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Transcranial magnetic stimulation (TMS) is a non-invasive and painless procedure that uses electro-magnetic coils to stimulate the left prefrontal cortex of the brain.

Phil Quin is scathing about the usual advice handed out to those who are depressed – get some exercise, connect with people, that sort of thing. He’s had times when he has been unable to will himself to get out of bed to turn off the light, such is the paralysis that comes with severe depression. “People who say go to the gym might as well say go to the moon,” he maintains.

For a long time Quin, an expat Kiwi who works in politics and communications, self-medicated with alcohol. It was after he had stopped drinking and taken a job in New York – one that he describes as “horrible and soul-destroying” – that he began contemplating suicide for the first time. 

“Every day I’d be standing on the platform of the subway asking [myself] if I had the courage to put myself under the third rail.”

Now, even Quin’s best days are blighted by the fear of the next bout of depression he knows is coming. Therapy and medication have only every offered temporary relief. He feels unable to take a full-time job and has been moving from place to place stitching together a living from short-term work – currently he is in Colombia taking advantage of the lower cost of living.


Phil Quin.


Returning to New Zealand isn’t an option as he says he has learnt from experience that while we’re doing pretty well on the awareness front, we’re lagging behind when it comes to treatment for depression.

He is pinning his hopes on transcranial magnetic stimulation (TMS), a technique for resistant depression that is more widely available overseas than here – it has been approved by the US Food and Drug Administration and there is increasing access to it in the UK public health system.

In New Zealand, there is only one psychiatrist offering the treatment, Dr Rui Mendel of Auckland’s Healing Minds clinic. Mendel puts this down to the high cost of investing in the necessary equipment, rather than the effectiveness of the treatment. TMS is a non-invasive and painless procedure that uses electro-magnetic coils to stimulate the left prefrontal cortex of the sluggish depressive brain.

“It pushes the brain to function at a normal level,” says Mendel, and for many people, it’s life-changing. “The evidence we have is that 70% of those who don’t respond to any other treatment will improve, and about 30% will have a full recovery. 


Dr Rui Mendel.


“You notice a difference by the end of the second week. People may have been crippled by depression for years and they start to sleep better, have energy, are more able to enjoy life.”

Some patients need to return at a later date for a two-week boost, but others Mendel never sees again. So long as there are no contraindications – for example, a metal plate in the head, heavy drinking, some medications – there are no side effects beyond possible facial muscle twitching during the treatment and a mild headache afterwards, which responds to paracetamol.

TMS costs time and money – four weeks of daily 30-minute sessions is required, which will set the patient back $1375 a week. Mendel gets referrals from the public health system, but only for those who have the means to pay. 

“Compared to surgical procedures, it’s cheap,” he says. “It’s a shame that insurance companies and the Government don’t fund it.”

This article was first published in the September 9, 2017 issue of the New Zealand Listener.