Crippling Depression Treated With Magnets By Pioneering Brooklyn Doctor

WILLIAMSBURG, BROOKLYN — Dr. Owen Muir doesn’t expect his patients to believe a helmet lined with magnets can cure their life-crippling depression. The people who see him are desperate who've tried every other known means of curing their seemingly relentless sadness.

So when Muir tells them a magnetic hat could be the answer, they scoff.

This is when Muir tells his patients the fact that convinces them – every time.

“It worked for me,” he says.

Muir is the medical director of Brooklyn Minds, a Williamsburg psychiatric center on North First Street that offers a non-invasive treatment for severe depression called deep transcranial magnetic stimulation – or deep TMS.

Muir first became fascinated by deep TMS during his fourth year of residency with the North Shore LIJ Health System in 2015. He was about to graduate, marry and begin the prestigious fellowship in child psychiatry at the NYU Langone Medical Center that had been a lifelong dream.

And he was incredibly depressed.

“Everything was great in my life,” said Muir, who lives with Bipolar Disorder. “My brain didn’t know it.

His disorder had forced Muir to check himself into a psychiatric ward once before, but he didn’t want to return. It wasn’t just that hospitalization would mean missing graduation and put his future at stake. Muir dreaded being a patient.

“If you’re a psychiatrist and you go to a psych hospital, they still treat you like sh--,” he said. “There were not a lot of charitable assumptions being shared.”

So Muir went to his psychiatrist and asked if there was another treatment he could try that would get him back on track.

According to Muir, his doctor said, ‘Let’s try this TMS thing.”

Deep TMS was new then, and it’s still relatively new now. The FDA only approved its use for depression in 2013 and scientists only began studying the effect of TMS treatments on humans in the 1990s.

It is the next step in a progression of medical treatments that fight mental disorders right at the source, the neurons or, as Muir likes to think of them, “the wires of the brain.”

But unlike alternative treatments such as medications, deep brain stimulation or electroconvulsive therapy, deep TMS doesn’t come with a long list of side effects – and it doesn’t involve a doctor opening up your skull.

The technology — patented by the U.S. and developed by a company called Brainsway — works by creating a magnetic field in the area of the brain where the mental disorder lives and fixing the rhythm of the local neurons that have gone slightly wrong.

Depression is caused by hypoactive — or slow — neurons in the left dorsolateral prefrontal cortex. When Muir puts the deep TMS helmet on one of his patients, tips it forward and turns it on, it creates an electrical field that changes when those neurons fire up.

Patients undergo daily treatments over the course of several weeks, until the pattern corrects itself. Soon, the neurons are lighting up on a normal pattern without the help of the helmet — and that’s when people start to feel better.

“It’s magic,” said Casey Wilen, a medical technician at Brooklyn Minds. “It’s science, but it’s magic.”

Wilen works with Muir to help calibrate the machine to make sure it hits its target in the patient’s brain, then she and Muir prepare the faulty neurons for treatment. This is not done with technology. In some cases, it could be done with gin.

That’s because deep TMS only works when patients are mentally engaging with their problems, and lighting those neurons up themselves.

Muir has set up three posters in direct view of the machine that he uses to help his patients with Obsessive Compulsive Disorder. He turns on the machine, then tips one of the pictures to the side, screwing up the symmetry, and driving those errant neurons wild. Muir’s patients with PTSD talk through their “trauma narratives” and alcoholics sniff and swish their drink of choice.

People with depression don’t need to feel sad for the treatment to work — they actually need to feel a little cheerful.

So Wilen has become an expert at elevated small talk — she’ll discuss favorite television shows and hobbies — and if that doesn’t work, Muir has a picture book of sleeping cats that are “too cute to handle.”

More often than not, Wilen sees the change before her patient does. “People don’t realize they’re getting better.” she said. “They’re used to that identity.”

But Wilen has also seen people make rapid changes. One patient, whom she noted was not “a believer,” walked in one day and told her, sounding stunned: “I feel better.”

“Sometimes the change is very rapid once you find the dosage,” said Wilen. “The lightbulb goes off.”

That’s how it happened for Muir. He still remembers his first deep TMS treatment on the Upper West Side, back in 2015. When he walked in, he was “like a zombie, a robot whose batteries have run out,” he said.

When he walked out, he was shocked to find himself hungry.

“I still remember the restaurant, it was Hummus Place,” said Muir. “I had this big meal; hummus, falafel, baba ganoush. It was delicious.

“I hadn’t felt hungry in months.”

Muir went on to marry his wife, complete his fellowship and, in April, 2017 he began offering the treatment that made his new life possible to patients in Brooklyn.

Muir estimates that he’s treated about 30 patients since he began offering deep TMS, and of those patients, only one didn’t see results because he stopped coming into treatment, according to Muir.

The others have had positive responses. Muir recommended deep TMS to a patient who suffered a depressive episode. She underwent three weeks of treatment and told him that she’d had a complete change of attitude.

“I didn’t know it was possible to feel this good,” she said. “And by the way, I’m dating a supermodel.”

Muir laughed. “Well, I can’t promise those results for everybody.”

Another patient came from the West Coast to receive treatment because she was considering suicide on a daily basis.

“Her friend told her, ‘You’re thinking about killing yourself every day, hanging yourself in your barn. Stop f---ing around.”

That same patient now sends Muir pictures of herself happily baling hay, he said.

At a recent event called Experiment Salon at Brooklyn's Union Hall, at which audience members watch scientific presentations and guess if they are real or made up, only 42 percent of the audience believed Muir might be telling the truth after he said, “I can fix your brain with magnets.”

Preliminary studies have not disproved this assertion, but as deep TMS researchers published in the Journal of World Psychiatry noted in 2015, the studies have been limited to depression that does not respond to other treatment and more research is needed to suss out its potential to treat other conditions.

Which is why the FDA has only approved deep TMS treatment for depression in the United States while in Europe and Israel, the magnetic therapy is being tested as a treatment for cocaine addiction, autism, Parkinson's disease and multiple sclerosis-related fatigue, among others, according to Muir.

The hope is that deep TMS — which can go, well, deeper than its predecessor, TMS — will be able to target those wider array of disorders that exist deeper in the brain.

In a test run by Patch, our reporter sat in a comfortable, black leather armchair as Wilen fitted he with a blue skull cap then lowered a helmet that resembled a salon hair dryer onto her skull.

“I’ll pinch your shoulder when I’m about to start,” she said.

As Wilen calibrated a low dosage — 30 percent on the frontal lobe — Muir said to expect a tap on the forehead, a woodpecker sound, and a possible headache later in the day.

That’s exactly what happened — a woodpecker seemed to knock on the reporter's forehead three times and she felt mildy aware of her brain a couple hours later.

The downside to deep TMS treatment, according to Muir, is that it can hurt. There is a one-in-30,000 chance it could cause a seizure and, at $450 a treatment, it’s prohibitively expensive.

Most health insurance companies will cover the treatment, but only for patients who have tried four trials of medication, two trials of psychotherapy and don’t not have other issues. It is not covered by Medicaid.

But Muir is hoping that his work will contribute to a growing amount of research that has shown deep TMS to be both safe and effective, and make it more widely accessible.

Muir still remembers the day he came back from completing his own deep TMS treatment and demanded that his advisor help him research the burgeoning solution to what can be a fatal disease — hopelessness. His mission hasn't changed since that day, Muir said.

"I have to know more."

Photos by Kathleen Culliton