My life has been changed by TMS - Transcranial Magnetic Stimulation.
As a 53 yo man I was diagnosed with major depression five years ago. For me, my experience has been days or sometimes weeks of 'episodes' where I struggle to get through the day and can't work. I'd feel absolutely devastated, crying or close to tears the whole time, obsessive suicide thought, etc. High doses of various medications sometimes seemed to work for a while, but then didn't.
I was admitted to a trial in Adelaide after waiting six months. The treatment was easy - four 5-minute treatments spaced twenty minutes apart over 5 days interspersed over two weeks, plus follow-up assessments. So 20 short sessions in all.
From being a driveling mess I started feeling some relief after three days. After the two weeks I was feeling completely normal. Actually a different feeling to the relief I would occasionally feel in the past after increasing medication doses. Just... normal. Like someone switched on the lights. My formal assessments went from an extreme end of the scale to complete remission.
This was four months ago and I am still doing well. I have had a few bad days, but those debilitating episodes have rarely lasted more than a day.
My subjective perception is that the TMS 'clears' the pathways. Those trains of thoughts that take you down familiar roads to the despair. I feel the TMS helped me to not continuously 'slide' down those pathways.
I have practiced mindfulness meditation for many years. While I eventually found myself unable to break through the blackness of depression through meditation (after many years staving off depression through meditation), it felt like TMS helped clear my inner landscape, allowing me to meditate again. I feel this practice has been indispensable as a follow-up to the TMS.
Especially for a few weeks of the treatment, I experienced 'trains of thoughts' that I needed to keep away from. It could have been easy to slide into the old despair, but I was able to avoid that with help from meditation. Over time this has no longer been a problem. Like, now I am used to being normal. Oh what a relief!
(I know this might not last and I may need to fly interstate to access TMS. It's simply not available in Adelaide as a therapy.)
So my strong suggestion is that the TMS should be followed up with some sort of talking therapy or meditation practice to help clear the old 'pathways' or trains of thought. Even if talking therapy hasn't been helpful in the past.