Amber Crawford had lost hope that she’d ever find a treatment for depression that worked for her.
Diagnosed at age 22, Crawford said her depression has impacted many aspects of her life, including her relationship with family members. The mother of twins (and grandmother of one) said when she first came to Vijay Dalai, MD, psychiatrist at Mercy Clinic Behavioral Health – Fort Smith, she was “at the bottom of a very black hole.”
“I had given up, basically, on ever feeling better. I had resigned myself to the fact that this was my life – I would feel bad until I die,” said Crawford, 45, a Fort Smith resident. “I went through a really dark time in December and January. I felt so bad that I didn’t want to see people; I didn’t want to talk to anybody. I was failing at my job, and my marriage was failing. I had lost the close relationship I always had with my children, my sister, and my mom. I sat in the dark and just ignored life.”
By her own estimation, Crawford had tried “probably 20” different types of medication to help treat her depression since her diagnosis. She eventually had genetic testing done and found out she has defects that caused her not to respond to the medication she was taking.
It was time to take a different approach.
Dalai suggested Crawford consider transcranial magnetic stimulation (TMS) treatments, a new option for patients at the Mercy Fort Smith clinic. TMS treatments use magnetic fields to stimulate specific nerve cells in the brain. The noninvasive procedure is done at the clinic during a series of appointments.
For Crawford, the treatment has made a huge difference in her life.
“From the very first time I came to Dr. Dalai’s office, I could tell that he’s a fighter and that he actually wanted me to feel better,” she said. “I was hopeful he could help me, but I didn’t have a lot of faith. I had tried so many other things in the past. It just seemed like nothing worked.” After TMS treatments, Crawford said, “I got to the point I felt like I was annoyingly happy, which was a new feeling for me.
For most patients, the positive results are the cumulative effect from a series of TMS treatments. Dalai said each of his 20 patients who have undergone TMS treatments has shown positive results. Mercy Fort Smith began offering TMS in early 2023 and is the only location in Sebastian County, Arkansas, to do so, although there are other locations in northwest and central Arkansas offering the treatments. Purchase of the equipment in Fort Smith was funded by Mercy Health Foundation.
“Depression is a chronic problem, and we have seen several patients try multiple medications who are still having a lot of symptoms,” he said. Any patient who has tried more than two adequate types of medication along with psychotherapy is considered a treatment-resistant depression patient, he said.
TMS treatments were first approved by the FDA in 2008 and work by stimulating the left dorsolateral prefrontal cortex. Dalai said MRI studies have shown this particular part of the brain can be more or less active depending on each individual.
“Stimulating that part of the brain with a magnet is helping these patients; that’s what the recent studies show,” he explained. “Basically, they activate the brain cells, helping them to feel better.”
Not all patients will benefit from TMS. Dalai said between 65 and 70% of patients are expected to show positive results.