Most people who come to Junction Brain Health have already tried medication. Some have tried more than one. A few have tried several — adjusting doses, switching formulations, waiting the six to eight weeks it takes to know whether something is working.
For many, medication helps. But for a significant number of people with depression, it doesn’t — or it stops working over time. If that’s been your experience, it doesn’t mean treatment is hopeless. It may mean that a different approach is needed.
TMS therapy is that approach for many patients.
What Antidepressants Are Actually Doing
Antidepressants work by changing the chemical environment of the brain — most commonly by increasing the availability of serotonin, norepinephrine, or dopamine. For a large portion of people with depression, this is genuinely effective. The brain’s regulatory systems respond to the change, and mood stabilizes.
But depression isn’t purely a chemical problem. It’s also a circuit problem. Specific regions of the brain — particularly the prefrontal cortex, which is involved in mood regulation, motivation, and decision-making — can become underactive during a depressive episode. When that happens, adjusting brain chemistry alone may not be enough to restore normal function.
This is where antidepressants have a ceiling, and where TMS works differently.
What TMS Is Actually Doing
TMS stands for Transcranial Magnetic Stimulation and works by delivering targeted magnetic pulses to specific areas of the brain — typically the left prefrontal cortex — to stimulate neural activity in regions that have become underactive.
It is not electroconvulsive therapy. It does not involve sedation, seizure induction, or any electrical current passed through the body. Patients sit in a chair, remain fully awake, and return to their normal activities immediately after each session.
What TMS does is help the brain essentially relearn how to regulate itself. The repeated stimulation over a course of treatment — typically around six weeks — encourages the targeted circuits to become more active and responsive. For many patients, this produces meaningful and lasting relief.
Who TMS Is Designed For
TMS thereapy is FDA-cleared for major depressive disorder in patients who have not responded adequately to antidepressant medication. It is also cleared for OCD and has been studied extensively for anxiety, PTSD, and other conditions.
The clinical term for what TMS is designed to address is treatment-resistant depression. But that label can be misleading. It doesn’t mean someone is beyond help. It means that the approach that works for many people — medication — hasn’t worked well enough for them. That’s not a personal failing. It’s a reflection of how complex and individual brain function is.
TMS therapy is also worth considering for patients who have had success with antidepressants but cannot tolerate the side effects. Sexual dysfunction, weight changes, emotional blunting, and sleep disruption are common reasons people stop medication even when it’s technically working. TMS does not carry those same systemic side effects.
What the Evidence Shows
TMS is not experimental. It has been studied extensively over the past two decades and is one of the more well-supported tools in psychiatric medicine.
In clinical trials, roughly half to two-thirds of patients with treatment-resistant depression experience a meaningful reduction in symptoms with TMS. Approximately one-third achieve full remission. Those numbers are notably higher than the response rates seen when patients try a third or fourth antidepressant after prior medications have failed.
Patients frequently report that TMS produced results they hadn’t experienced with any previous treatment — not just a reduction in depression scores, but a qualitative shift in how they feel, their energy, and their ability to engage with daily life.
What the Treatment Process Looks Like
A standard TMS course involves daily sessions, five days a week, over approximately six weeks. The sessions last between twenty and forty minutes depending on the protocol being used. Patients come in, complete their session, and leave. There is no recovery time and no impact on their ability to drive, work, or function normally.
The most common side effect is mild scalp discomfort or headache during the first few sessions, which typically resolves as the patient adjusts to the sensation. Serious adverse effects are rare.
Throughout the treatment course, patients work closely with the clinical team to track response, adjust as needed, and ensure the experience is as supported as possible. At Junction Brain Health, that coordination is central to how we operate — every patient has a team actively monitoring their progress, not just administering a procedure.
When to Consider Having This Conversation
TMS may be worth exploring if any of the following apply:
- You’ve tried one or more antidepressants without adequate relief
- Medication has helped partially but not enough
- You’ve had to stop medication due to side effects you couldn’t tolerate
- Your depression has returned after a period of improvement
- You’re looking for a non-medication option and want to understand what’s available
None of these scenarios means TMS is automatically the right next step. But they do suggest that a conversation with a provider who can evaluate your history and walk through your options is worth having.
Common Questions About TMS
Q. Is TMS covered by insurance?
A. Many insurance plans, including major commercial insurers, cover TMS for patients who meet clinical criteria — typically a documented history of inadequate response to antidepressants. Our team can help verify your benefits before you begin.
Q. How long do the results last?
A. Many patients experience sustained improvement for a year or longer following a TMS course. Some return for maintenance sessions over time. Results vary by individual, and our clinical team will work with you to build a plan that supports long-term stability.
Q. Can I stay on my antidepressant while doing TMS?
A. In most cases, yes. TMS is frequently used alongside existing medication rather than as a replacement for it. Your provider will review your current regimen as part of your evaluation.
Q. What if I’ve never tried medication — can I still do TMS?
A. TMS is FDA-cleared specifically for patients who haven’t responded to medication, so a prior medication trial is typically required for insurance coverage. If you’re earlier in your treatment journey, your provider can help you think through the right sequence of options.
Moving Forward
Depression that hasn’t responded to medication is not a dead end. It is a signal that the approach needs to change — not that recovery isn’t possible.
TMS offers a fundamentally different mechanism of action, a strong evidence base, and a track record of helping patients who had stopped believing something would work.
If you’ve been through the medication cycle and are still struggling, Junction Brain Health is here to help you understand what else is possible.
Contact us today to schedule an evaluation and learn whether TMS might be the right next step for you.