Kate Tolo Tries SAINT: A Five-Day Magnetic Brain Stimulation Protocol for Depression

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Overview

Kate Tolo, co-founder of Blueprint with Bryan Johnson, says she has not been herself for about four years. She had wanted to address her depression for a long time but did not want to start SSRIs. With Bryan's encouragement, she travelled to Kaizen Brain Center in San Diego to undergo the SAINT protocol, an accelerated form of transcranial magnetic stimulation (TMS) that compresses treatment into five days. The film follows her through the week and asks whether it worked. Her own answer shifts from day to day, and she ends up concluding that she is not the most reliable judge of her own state.

13 min read

The Treatment and Its Promise

The video opens by describing SAINT as a depression treatment that is non-invasive, is not a drug, and has a 79% success rate. It is presented as a sprint. Standard TMS usually runs over months. SAINT runs for five days, from 8:00 a.m. to 6:00 p.m., with a 10-minute TMS session every hour followed by a 50-minute break. Across the week that adds up to 50 sessions, and each session delivers about 60 "trains" of stimulation.

A clinician at the center explains that TMS has been FDA-approved since 2008 and has a standard protocol, but that SAINT is more precise. The video notes that the protocol has shown results even in patients with treatment-resistant depression, and that some people notice a difference by day five. For some, Kate says, the change is instant, "like flipping a switch."

Kate's stated motive goes beyond her own recovery. She wants the treatment to work "not just for me but for everyone struggling with depression." She cites figures: about 13% of people in the US are on antidepressants, and women are twice as likely as men to take them. Later she adds that only 35% of people struggling with depression seek treatment, often because they don't see it as serious or feel ashamed to admit it.

Access and Cost

Kate calls TMS "a really good first-line treatment if you can get access to it," and says access is the hard part. She estimates SAINT costs something like $30,000 out of pocket and says getting insurance to cover it is almost impossible. The clinician argues that medications are the first choice not because they are better, but because they are cheaper, easier, and more accessible. Asked whether the treatment could eventually reach everyone, the clinician answers "absolutely." Medicare does cover it, but only in a hospital setting, and the hope is that most insurance carriers will one day cover it too. Kate says she feels very lucky to have access and motivated to make sure people find out the treatment exists.

What Her Depression Looks Like

Before treatment, Kate describes her symptoms. She has trouble understanding herself and staying in touch with her own feelings, and she tends to undermine her own experience. The physical symptom she describes most vividly is getting "stuck." Her body seizes up and she feels she literally cannot move. Some mornings she can't find the motivation even to get up and pee, and that is how she knows it will be a bad day. She estimates it gets that bad about once a week, or perhaps once every two weeks. Asked whether she feels sad, she says she feels "numb."

At the start of the week she fills out a self-assessment. She rates emotional support as good and loneliness as average. She reports irritability, social dissatisfaction, and feeling cognitively impaired and slow. On a series of questions she answered "rarely" to all of them: whether she had a sense of well-being, felt hopeful, found her life satisfying, felt it had purpose or meaning, felt cheerful, felt life was worth living, or had a sense of balance.

Preparation: MRI, Kernel Flow, and Motor Threshold

Treatment starts with an MRI to pinpoint the brain region that will be targeted. Kate recalls wondering during the scan whether her brain, once encoded into ones and zeros, could someday be recreated from that data. If it were, she asked herself, would that brain be having a depressed experience just like hers?

She is also measured with Kernel Flow. Kate explains that Bryan founded Kernel years ago and that the two of them worked on it together. According to her, Kernel has an algorithm that predicts whether a person will respond to TMS. The team also collects resting-state data. Bryan calls in on speakerphone, calls it "the first day of school," and promises her the best week ever.

The final step is calibrating intensity. The technician stimulates until her hand visibly twitches, which gives a reading of 39. Treatment then begins at low intensity and is raised gradually, and Kate can ask to hold it at any level if it becomes too intense. Her first reaction to the stimulation is that she doesn't know how to describe it. She then calls it "electricity mixed with tapping" and notes that her whole face is moving.

Doubts About the Method Itself

Kate admits the method worries her somewhat. She thinks about times in the past when people used strange techniques in medicine, and she expects TMS will probably look archaic in the future. "But that doesn't mean it doesn't work," she adds.

Searching for a Cause

Between sessions, Kate reflects on how her depression might have started. She grew up in a small town in Australia, from "the middle of nowhere," and says she sacrificed a great deal for her career. Then, as she puts it, "we did what we set out to do," which was to play on the global stage. After the virality that followed, something shifted. She had believed in larger systems, but once she was interfacing with them directly she concluded they were "all made up." She began asking what the purpose of anything was, and that period coincided with the depression. She has run through many possible causes, including losing her ambition or her motivation for existing. She acknowledges, though, that "it's hard to know what caused what."

The Grind of the First Days

The first day is more tiring than she expected. She feels tired, a little nauseated, and "out of it." She attributes this partly to being in a tiny room all day and eating differently than usual. Her verdict on the procedure: not painful, a weird and uncomfortable sensation, "but overall something that everyone could do."

On day two she thinks she might be starting to feel better and describes moments when her overall mood felt good. By the end of the day, though, she says she is so tired that she feels "pretty depressed."

Realizing What Depression Actually Looked Like

On day two Kate reaches a realization she calls "mind-blowing." She had been telling herself all along that she wasn't "the picture of depression." Only then did she ask what picture she had been imagining. She had assumed depression would look like an emo experience of sulking all day. She suspects that image came from some deeply embedded taboo that she had never examined.

Looking at herself now, she is surprised at how much she has kept going. She still functions at work and still tells friends she's fine. "My ability to act like everything's okay somehow convinced me that I am okay," she says. This ties into what she describes as a general "self-perception mismatch" with others. Earlier in the week, when she told friends about the treatment, several said they had no idea she had been struggling. She had assumed it was obvious.

Day Three: Doubt, Fear, and Impostor Syndrome

By day three, having finished her first session of ten that day, Kate's doubt grows. She worries it is too soon to feel anything, and then worries she never will. If the treatment fails, would that mean her depression is treatment-resistant? She calls that a scary category. What frightens her most is the possibility that the part of her life when "things were light and easy" and she wasn't in friction with the world is closed for good. She tries to "trust the process."

She also can't shake the feeling that she doesn't deserve the treatment. When she asked a technician what patients are usually like when they arrive, he told her honestly that most are at a last resort. They have tried many things and have little hope left. That revived her impostor syndrome, and she began to wonder whether she is even depressed. That night she says she is "spiraling" and that "the weight of it all feels unbearable," and she records herself in bed in tears.

Bryan's Perspective and the Surprise Visit

On day four, Bryan and his son Tage drive to San Diego to surprise her. By then she has done roughly 35 sessions. On the drive, Bryan explains his reasons. He describes Kate as someone who spends her whole life thinking about other people's needs, and says this is one of the first times he has seen her invest in herself. When she had complained of not feeling well, he asked questions and saw patterns similar to his own experience of depression. He told her he thought she was depressed. She denied it and said she was just stressed and tired, and he insisted. He was familiar with the SAINT research out of Stanford and suggested she try it.

Bryan describes the layers of what Kate is dealing with. Functionally, the two of them build a business together all day. Spiritually, they are trying to "give birth to a new era of humanity." Philosophically, they are grappling with what it means to be human. He speculates that she may have been depressed so long that she no longer knows what not being depressed feels like.

At the clinic, Bryan says her messages have changed and points to her "word construction." Kate denies it. When he asks about the mechanism, she describes it as stimulating a dormant, dysregulated area of the brain back into regulation. He says he has been warning everyone to be ready for a "jump-started Kate." She replies that this hasn't happened yet.

Kate says she had been very sad the previous night and that morning, and the visit "really threw me off" in a good way, giving her "a pep in my step." She then catches herself in a pattern. When they offered to stay, she worried about being a burden. Bryan read her hesitation as a sign that she didn't want them there, and then prepared to leave so as not to burden her. In fact she wanted them to stay. "I gotta stop making it difficult for people to show their appreciation for me," she says.

She is candid about her remaining skepticism. Deep down she is hopeful, but on the surface she doesn't think the treatment will work. That troubles her because she wants the video to give hope to others. If it fails, she won't know whether the cause was her specific kind of depression or the treatment itself, and she would hate for other people to lose hope because it didn't work for her.

Day Five and the Weeks After

On the morning of day five she wakes up feeling good. She has been "very chipper" since the visit and feels "lit up," though she is unsure whether it will last. After her final session, she describes a subtle shift, like a weight she had carried for years finally lifting.

In a later check-in, she describes a "night and day difference." The absence of depression feels like "life is okay." She no longer finds herself at the end of the day wanting to stay up late, eat junk food, or self-sabotage. She adds that her HRV has been steady since treatment compared with other weeks.

The recovery has not been linear. Two nights before the day-five check-in, depression came crashing back while she was with Bryan and Tage, and all her positivity vanished. Since the visit, bad events in her life have sometimes made her dip deep into depression again. She now finds those dips useful, because she can feel how different they are from her new baseline. She also recounts a week of PMS when she feared the depression had returned; once her period began, she felt much better again.

When people ask whether she's better, she says she isn't a reliable person to answer. So she asked those around her, and they told her she's different and that TMS worked. Weighing all of this, she concludes: "I think genuinely TMS worked, which is mind-blowing." Watching footage of herself from before, she thinks she looked "duller."

Looking Back, and Advice

Asked what she would have done differently, Kate says she wonders what would have happened if she had done this sooner. Still, she feels she was so out of control, "just scrambling to get by," that she couldn't realistically have organized it earlier. It would have been nice, she says, to have done it a year ago rather than waiting through years of depression.

Her advice to others centers on denial. The faster you get through the denial phase, the faster you move toward recovery, because staying in denial means denying yourself reality, and without reality you can't put solutions or support in place. She suggests telling a doctor what you've been experiencing and asking what they think, or asking people close to you, as she did. She cautions against over-diagnosing or overcomplicating things, and recommends reducing your situation to "the true raw facts and data." The video closes by telling viewers struggling with depression that they are not alone and encouraging them to reach out to someone they trust.