How I Found a Solution to My Depression

Decades of medicines and therapies didn’t work. But in what appeared to be my darkest times, an alternative therapy rescued me

Clinton Colmenares

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En español

Published January 17, 2024

Side-by-side images of Clinton Colmenares wearing a suit (left) and sitting with his hands on his face (right)

Courtesy Clinton Colmenares

A magnet the size of a lunchbox is sitting against the side of my head. The technician who has placed it, satisfied, walks away and turns on a machine that makes a loud, rapid tap-tap-tap-tap-tapping noise as it sends magnetic waves through my brain.

I’m here because I’ve been stuck in a severely depressed mode for a year and a half. This therapy, called transcranial magnetic stimulation, or TMS, has come highly recommended; nonetheless, it feels like a last-ditch effort in the wake of so many other failed therapies. “This has to work,” I tell myself. If it doesn’t, I’m out of answers.

I’ve coped with depression most my adult life; despite its challenges, I’ve carried on. But when I turned 50, I began to worry more deeply about the condition and my future. In my psychiatrist’s office one summer day a few years back, she asked if I had any questions. Yes, I said. What happens when I run out of options?

I knew that could happen. Over the decades, I’ve tried almost every available antidepressant — Prozac, Wellbutrin, Zoloft, Paxil, Celexa, among others — with limited success. About 30 percent of U.S. adults diagnosed with depression don’t get relief from standard therapies, or the treatments just stop working, according to a 2021 report in The Journal of Clinical Psychiatry. Considering that possibility was like staring down a tunnel and not seeing a light at the end.

A small but significant percentage of men with depression end their own lives. I didn’t want that for myself. I had a teenage daughter. Since her mom and I divorced in 2017, my daughter and I had begun traveling together, just the two of us, on short trips — Boston, Washington, Nashville. I didn’t want to let my challenges affect her and our relationship.

But when the pandemic hit in 2020, the travel stopped. I was living alone in a small town. Working from home, I wasn’t getting out and seeing people, and my depression began to spiral. Then, as I had feared, my meds stopped working. What enjoyment I could still find in my life evaporated.

I always loved cooking, making up meals from scratch or re-creating dishes I’d eaten at restaurants. No dish was too intimidating. I’ve even tackled molé, the sauce from my father’s hometown of Oaxaca, Mexico. I use chocolate, chiles and two dozen other ingredients. Depression took that away. I didn’t have the energy to cook, or the interest. I started eating out a lot and sleeping more — eight hours at night and several hours during the day. Contact with my daughter fell off. I felt myself sliding deep into the dark tunnel. My mind filled with thoughts of suicide, which led to a five-day stay in a mental health facility.

It was there that my journey into alternative depression therapies started. A psychiatrist recommended electroconvulsive therapy, or ECT, apparently the gold standard for treatment-resistant depression. He explained that in ECT, an electrical current is sent through the brain, triggering a seizure. Mine lasted about 30 seconds. Studies have shown that the procedure can change brain chemistry and effectively alleviate depression. My personal psychiatrist thought this was a good idea. I would stay on medication but add the brain stimulation for my suicidal thoughts. I was anxious about having my brain shocked, but I also felt desperate enough to try.

Trial #1: Electroconvulsive therapy

I signed on for a standard ECT course: three treatments a week for four weeks. First, a nurse would insert a thick foam mouth guard to protect my teeth and tongue, then place a clear plastic mask over my nose and mouth. A silvery bag of pure oxygen was attached to the mask. Each time, I had the sensation of falling backward into a chemical cloud, losing control of my body and mind.

As the oxygen flowed, a doctor came in and connected three nickel-sized pads with electrodes to my chest and temple. An anesthesiologist injected me, and I was out in seconds. The procedure lasted a few minutes, the anesthesia wore off in 30, and a nurse walked me to the front door. Because each treatment involves anesthesia, there’s no driving; a friend had to bring me to and from each session.

After the first treatment, I felt excruciating pain in my jaw. I’d often crawl into bed, exhausted, and sleep the rest of the day. At the end of four weeks, ECT had not improved my depression. I felt dejected, like I’d failed a test most people easily pass. Some side effects still linger: Memory loss is a common one. My recollection of that time is like a moth-eaten blanket. Now and then, the sickening smell of the bag that pushed pure oxygen into me, saccharine-sweet with a chemical undertone, fills my nose from out of nowhere.

Trial #2: Esketamine

Six months after ECT, I read about esketamine, specifically the nasal spray version, called Spravato, approved by the Food and Drug Administration in 2019. Esketamine is a chemical cousin to the anesthetic ketamine, which has been around since the 1960s and used for both medical purposes and as a party drug. Recently, it’s been shown to work for drug-resistant depression. My hopes rose with everything I read. My psychiatrist thought it might work, so a few months later, I visited a psychiatrist who specializes in using Spravato.

In a darkened conference room, I sat in a plush recliner, and a tech handed me a spray bottle. I squirted the medicinal mist into both nostrils and closed my eyes. For an hour, I heard distorted noises that sounded like an air conditioner powering up, a doorbell ringing on repeat, doors opening and closing. Geometric shapes in muted tones marched across my mind from all directions. At first, I thought the sensations meant that the drug was working. But after a few weeks of twice-a-week sessions, my depression and anxiety worsened. My suicidal thoughts remained.

Two of the most promising treatments hadn’t worked for me. I was slipping further into the tunnel and losing hope that anything could turn my depression around. Would I have to quit my job, go on disability, move to a city where other options, such as deep brain stimulation or microdosing the psychedelic drug psilocybin, were available?

Trial #3: Transcranial magnetic stimulation

I had one more alternative within driving distance: transcranial magnetic stimulation. That’s how I wound up with the magnet propped against my head. I read that in one study at Stanford, nearly 80 percent of people with severe depression were free of it after five days of treatment. But I was more skeptical than I’d been about the other two treatments. Magnetic waves would somehow restore chemical balance to my unbalanced brain, specifically to the area that regulates mood? I couldn’t imagine how that would work, but my doctor recommended it. And my blessedly loyal friends, whose hopes rose and fell as I tried and failed with ECT and Spravato, asked what I had to lose. I felt I had no choice but to try it. My course was once a week for six weeks. (Doctors at Stanford University have since reduced the total treatment time to multiple sessions over five days. Their approach received FDA approval in September 2022.)

I didn’t feel anything with TMS; just took a nap and drove myself home afterward. Throughout the treatment, I did not dissociate, hallucinate, seize or hurt. But I was changing. After six weeks, friends told me I seemed different, lighter. In conversation, I wasn’t jittery or jumpy. I made jokes and thought, I’m funny! Where did that come from? My brain was relaxed, and I wasn’t distracted. I wasn’t sleeping so much. I cooked an omelet. And it was good! Slowly I realized; I wasn’t depressed. It was like watching a scar slowly heal and one day realizing it’s no longer visible. I was out of the tunnel, and the skies were bright.

More than two years after my TMS treatment, I feel great, much better than normal because my “normal” was being immersed in depression. I spent years of trial and error before I found the right fit. The experience was frustrating, and at times scary, not knowing if anything was working.

If I could do it over again, I would have started with TMS, the least invasive therapy. But I know doctors recommend ECT because of its long track record. And I know ECT and Spravato work for many people. I suppose the lesson I learned is not to give up. If I had not been open to trying ECT when I was most desperate, I may not have found my way to the therapy that worked. If you find yourself entering a tunnel, ask your doctor for options, and try them all until one works.

If you or someone you care about is considering suicide, call, text or chat the 988 Suicide & Crisis Lifeline.

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Clinton Colmenares is a writer based in Greenville, South Carolina. The smell of garlic, onion and basil once again waft from his kitchen. He and his daughter recently returned from a trip to the Caribbean.