Please note, this post is meant to inform, but is not meant as medical advice, and it shouldn’t take the place of working with your own health care professionals.
I recently posted about receiving TMS treatment for depression. TMS is short for transcranial magnetic stimulation; the treatment involves using the same type of electromagnetism used in MRI imaging, which stimulates neuronal connectivity in the brain. TMS was by far the single most helpful thing I’ve done for my chronic, treatment-resistant depression, and I’d highly recommend it to others.
One of the first steps in this process of getting this treatment was meeting with a psychiatrist. During this appointment, the doctor evaluated whether I would be a good fit for TMS. He was also responsible for officially prescribing the treatment.
By the time I had this initial doctor’s appointment, I had spent some time looking into TMS. I had seen that research has been done on what makes TMS more effective—I found one study, for example, that said taking antidepressants during the course of the treatment augmented TMS’ effects. So during that initial appointment with the TMS doctor, I asked him: What else could I do to help TMS treatment be as effective as possible?
His answer? Therapy. He actually told me that he really wanted to offer talk therapy with a professional during the TMS sessions at his clinic, but that insurance wouldn’t cover two treatments that occurred simultaneously. He explained that TMS is kind of like “re-wiring” the brain—or, more precisely, reinforcing and strengthening the connections for neurotransmitters that, the lack of which, are associated with depression.* He said doing talk therapy during the course of TMS treatment would also help reinforce and “wire in” the positive coping mechanisms that therapy helps teach you.
After that conversation, I decided I would do my very best to simulate therapy during TMS treatments. I started planning how I could do this—activities like reviewing my workbooks from when I did DBT group therapy, meditating, and writing and reviewing positive affirmations. In preparation for this, I bought a deck of colorful notecards and a book on mindfulness.
TMS therapy involves thirty or more sessions that can last 30-60 minutes. Personally, I did thirty-five treatments, and over the course of these visits, I started to refine my cobbled-together DIY therapy method. Though I’ve finished my TMS sessions, this routine continues to be helpful to me.
I’m excited to share it with you. I share this with the hopes that it will give you ideas for how you can build and maintain your own mental wellness. As I mentioned above, I don’t share it as a substitute for working with health care providers like doctors and professional therapists.
My personal DIY therapy plan
My personal “DIY” therapy routine has several components, which I’ve labeled below.
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I’ve purchased a few simple tools to go along with this plan. I really like using multi-colored index cards. I also use some different books and workbooks, since it’s important to keep learning mental wellness tools, techniques, and ideas from outside sources to help improve your mental health.
I don’t go through all the components I’ve listed every time I sit down for a “session” with myself, instead just focusing on two or three that feel like they would be helpful right then. Different sessions seem to have different lengths, too, based on the time I have and what feels helpful. Also, this is a dynamic process. I read different materials, I keep updating my index cards.
Component I: Learning and reviewing positive coping mechanisms and skills (books, workbooks, and orange index cards)
I’m not yet a health care professional, but from my experience and observation, mental health issues—whether depression, anxiety, autism spectrum disorder, obsessive-compulsive disorder, or others—can generally be summed up in this way: Experiencing strong emotions that are unpleasant plus handling those feelings with inappropriate or unhealthy coping mechanisms.
I think people often just don’t know healthy, effective ways to handle strong emotions. We all stumble around in life figuring this out. Sometimes, people figure out healthy skills like talking it out or exercising. But, I think it’s more frequent that we figure out to handle our strong emotions by doing not-so-great things like eating excessively, stonewalling and ignoring people who offended us, yelling or getting angry, spending money, and so on. Those are just the lighter end of the spectrum, a continuum that then gets into things that can be considered symptoms of mental illness—things like self-harm, substance abuse, obsessive cleaning, etc. are just the same thing: unhealthy attempts to deal with strong emotions.
This is why talk therapy is prescribed as a treatment for mental illness. Therapy helps you see the patterns of what causes your strong emotions and how you handle them, then teaches you new, more effective ways to deal with them and prevent them.
I talk about this to illustrate a simple point. If you’re attempting to improve your own mental wellness, you need an outside source to teach you new ways of dealing with things. Part of mental illness is that we’re already using the resources we have, but those resources and techniques aren’t super effective. So, you need new skills and techniques from somewhere else, somewhere outside of yourself and what you already know.
When I was trying to do therapy-type sessions with myself while receiving TMS treatment, I did this a few ways.
First, I reviewed notebooks and handouts from DBT therapy. Dialectical Behavioral Therapy (DBT) focuses on four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, with the goal of “building a life worth living.” It was originally designed for people with borderline personality disorder, but can be very helpful for other mental health struggles, too. I found it to be the first time talk therapy was really helpful in dealing with my chronic depression. I learned DBT skills through one-on-one and group therapy. This is how the therapy was designed, but there are also many publications and workbooks available that teach DBT skills. I've included a link to a book of DBT handouts and worksheets written by Marsha M. Linehan, who invented Dialectical Behavioral Therapy.
I also found reading the book Fear by Thich Nhat Hanh helpful. The author is a Buddhist monk, but his books aren’t particularly religious. They focus on concepts like mindfulness, forgiveness, experiencing peace, and enjoying the present moment. Mindfulness is a key concept of DBT therapy, as I mentioned, and something that has been incredibly helpful to me for handling depression. Thich Nhat Hanh’s words have helped me learn more about that skill. I’ve included links to the books of his I’ve read and found so helpful.
When I read or re-read about a skill or idea that is particularly helpful, I want to remember it, and I want to start putting it into practice. This is where my index cards start to come in. I use orange cards to jot down coping techniques, DBT skills, quotes from my reading, and my own ideas that are particularly helpful for processing difficult emotions. Then, like my other index cards, I try to review these regularly to keep the things written on them in my mind and at the ready when I need them.
A couple of my orange index cards with quick-reference notes on coping techniques
Component II: Meditation
As I mentioned, meditation and mindfulness have been really helpful for me and my mental health. I feel like this is a continual effort. It’s worth learning abou