Deep TMS and Deep Brain Stimulation

I want to start out by saying that I think my case is rare and most people will not need what my psychiatrist is recommending. I have severe ocd that my therapist who is specialized in ocd and I have met two times a week from October to April (now it is once a week). My Y-BOCS scores are in the high 30s. I’ve tried almost every medication available for OCD including 80 mg of Prozac, 200 mg of Zoloft, 60 mg of buspirone, 10 mg of abilify, 20 mg of memantine, Xanax for anxiety spikes, Seroquel for anxiety spikes, and I am now on 100 mg of chlomipramine which I’ve been on since Thursday (before that I was on 50 for a week, then 25). I have had ZERO side effects to any medication including Xanax, and no medication has helped at all. I’ve tried doing ERP with my therapist and been unsuccessful. I had someone at my university’s counseling who was specialized in OCD center refer me to this other place cause of how bad it was. Now, the ocd treatment center I am going to is saying they won’t see me in the fall unless I do a residential or PHP program at Roger’s, which my parents have said is not happening. I’m at a dead end with treatment and nothing has worked so far. My psychiatrist is recommending either residential treatment (which my parents said I’m not doing) or deep TMS, if 100 mg of chlormipramine doesn’t do anything in 4 weeks. Honestly, I don’t expect it to. If that doesn’t work, he is recommending Deep Brain stimulation. I have thought I needed something like deep brain stimulation or brain surgery for ocd since October. I also thought I needed something like residential treatment for ocd before it got recommended. I talked to my parents about it, and they said “there is no surgery for ocd and it would be too expensive.” When I talked with my therapist about deep brain stimulation he had barely heard of it for ocd. Has anyone ever done deep TMS or Deep Brain stimulation for ocd?

Jessica B.

Date posted: 20h

I’m curious if you’re a minor because you mentioned your parents not wanting you to do an inpatient stay. DBS is meant to manage symptoms; if the device is turned off, symptoms are likely to return. Your brain matures until you’re about 25, so I would be hesitant about doing it if you’re younger. But I’m certainly not a psychiatrist. One thing I can tell you is that some psychiatrists look down on psychologists/ therapists and vice versa. Do you think you’ve exhausted therapy as a solution, including multiple therapists and multiple modalities? If so, I would seek a second neuro psych opinion, to make sure.

anonymous23635

Date posted: 19h

@Jessica B. I’m 20 years old but my parents are very controlling. I could pay for residential but my parents said I’m not going to Massachusetts for it, and my mom has threatened to not pay other things like my apartments rent if I do it, so I can’t really afford it. I definitely see what you’re saying with DBS, but for me nothing has worked and the ocd can be debilitating. I’ve held my breath before during therapy when I tried to do ERP cause of how overwhelming it was. My ocd is also very complicated and I can’t really explain it. I honestly feel like I need some sort of brain surgery cause even if it’s risky to me, the risks are worth it. OCD was so bad at one point during part of the summer between 11th-12th for 3 weeks every day I said to myself “this is my last day.” I didn’t actually do anything (I did write a note but that was it), but maybe I am looking at it wrong, but I feel the risk of suicide is higher than the risk of DBS or brain surgery, and I don’t have a ton to lose

anonymous23635

Date posted: 18h

@Jessica B. I think I have exhausted therapy as a solution mostly besides residential (which I doubt would work but my parents aren’t letting me do). I looked it up and for people with ocd it said only .01-.05% of people get deep brain stimulation, so idk if my case is that bad but it might be. I’ve gone to therapy twice a week at an ocd specialty center, and the obsessions have been so complicated, I can’t even easily explain them to the therapist (meta ocd is involved), so if I can’t explain it to the therapist because it’s so severe, how am I supposed to get better? My therapist at college is not recommending TMS, but my therapist at home is as well as my psychiatrist. My therapist at college is heavily recommending Roger’s (residential treatment or PHP), as is my psychiatrist, and my therapist at home (if I am able to do ERP), but my parents said “we’re not doing that this summer.”) I guess TMS makes the most sense first cause it’s not as invasive, and I should definitely get a second opinion, but it seems like no medication I take seems to affect me at all (I’ve had no side effects to anything, including Xanax). I don’t know if I’m missing something with therapy, or if my ocd is really that bad that it’s in the less than .1% range, but I know it’s bad.

Jessica B.

Date posted: 17h

@anonymous23635 Can you ask your parents to talk to the providers recommending inpatient care? If you do TMS, wishing you success.

anonymous23635

Date posted: 16h

@Jessica B. I have and they’re not interested in talking to the providers near my university, and they did talk to my provider at home and weren’t happy with how the discussion went. They’re ok with TMS now, but over the winter, my provider at home said she thought even a TMS expert wouldn’t be able to convince them

anonymous23635

Date posted: 16h

@Jessica B. My dad also said that what the providers don’t see is the financial aspect of it, and I feel like he is acting like he and my mom know better than the providers which is wrong. We’re not poor either, but my parents are making me pay for treatment, TMS is going to be a third of the money I have

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