“The Most Impressive Therapy I’ve Ever Tried” — Tim Ferriss On Transcranial Magnetic Stimulation

Summary

In this engaging discussion, the speaker shares their transformative experience with accelerated transcranial magnetic stimulation (TMS), a cutting-edge mental health intervention. They delve into the technology's potential for treating conditions like OCD, depression, and anxiety, emphasizing its high efficacy and durability. The conversation highlights the importance of proper clinical application, the risks of DIY approaches, and the exciting prospects of TMS for performance enhancement and broader therapeutic use.

Takeaways

• 🧠 The speaker has experienced a significant and durable change in their mental state after trying a new mental health intervention.
• 💡 They are excited about the advancements in Transcranial Magnetic Stimulation (TMS), which has seen rapid progress in protocols and targeting.
• ⚠️ The speaker strongly advises against DIY TMS due to the risk of skin burns and worsening mental health conditions if done incorrectly.
• 🛑 There are subreddits and online resources for DIY TMS, but the speaker emphasizes the importance of professional administration to avoid harm.
• 🌟 The speaker underwent 'accelerated TMS', a condensed protocol developed by scientists like Nolan Williams from Stanford, which has shown promising results.
• 🧲 TMS involves using magnetic fields to stimulate the brain, with different technologies like helmets or paddles being used for treatment.
• 🚫 The speaker's experience with TMS has led to a significant reduction in their OCD, anxiety, and depression symptoms, to the point of no longer meeting diagnostic criteria.
• 💤 TMS has also helped with the speaker's lifelong insomnia, improving their sleep quality drastically.
• 🔍 While TMS is showing positive results, the speaker acknowledges that sample sizes are still small and there's much to learn about its long-term effects.
• 💰 The cost of accelerated TMS is currently high, ranging from $5,000 to $15,000 for a 5-day treatment, and is not typically covered by insurance.
• 🚀 The speaker believes TMS could be used for cognitive enhancement and performance improvement in various fields, including sports.

Q & A

What is the most significant change the speaker has experienced in their mental state?

The speaker has experienced the most durable and noticeable change in their mental state on a day-to-day and week-to-week basis after undergoing a mental health intervention involving accelerated TMS (Transcranial Magnetic Stimulation).

What is the speaker's view on psychedelic compounds and therapies?

The speaker believes that psychedelic compounds and therapies can significantly change the way we perceive psychiatry and mental health due to their potential effects on complex PTSD, treatment-resistant depression, and their large effect sizes.

What does the speaker mean by 'tool agnostic' in the context of mental health interventions?

Being 'tool agnostic' means that the speaker is open to various methods and technologies for mental health interventions, focusing on their effectiveness rather than being attached to a specific tool or approach.

What is TMS and how has its application advanced recently?

TMS, or Transcranial Magnetic Stimulation, is a type of brain stimulation that has existed for decades. However, recent advancements in protocols and neuro-targeting have made it more effective, with new iterations allowing for condensed treatment protocols.

Why does the speaker warn against DIY TMS?

The speaker warns against DIY TMS because it can be dangerous if not done correctly, potentially causing burns or worsening conditions. It requires proper knowledge and equipment to ensure safety and effectiveness.

What is the 'saint protocol' mentioned by the speaker?

The 'saint protocol' is a condensed protocol for administering TMS developed by scientists including Nolan Williams from Stanford. It compresses typically lengthy TMS treatments into a shorter period, such as 50 sessions into five days.

What was the speaker's experience with accelerated TMS and its impact on their mental health?

The speaker underwent two rounds of accelerated TMS and reported a significant improvement in their mental health, noting that after three months, they no longer met any diagnostic criteria for OCD, anxiety, or depression.

How did accelerated TMS affect the speaker's sleep?

The speaker, who had lifelong insomnia, reported that after the accelerated TMS sessions, their insomnia effectively disappeared, resulting in the best sleep they've had in decades.

What are some potential side effects or risks associated with TMS?

While TMS is generally well-tolerated, it can, in rare cases, trigger seizures. There is also the risk of worsening conditions if not administered correctly, and it may have unintended effects on other aspects of mental health.

What does the speaker suggest about the future of TMS in terms of accessibility and application?

The speaker suggests that TMS will become more widely available and accessible within the next 6 months to 12 months, and may be used for performance enhancement in various fields, including sports.

What advice does the speaker give regarding choosing a TMS provider?

The speaker advises looking for providers with real clinical experience, those working with established hospitals, and having a good reputation. They warn against 'fly by night' operations and emphasize the importance of proper due diligence.

Outlines

00:00

🧠 Innovative Mental Health Treatments: TMS and Psychedelics

The speaker discusses their most significant personal mental health improvement due to treatments, particularly highlighting the impact of accelerated transcranial magnetic stimulation (TMS). They've been involved in psychedelic research for its potential to revolutionize psychiatry, but emphasize a tool-agnostic approach, seeking high-impact solutions. They've recently explored TMS, noting advancements in protocols and targeting. Warning against DIY TMS due to safety risks, they share their positive experience with accelerated TMS, which contrasts with conventional long-term treatments. The speaker mentions undergoing the treatment with Brain Sway and Magnus Ventures, resulting in no longer meeting diagnostic criteria for OCD, anxiety, and depression after just two sessions.

05:01

🌱 TMS's Therapeutic Promise and Personal Impact

This paragraph delves into the speaker's personal experience with TMS, noting its profound effect on their OCD, anxiety, and insomnia, to the point of no longer meeting diagnostic criteria for these conditions. They share specific examples of improvements, such as their lifelong insomnia being effectively resolved. The speaker also addresses the variability in individual responses to TMS, the potential for it to worsen conditions in some cases, and the importance of professional administration. They discuss the current state of TMS research, its cost, and the potential for wider availability and acceptance in the future, while cautioning against non-professional or 'fly by night' TMS providers.

10:02

🚫 The Risks and Realities of DIY TMS and Unregulated Services

The speaker warns against the dangers of DIY TMS and unregulated services, likening it to untrained individuals offering shamanic healing or unprofessional clinics offering TMS alongside unrelated services. They emphasize the sensitivity and complexity of the brain's circuitry, the potential for misuse of TMS to cause adverse effects, and the importance of seeking treatment from credible, experienced professionals. The speaker also shares a personal anecdote about a temporary side effect affecting their sexual function, illustrating the need for caution and professional guidance in TMS treatment.

15:03

🛑 Future Prospects and Considerations for TMS Therapy

In the final paragraph, the speaker expresses a desire to withhold specific treatment recommendations until they have more personal experience and can assess long-term durability. They mention an interview with Dr. Nolan Williams for those interested in a deeper understanding of TMS. The speaker also touches on alternative theories of mental health conditions, suggesting TMS could correct the firing sequence of brain structures. They highlight TMS as a well-tolerated treatment with low risk for most people, and note its potential use in performance enhancement and for individuals for whom psychedelic therapies are contraindicated.

Keywords

💡Psychedelic Therapies

Psychedelic therapies refer to the use of psychedelic substances in conjunction with psychological support to treat various mental health conditions. In the video, the speaker mentions their involvement in supporting research related to these therapies, highlighting their potential to change the perspective on mental health due to their significant effects on conditions like complex PTSD and treatment-resistant depression.

💡Transcranial Magnetic Stimulation (TMS)

TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. The script discusses the speaker's experience with a newer iteration of TMS, called accelerated TMS, which has shown promising results in treating mental health conditions with a condensed protocol, as opposed to traditional TMS that may require treatments over many weeks or months.

💡Mental Health Intervention

A mental health intervention is any treatment or therapeutic approach used to improve mental health conditions. The video emphasizes the speaker's excitement about the effectiveness of accelerated TMS as an intervention, describing it as the most impressive they have encountered in the last decade.

💡Obsessive-Compulsive Disorder (OCD)

OCD is a chronic mental disorder characterized by intrusive thoughts and repetitive behaviors. The speaker discusses their personal struggle with OCD and how accelerated TMS has helped them no longer meet the diagnostic criteria for the condition, illustrating the potential of TMS in treating mental health disorders.

💡Durability

In the context of the video, durability refers to the lasting effectiveness of a treatment over time. The speaker emphasizes the durability of the changes they experienced after undergoing accelerated TMS, noting that the effects have been noticeable and long-lasting, unlike some other treatments.

💡DIY (Do It Yourself)

The term DIY is used in the video to caution against attempting to perform TMS at home without proper training and equipment. The speaker warns of the risks associated with self-administering TMS, including the possibility of causing harm or worsening conditions.

💡Neurotargeting

Neurotargeting in the context of TMS refers to the precise targeting of specific areas of the brain for treatment. The script mentions the advancement in protocols and neurotargeting that has occurred in recent years, allowing for more effective treatment of various mental health conditions.

💡Effect Size

Effect size is a measure of the strength or magnitude of the impact of a treatment or intervention. The speaker discusses the large effect size of accelerated TMS, indicating that the treatment has a significant impact on mental health conditions and is more effective than many conventional treatments.

💡Boosters

In the video, boosters refer to follow-up treatments that may be necessary to maintain the benefits of a therapy like TMS. The speaker mentions that most people will require boosters every 3 to 6 months, suggesting that while TMS is effective, it may not be a one-time cure for all conditions.

💡Productivity vs. Calmness

The speaker contrasts the concepts of productivity and calmness, noting that while TMS has made them less productive in some ways, it has also brought a sense of calmness that they value more. This highlights the potential trade-offs between the immediate benefits of certain treatments and their impact on overall well-being.

💡Parasympathetic vs. Sympathetic

The sympathetic and parasympathetic systems are parts of the autonomic nervous system, responsible for the 'fight or flight' and 'rest and digest' responses, respectively. The speaker discusses an unintended side effect of TMS where their sympathetic response was dampened, affecting their ability to orgasm, illustrating the complex interplay between mental health treatments and physiological responses.

Highlights

The speaker has experienced a significant and durable change in their mental state after trying a new mental health intervention.

The intervention discussed is an advanced form of TMS (Transcranial Magnetic Stimulation), which has seen rapid advancements in protocols and targeting.

The speaker warns against DIY TMS due to the risk of skin burns and worsening conditions.

Accelerated TMS is a condensed protocol that compresses 50 sessions into 5 days, developed by scientists including Nolan Williams from Stanford.

The speaker underwent two rounds of accelerated TMS with different technologies, resulting in no longer meeting diagnostic criteria for OCD, anxiety, and depression.

Accelerated TMS has shown remarkable effects on conditions like complex PTSD and treatment-resistant depression.

The speaker emphasizes the importance of not DIYing TMS due to the sensitivity of brain circuitry and the potential for adverse effects.

TMS is expected to be used for performance enhancement in various fields, including sports.

The speaker noticed a decrease in productivity but an increase in calmness after the TMS treatments.

TMS can be used to change trait hypnotizability, indicating its potential for various psychological applications.

The speaker experienced a temporary inability to orgasm due to the TMS treatment affecting sympathetic response.

TMS is generally well-tolerated with rare risks of triggering seizures, making it a safer alternative for some individuals.

Psychedelic-assisted therapy is contraindicated for some individuals, but TMS may offer an alternative treatment option.

TMS may correct the firing sequence of different brain structures, potentially addressing the root cause of conditions like depression.

The speaker is cautious about recommending specific TMS clinics until they have more personal experience and data on durability.

The cost of accelerated TMS is currently high, ranging from $5,000 to $15,000 for a 5-day treatment, but may become more accessible in the future.

The speaker suggests looking for TMS providers with clinical experience and established hospital affiliations for safety and efficacy.

Transcripts

it has been the most

durable noticeable on a day-to-day week

toe basis change in my state that I have

ever experienced uh so I want to switch

gears a little bit and mention something

that I'm incredibly excited about which

is the most impressive let's call it

mental health intervention that I have

encountered in the last 10 years so as

some of you may know I've been very

involved with supporting a lot of

research basic science and so on related

to psychedelic compounds and psychedelic

therapies that has been because I

believe they can really change the

lenses through which we look at

Psychiatry mental health and so-called

mental disorders completely due to some

of the effect sizes and durability of

say effects on complex PTSD treatment

resistant depression and so on

but I'm actually tool agnostic just like

with startup investing I'm looking for

uncrowded Bets with super high leverage

potential

outcomes I'm quite agnostic about the

tools and I will say and you and I have

talked about this privately a little bit

but in the last let's call it year

especially the last six months I've done

a very deep dive on a new iteration of

an older technology which is TMS trans

cranial magnetic stimulation so this is

a type of brain stimulation the

technology has existed for a number of

decades but the protocols and the neurot

targeting has advanced really quickly

there was the full subreddits where you

could go and learn how to do it yourself

at home don't DIY this do not people

were literally having burns on their

skin doing it yeah this is Darwin Awards

territory don't do this

guys in part because you can make things

a lot worse if you don't do it the right

way but to to to the punchline I have

gone through two rounds of something

called accelerated TMS you can learn a

lot about this by looking at a number of

scientists including Nolan Williams out

of Stanford I did an interview with

Nolan on the podcast for people who want

to do a deep dive and they developed

what was previously known it's gone

through summary branding the saint

protocol which is a very condensed

protocol for administering TMS so you

have these magnets they elicit in this

case Theta burst and typically you might

have TMS treatments over the span of

many weeks many months they're

compressing 50 sessions into 10 days or

actually 50 sessions into five days

excuse me pause for one second though

for people that don't know what does

this look like for you you said magnets

I'm I'm thinking like you know I don't

know what I'm thinking but like what do

you what are you actually doing are you

hooking [ __ ] up to your head are you in

a lab are you doing it at home you're

not doing it at home so you are in a

clinic or lab and there are different

iterations of this so my first round was

with a uh company called brain Sway and

they use a particular H7 coil they're

developing new technologies that's

effectively a helmet that you then

attach to your head with a chin strap

and based on specific targeting

depending on the condition you're trying

to address which could be depression

treatment resistant depression could be

generalized anxiety disorder could be

OCD any number of things

right Ed sure everybody's got their

thing if there's magnetic Viagra then

there's a whole new business I need to

invest in so yeah sure

and and then the second round was with

uh Magnus Ventures and a different

slightly different technology but it

effectively looks like a paddle that is

placed on the head and they use computer

vision and and pretty sophisticated

targeting but the upshot of this is

going into it no one will be surprised I

remember when I had my first diagnostic

interview with one of these

psychiatrists and we went through this

long multi-hour process and they said

you know you score X Y and Z and it

seems like you have moderate to severe

OCD and they're like this might take a

little while I know this is heavy news

if we need to take a break and I was

like are you kidding me like this is no

one this is a surprise to no one like

let's move

on so I went in with pretty high

assessment scores for just to simplify

the whole thing OCD which looking at my

family you'd be like yeah obviously and

then anxiety and a lot of long-term

listeners will know bouts of uh

depression um that also is is pretty

much kind of genetically

hardwired did these two sessions and

with 3 months so far of durability no

longer meet any diagnostic criteria for

any of those

it has been the most

durable noticeable on a day-to-day week-

toe basis change in my state that I have

ever experienced can you give me or if

you care to share can you give me

something like let's just say on the OCD

side where you were doing it previously

you had the treatments and now it's no

long yeah I give examples and I should

say your mileage will vary and the

sample sizes are still very very small

for Accelerated TMS which is I'm an

early stage guy too right like I like to

get involved but there are many unknowns

many open questions they're still in I

want to

say sub you know thousands in terms of

subjects in some cases for say OCD it's

probably fewer than 200 would be my

guess I'm I'm making up some of these

numbers but I don't think they're very

far off so there's still a lot to figure

out but as an example I've had lifelong

onset insomnia where my brain will just

not quiet down you know my mind is like

I've been waiting all day to talk to

you you know

and and it can take me an hour two hours

to fall asleep in three months that's

effectively gone to zero none of that

the best sleep I've had in a in decades

do you look at Aura data as well to see

like am I getting the proper deep sleep

am I getting you know I haven't gone

super granular I recognize the how that

could be helpful in a sense but I really

feel like we

can Outsource

our awareness

to devices and metrics where it's it's

pretty well you know when you wake up if

if the effect size is large enough it

should be pretty

obvious and I will say just there are

some people who respond inversely to

this right it can worsen some people's

conditions

I've seen a number of lives transformed

we have the most data for depression by

far and if you talk to really competent

sophisticated psychiatrists who have

looked keep a breast of the latest

technology they will say finally TMS is

delivering on what we hoped it would

deliver like the promise is finally

finally we're seeing some of the results

we were hoping to see so there's been so

many devices even at home devices that

claim to do you know TMS that you can

you can literally I've seen them on

Amazon yeah but here's the the real

question is like okay obviously you did

all the proper due diligence around

figuring out who's the best the best in

this business that's actually doing the

real science how soon until that

actually propagates out to clinics where

you would feel comfortable saying okay

Now's the Time when the average person

can go and do

this it it's hard to say I I will say on

a widely distributed basis but that's

also like uber black got all this

criticism early on and then those people

subsidized the development of Uber X and

overtime cost went down and that's how

what's the price well I would say it

ranges at this point because insurance

will not cover accelerated TMS at least

as far as I'm aware from let's call it

if we're looking at competent

well-trained outfits who are vetted 5 to

15K for that 5day period but here's the

thing

depending on your conditions depending

on your resources if you were to ask me

how much would you pay to go back 20

years and have this treatment I'd be

like take half my net worth it's fine

like the the payoff is the payoff is so

noticeable now it's not a silver bullet

nor are psychedelic assistant therapies

by the way it's not one shot one kill

with conditions so most people will go

back for boosters every 3 to six months

for say a single day of of treatment not

necessarily 5 days but the when I say

effect size people can look this up but

the magnitude of change and durability

is so far

beyond pretty much any conventional

treatment that I can think

of especially if you exclude maintenance

therapies that are really just covering

symptoms or suppressing

symptoms I'm very very excited about

this in terms of time I can't I couldn't

tell you I think that it will be more

widely available at retail where people

pay out of pocket in the next 6 months

to 12 months how will someone know if

that has been the same thing that you're

doing is there like a is there some type

of like certification or what what do

you look for because I've seen these

types of clinics I've seen it being

offered in various places yeah I would

look for people who have real clinical

experience who are working with

established hospitals and have some

bonafides there's a lot of Fly by Night

TMS operations just like there are lots

of rent of shamans on like Craigslist

and

Facebook who did some weekend yoga

course in Costa Rica and suddenly

they're going to save your soul probably

not a great idea similarly if it's like

yeah we run a you know dentist office

and we offer TMS like maybe you don't do

that or like the people are like yeah we

will fix your nails and give you

semaglutide like you mix in the bathroom

like maybe you don't do that so I I

think you know Common Sense applies but

it has been really fascinating and the

reason you don't want to DIY it or one

of the many many reasons you don't want

to DIY it is that you're dealing with

very sensitive circuitry right this

whole thing in our heads as far as I

know is powered on roughly the

electricity of a light bulb we really

don't know how it works how we are able

to function at such a high level I

suspect there are all sorts of and this

is true for all faction like Quantum

effects many many complicated mechanisms

that we just do not understand and when

you're

applying a magnetic pulse to your

brain you are and this is simplified but

you're either activating or

deactivating right enhancing or

suppressing some degree of activity or a

network of activity and if you screw

that up you can get the opposite of what

you're looking for is there any real

time like feeling like when you're there

are you like seeing [ __ ] feels like

someone flicking the side of your head

there are no visuals or anything but you

feel like someone's flicking the side of

your head and each day you feel like you

ran a mental ultramarathon like if you

were cramming for the lsats every day

for 15 hours straight that is the degree

of mental exhaustion it's very tiring do

you find that it's improved your

cognitive tasks like are you like able

to like is there any performance

enhancing benefits to this as well well

I do think TMS is going to be used for

for performance enhancement I think it

could be used for sports enhancement and

many things so I I do think especially

in the world of anti-doping and so on

that athletes are going to start to use

TMs pre-competition for enhancing who

knows visual Acuity reaction speed

that's going to happen for sure because

you can already use TMs to change trait

hypnotizability like if you want to make

people more susceptible to being

hypnotized you can use

this it's going to get super wild really

quickly I will say that one thing I

noticed on the Plus or negative side

depending on how you look at it is

that I've been so much less productive

in the last few months you seem really

chill right now yeah super

chill here's what I would say I wouldn't

trade the productivity for my current

sense of calmness and I was chatting

with therapists about this and they said

well I think for a lot of people that

anxiety is used as a fuel to work

to basically run away from things not

run towards things and I was like yeah I

could see that that doesn't seem

shocking to me so you know question I've

tried to ask myself with a lot

of different projects is am I am I

running away from something or am I

running towards something that seems a

very important distinction to

make and also another reason not to DIY

this is in a lot of cases you're let's

just say in the case of anxiety so you

have too much

like fight ORF flight or freeze let's

just say so you want to dampen that a

little bit so you can move around

without being a head case okay great you

still need some of that fight or flight

in your life so you can over dampen that

or maybe you want to increase your

parasympathetic

response this is going to be very

personal I didn't really think I would

talk about this publicly but so there's

there's a shorthand in medical school

they say point and shoot in other words

parasympathetic to get an erection

sympathetic to orgasm both of those are

really important so after I got my

sympathetic smashed I couldn't orgasm

for like two weeks and I was freaking

the [ __ ] out I was like did I just

completely screw up my hard wirring like

I'm never going to orgasm again that

seems like a high tax to pay uh [ __ ] you

know was the engine there scary moment

like you didn't have a problem with the

thing the point no no okay it was just

the finish it the shoot that was Jesus

man so like that could freak you out or

let's say like this is classic Tim

Ferris like early like trying the

craziest [ __ ] you know I'm taking the

bullet so other people don't necessarily

have to but these are all reasons why

you don't want to buy a kit on Amazon

and just start sapping your brand while

you're watching Netflix yeah all right

unless you're fast and you need to slow

down you know if somebody else wants to

run that N1 like knock yourself out but

I'm not going to do that any moving on

so last question and then we can move on

is there a website or anything where

where you went like where did you go if

someone's listening to this and they're

like I want to go where Tim went yeah I

mean this is where I would like to have

and this is not for any reason other

than I'm going to I'm going to defer on

that just because I want to have some

more experience also I want to do a

followup I want to see what the

durability looks like before I start

recommending outfits I appreciate that

so I will do that I'll have more to say

about this but for people who want to do

a deep dive Dr Nolan Williams and the

podcast that I did with him touches a

lot of this I will also say just a quick

note which

is there are some theories around say

depression which are not chemically

focused so instead of like oh serotonin

imbalance this imbalance which is a

little Antiquated in a bunch of Senses

it's not that it is a nonvariable but it

doesn't seem to be the primary

determinant it could be that different

structures in the brain are firing out

of sequence and you can use the TMS to

correct that sequence so instead of

firing like BAC it's like oh well let's

slightly tweak that system so it's

firing in what we see in normal health

is which is

ABC pretty interesting yeah to be able

to basically just reset the the trip

wire sequence yeah so something I think

we'll be hearing a lot more about in the

next handful of years and it is better

tolerated than most medications like

from a risk profile perspective for most

people in very rare cases it can trigger

seizures like there are adverse side

effect potentials but for the vast

majority very well tolerated so I'm I'm

excited about it because for instance

psychedelic assisted therapy is

contraindicated for lots of people there

are many people who should not take this

or engage in in that type of therapy too

many risks involved people with say

Borderline Personality Disorder with

family history of schizophrenia Etc but

they wouldn't NE be automatically

excluded from doing something like

accelerated TMS yeah so that's exciting

to me