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Fargo psychiatrist using high-energy magnetic beam to treat depression

Dr. Rachel Fleissner, who has a private practice in Fargo, explains that the "transcranial magnetic stimulation" treatment for depression directly affects for 30 seconds a part of the brain the size of a quarter. Michael Vosburg / Forum Photo Editor

Joan Scheveck was so withdrawn that even idle chitchat was an enormous mountain she often couldn't climb.

She thought she'd managed to conceal her depression - she confided about it only to her husband and grown daughter - but the problem was obvious to her friends and relatives.

"I guess I wasn't doing such a good job with my happy face," she says.

It's not that Scheveck, a retired telephone operator, denied to herself that she suffers from clinical depression.

The 71-year-old Fargo woman has been in treatment for years. But a series of medications had run its course. Nothing seemed capable any more of lifting her out of her debilitating gloom.

Then she decided to give a new type of treatment a try. She went to the office of her psychiatrist and sat in a plush blue chair that looks like something a dentist might use.

Except this chair is equipped with a metal coil that transmits magnetic energy beams into her brain in alternating pulses of four seconds on, 30 seconds off, in sessions lasting half an hour.

She had a series of treatments starting before Thanksgiving and ending around Christmas.

"In three sessions I could feel there was something going on in my head that was different," she says. "It was more clear."

Dr. Rachel Fleissner, a psychiatrist in private practice in Fargo, recently began using the technique - transcranial magnetic stimulation - after one of her patients experienced good results following treatments in Atlanta.

The method, approved three years ago by the U.S. Food and Drug Administration but used earlier in Europe and Canada, is employed by a number of leading medical centers around the country, including Mayo Clinic, Massachusetts General Hospital in Boston and John's Hopkins Hospital in Baltimore.

Before making the significant investment to buy the FDA-approved equipment for her clinic, Fleissner immersed herself in literature about the technique, which is reserved for patients for whom standard medication has proven ineffective.

Fleissner, who was a bit skeptical before the device was approved, became a believer after witnessing the results experienced by her patients.

"We feel that our area deserves these cutting-edge treatments," she says. "North Dakota has a huge rate of depression because of where we live."

Most patients require 20 to 30 treatments, Fleissner says. Some patients require several follow-up, "booster shot" treatments.

The rhythmic sensation of the invisible pulses of energy is palpable, experienced as a tap on the head.

"The only way I can tell you," Fleissner says, "is it feels like a little woodpecker."

That therapeutic "woodpecker" tap comes without any of the side effects common to medications used to treat depression, including weight gain, loss of sexual desire, sweating, dry mouth, and even cardiac problems.

To help patients relax during treatments, Fleissner and her nurse can play soothing music, use bright lights, or light scented candles.

"We've certainly had some patients fall asleep," Fleissner says.

The magnetic energy is focused on an area of the brain about the size of a quarter, located in the frontal lateral cortex. The energy seems to stimulate production of chemicals in the brain, "neurotransmitters," to alleviate depression.

Sophisticated brain scan images show that the improved production of neurotransmitters, and associated brain activity, spreads beyond the area treated with the magnetic energy.

As with Scheveck, many patients feel a restoration of clarity following the treatments.

In rare cases, patients can experience seizures from the magnetic treatments, although some patients had conditions that predisposed them to seizures. Doctors at Walter Reed Army Hospital are using it to treat post-traumatic stress disorder among combat veterans.

As for cost, Fleissner declined to give specifics but urges prospective patients to contact her clinic, which can work out payment plans.

Scheveck, who had to tap her savings for the treatments, says she only became aware of how isolated her depression left her until after the treatments made her feel better.

"You just don't realize how far down you are and what you look like," she says.

Readers can reach Forum reporter Patrick Springer at (701) 241-5522