cause harm and the triggers are still all around. So hard to know how to move forward and stop zooming in on everything and accept less then knowing absolutely what to do with certainty. I think today is valid because I have some suspect symptoms but I am so sad for the loss of the feeling of knowing I am sick or not sick and what is a reasonable precaution . I am going to try another round of Rapid transcranial magentic stimulation and really hope it helps specific with anxiety...just really want to get better! Any thoughts welcome!!
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redcedar91
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Hi! I got interested in your message because you mention there Transcranial Magnetic Stimulation. I don't have own experience but I know it is used. Could you, please, tell me about its effect when you will get it?
Yes I recently used rTMS in a residential mental health facility that was ve privately funded. This is the second time I attended the facility in 1 year, they did not suggest rTMS the first time and unfortunately trying to work close contact with vulnerable clients during the heightened fear environment in the pandemic with the intolerable obssesive fear of spreading COVID somehow despite mulitiple rapid tests daily,temperature checks, emergency room visits,perimenopausal hot flashes and anxiety somatic skin crawling sensations paired with allergies and asthma send me right back into being a prisoner of my obsessive fears and complulsions to continue cancelling my clients, checking my body for symptons and daily testing. My lack of capacity to challenge my anxiety and the loss of income and sense of being a burden to my family send me into suicidal ideation and crisis.
I returned to the center where this time they reffered me for rTMS. I recieved 30 sessions in 21 days, My depression and anxiety lifted but unfortunately I am still intensely struggling with my obsessions and compulsions though I am a bit better at objectivity.
I recently consulted with another clinic and am seeing a 4th psychiatrist(privately) on Tuesday and have been informed that the rTMS I recieved was a protocol for anxiety and depression but not for OCD. Apparently for OCD the coils need to be placed midline and they use a longer coil called dTMS which penetrates deeper into the brain please see my copy paste from IOCDF:
"Using dTMS to target the anterior cingulate cortex (ACC) and dmPFC were found to be helpful for OCD. [2]
The FDA-cleared TMS “recipes”
The US Food and Drug Administration (FDA) has cleared certain combinations of devices, protocols, and target areas of the brain to be used in treating OCD. The FDA cleared “recipe” for OCD treatment using TMS is:
A dTMS device, specifically either the BrainsWay [3] dTMS H7 coil or the MagVenture [4] cool DB80 coil devices
Using high-frequency stimulation (20 Hz)
Targeting the dmPFC or ACC
Additionally, this treatment should be paired with exposures (or “provocations”) that trigger OCD fears right before the TMS session begins.
How to tell which recipe is being used in your treatment
If you are considering TMS for your OCD, or are currently undergoing treatment, there’s a few things you can look for and ask about that will help you understand which one of these treatment recipes you are receiving.
Find out which type of TMS is being used in your treatment (e.g., surface TMS or deep TMS)
Ask about the areas of the brain or the brain structures that are being targeted
Pay attention to where the helmet or coil is placed on your head during treatment. Draw an imaginary line on the outside of your head from your nose, up between your eyes, over the top of your head and to the back of your neck. FDA cleared treatments require the helmet or coil to be placed on head so that is aligned with this imaginary center line. If the TMS device is placed on the side of your head, or off-center from this imaginary line, you might not be receiving treatment intended for OCD, and you should check with your doctor or TMS clinic about this."
On Monday I did consult with psychiatrist # 4 and he also confirmed a diagnosis of OCD ( I felt unclear about this from the other 3 I had seen) and treated me with regular rTMS, on the left habd side of the brain. I feel full of energy since the treatment and in a good mood, but still having problems with OCD.
The person I will see on Tuesday apparently does the specific targeted dTMS in the correct area for OCD, also provoking exposures while treating . I am hopeful this will help and encourage about how my treatment has helped with depression and anxiety , this creates optimism about OCD treatment. But the process to find what helps is exhausting and expensive, also hard since my income is so reduced. But I have to get better and I know I have been better before so I will hunt until I find the solution. This flare up is the hardest thing I have ever faced and I am determined not to let this unravel the life I have built.
Hi there! That was wonderful to read your text, I didn't know that those both (rTMS and dTMS) help a lot OCD symptoms. I have only seen those terms in literature, but thank you for your detailed information. And I do hope that also you will benefit from this treatment. - - - In that text by IOCDF, there they also list other treatment methods and there they mention e. g. those ablative methods for severe OCD. Hope you will have time to look in this chat my contribution under "CAPSULOTOMY + OTHER OPTIONS". There I have attached a file with further information on various ablative neurosurgical methods - if you just are interested.
Hi! How are you now? Have you already had dTMS? --- You sent the link to IOCDF, and there they also list DBS, Gamma Knife and ablative surgery. How is it in general regarding these 3 methods - has FDA accepted? I have read that there exists the so called "humanitarian device exemption for the use of one of Medtronic's DBS devices for refractory OCD (2009)". And is it so that FDA has accepted this exemption? I ask this because here in Europe there are problems in managing DBS for OCD.
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