TMS frequently asked questions.

TMS therapy is a novel approach to achieving remission of depression. It works by non-invasively accessing and stimulating specific regions in the brain that are underactive in depression.

Trained TMS professionals use your unique neuroanatomy to map these regions in the brain and devise a treatment dose that is specifically calibrated to your individual physiology. TMS then uses magnetic pulse waves to help restore function and connectivity between regions of the brain. This is called neuroplasticity.

Depression is a serious illness that affects approximately 350 million people worldwide. While medications may help manage symptoms, many patients are not satisfied with the results they receive from standard medication therapy.

During a TMS session, a special coil is placed on your scalp, usually above or near your forehead. Then, a small magnetic pulse is delivered into your brain, which stimulates the nerves in the area responsible for mood and emotion. The process is totally painless and is thought to help reawaken parts of your brain that depression has slowed or shut down.

A person undergoing TMS therapy typically receives five daily sessions per week for a total of 4 to 6 weeks. The first session lasts about an hour in order to map the individual’s brain and set the dosage needed for each treatment. The rest of the treatment sessions last about 30 minutes each, with the actual time the coil activation occurs lasting anywhere from a few minutes to most of the half-hour. Many people only need the initial set of sessions, while others may benefit from engaging in maintenance sessions. The maintenance sessions happen an average of once per month in order to help maintain the results accomplished in the original sessions.

Because depression and its root causes vary so much, how long the effects of TMS therapy last depends on the individual. In fact, the average person will continue to feel the positive benefits of TMS therapy for six months to a year. These results can range from a decrease in depression symptoms to full remission. Whether or not the person also incorporates talk therapy and medication as needed can influence how long the benefits lasts. Fortunately, the TMS therapy provider will discuss expectations for how long positive effects may be felt and any need to address further sessions down the line.

The biggest benefit of TMS is giving people relief from their depression symptoms when other treatment plans have failed to work. While therapy is often very beneficial for people who are dealing with depression, it only addresses the mental and emotional aspects of depression, not the physical ones. TMS helps to boost recovery from depression by addressing the physical effects that trigger symptoms.

It also presents a safer, less risky alternative to other forms of brain stimulation and is able to be performed in an outpatient setting. In addition, TMS also helps to reduce the risk of death due to depression. It can be utilized as a long-term solution to depression, increasing your chances of being able to live a long, happy, and healthy life.

Transcranial magnetic stimulation (TMS) therapy has many advantages over other types of brain stimulation techniques. It does not require surgery or implant devices, sedation, or anesthesia, and it also carries only a very small risk of seizures. Most people experience very mild side effects that go away shortly after completing the session and become less common as you continue treatment. The most common side effects include:

• Headache
• Lightheadedness
• Scalp discomfort around the area of stimulation
• Tingling, spasms, or twitching of the facial muscles

If you do have these side effects, your doctor can decrease the level of stimulation to help avoid them. They may also recommend that you take a low-dose pain reliever before treatment.

There is a very small risk of additional, more serious side effects for some people. These can include seizures, hearing loss if hearing protection is not worn correctly, and for people with bipolar disorder, manic episodes.

The first treatment takes closer to an hour because we are mapping your unique brain characteristics and calculating the dose based on your motor threshold (MT). Subsequent treatments are usually scheduled for about 30 minutes which includes getting you comfortable in the chair and placing the treatment coil in the correct location. Actual coil activation protocols can be anywhere from a few minutes up to 30 minutes, with 19 minutes being the most common. Most people are prescribed sessions five days a week for 4 to 6 weeks. To add, they typically take place at a doctor’s office or clinic that specializes in this type of treatment.

Your first session will usually be a little longer than subsequent sessions, as your doctor must first determine the most effective magnet placement and intensity for you. You will be sitting in a comfortable chair at a slight recline so that you can relax, and you will remain awake for the entire procedure. You will also be provided with ear plugs to protect your hearing from the noise of the machine. After treatment, you will be able to do your normal daily tasks, including driving and going to work or school.

While TMS may not work for everyone, those that do see results will find their depressive symptoms decreasing or going away entirely within a few weeks of starting treatment. Sometimes “maintenance TMS” will be prescribed, and you will receive treatment once per month on average to help avoid the return of symptoms. If your symptoms return, you can most likely begin a new round of TMS therapy.

TMS is a covered benefit under Medicare and most commercial insurance plans when you’ve been diagnosed with major depressive disorder, and we’re familiar with most plans’ criteria for approval.

Wave is an out-of-network provider, so we don’t bill insurance directly — but TMS is exactly the kind of higher-cost treatment where PPO patients with out-of-network benefits are often reimbursed for a significant portion. We’ll help you understand your coverage and submit your claim. See our Fees & Insurance page for how reimbursement works.