TMS Treatment Planning Questionnaire
The questions below will help to design the optimal treatment environment for your upcoming course of TMS. Answer any questions you feel comfortable with; or just think about these topics and discuss further with your treater in person.
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Birthdate as MMDD (eg March 8 = 0308)
What objective, trackable measures help you notice how strong your depression is?  (Try to think of 1-3 measures so we can use them to monitor during your treatment course.)
e.g.: frequency of exercise, how often I wash my hair, specific things I will or won't eat, specific things I do at work, the time I wake up in the morning, how many events I have in a weekend...
Describe your sleep: What is typical for you these days? How do you sleep when not depressed? What is your ideal sleep?
Research has shown that being in a happy, relaxed state of mind during TMS treatments improves outcomes.
 (All activities below will be entirely optional during treatment.)
On some treatment days, we will be training you on new techniques to enhance your happy relaxed state of mind during treatment, and also to provide you with tools to maintain your mental health when treatment is done. Are there any techniques that you are already practiced in, or use on a daily/weekly basis?
On other days, you will get a break with some "passive relaxation." Think about some programs you'd like to watch that make you feel warm, happy, nostalgic, relaxed, etc.
(For inspiration-- some popular choices in the past include Big Bang Theory, Parks & Recreation, Dirty Dancing, various Netflix comedy specials)
Try to brainstorm some types of music that will put you in a positive mental state. You can choose an artist or genre for a Pandora playlist, bring your own playlist to hook up to our speakers, etc.
On some treatment days, your treater will lead you through a guided visualization of your own positive memories. List some events, vacations, projects, interactions, movies, competitions, or anything else you think you can talk about. They can be as mundane or exotic as you'd like, and you can even make up the details you forget-- all that matters is that they inspire some positive emotion in you.
Dr. Mednick will be available for any questions during your treatments, and will also meet with you every 10 treatments to discuss your course more specifically. What is your preference for treatment follow-ups with Dr. Mednick?
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TMS makes change to your brain's neuroplasticity-- essentially, making it more receptive and able to change. That means that what you are "putting in" is very important, and we want to make sure you are getting full support and doing the kind of work that can advance change.
For this reason, you are required to be in psychotherapy during treatment.  
Also for this reason, we'd like you to think about a new way you might challenge your brain in the upcoming months,  to utilize and strengthen the "new networks" you are building. Some examples include: learn a new language, instrument, recipe, or other skill; read more or different types of books, try out a new social connection, etc. You can think about this on your own or jot a note down here if you'd like.
It was recently discovered that bright light therapy may speed up your response to TMS (Barbini et al, Int J Psychiat Clin 2021 Mar 18), making it more likely for you to respond within the first week while not necessarily changing your overall response. This requires exposure to a "SAD lamp" or 10,000 Lux light every morning for 20-30 minutes. We recommend this one that has been used in clinical trials:
Are you interested in learning more about adding bright light therapy?
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It is important to approach TMS with realistic expectations. Dr. Mednick has reviewed the data with you showing that generally, around 65% of people have a response to TMS and 40% have remission of symptoms. Sometimes response is very clear and obvious; other times it is more subtle.
 Please take a moment to read over these two typical descriptions of a more subtle response, and continue to talk this over with Dr. Mednick, your treaters, and your outside providers.  
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