Many people living with depression do not feel better after trying medication or therapy alone. Transcranial magnetic stimulation (TMS) is a safe, noninvasive treatment that can help. It uses magnetic pulses to activate areas of the brain involved in mood and emotion.
TMS has been FDA-approved since 2008 and is recognized as an effective option for adults with depression that has not improved with medication. The treatment is done in an outpatient setting, requires no anesthesia, and allows clients to continue their daily activities afterward. More than 7.6 million NeuroStar® TMS treatments have been performed worldwide, and the therapy continues to expand in use.¹
At Columbia Mental Health, we offer NeuroStar® TMS at select locations. Our providers are trained to deliver this treatment with precision and care, combining clinical experience with a focus on comfort and support.
What is transcranial magnetic stimulation (TMS)?
TMS is a brain stimulation therapy that uses magnetic fields to target specific areas of the brain. During treatment, an electromagnetic coil rests gently against the scalp near the dorsolateral prefrontal cortex, a region associated with mood regulation.
The coil delivers pulses that stimulate underactive brain cells. This can restore balance to brain activity and help reduce depression symptoms. TMS is not invasive. There is no sedation or recovery period, and it does not cause memory loss or seizures. Clients can return to work or other activities immediately after each session.
How TMS works
TMS is based on electromagnetic induction. Magnetic pulses pass through the skull and produce small electrical currents in targeted nerve cells. This activity encourages the brain to function more normally in areas that control emotion and behavior.
When delivered repeatedly, TMS strengthens these neural pathways through neuroplasticity, which is the brain’s ability to create and reorganize connections.¹ Over time, these changes can lead to sustained improvements in mood.²
Each treatment plan is customized. Key variables include:
- Frequency of pulses (high frequency increases activity, low frequency reduces it)
- Stimulation intensity (based on your individual motor threshold)
- Treatment location (often the left dorsolateral prefrontal cortex)
- Session length (typically between 3 and 40 minutes)
This structured approach helps ensure that every client receives the right amount of stimulation for their needs.
Conditions treated with TMS
TMS is approved by the FDA for several conditions:
- Major depressive disorder (difficult-to-treat depression)
- Obsessive-compulsive disorder (OCD)
- Migraine prevention
- Smoking cessation
TMS is especially effective for depression that has not improved with antidepressants. In studies, 83% of clients experienced improvement, and 62% achieved remission, meaning their symptoms dropped to a level no longer considered clinically significant.¹
There is also ongoing research into how TMS can help with anxiety, PTSD, chronic pain, addiction, and cognitive function.
At Columbia Mental Health, our clinicians stay current with this research to help clients explore whether TMS could be part of their care plan.
Who is a candidate for TMS?
TMS is for adults 18 and older who have not found success with standard depression treatments. Clients are typically eligible if they:
- Have tried at least one antidepressant medication without improvement
- Are medically stable and can attend sessions regularly
- Have a support system and realistic expectations about outcomes
Before beginning treatment, a CMH provider conducts a full medical and psychiatric evaluation. This includes reviewing your medication history, screening for contraindications, and discussing any previous therapy experiences.
Safety and contraindications
TMS is safe for most people.¹ Before treatment, each client completes a safety screening to rule out risks.
TMS is not suitable for people with:
- Metal implants or fragments in or near the head
- Implanted medical devices like pacemakers or cochlear implants
TMS may require caution for people with:
- A history of seizures or epilepsy
- Pregnancy
- Substance use disorders
- Medications that lower the seizure threshold
Your CMH provider will review all health details before treatment and answer questions about safety.
What to expect during TMS treatment
The first appointment includes a procedure called motor threshold mapping, which measures how strong the magnetic pulses should be for your specific treatment. This helps personalize the stimulation level.
During each session, you’ll sit in a comfortable chair while the coil is positioned on your head. You’ll hear clicking sounds and feel a light tapping on the scalp. Most people describe this as mildly uncomfortable but tolerable.
Each treatment lasts about 20 to 40 minutes. You remain awake throughout and can drive home or return to work immediately after. Consistent attendance is important to achieve the best results.
Effectiveness and outcomes
TMS has been shown to significantly reduce symptoms for many people with difficult-to-treat depression.¹ Most clients begin to notice improvements after two to three weeks. These can include better mood, improved concentration, and more stable energy levels.
Research shows that benefits often last for months or longer, particularly when clients continue therapy and medication as part of ongoing care.² For those whose symptoms return, maintenance sessions can help extend results.
At Columbia Mental Health, we’ve seen TMS give clients a chance to reclaim their routines and relationships. It can help restore motivation and hope after years of trying different treatments.
Side effects and comfort
TMS does not have the systemic side effects of antidepressant medication. Most side effects are mild and resolve quickly. Common effects include:
- Mild headaches or scalp tenderness
- Facial muscle twitching during treatment
- Temporary fatigue after sessions
Rare complications include fainting or seizure, which occur in less than 1% of cases. Clients wear earplugs during treatment to protect hearing from the clicking sound.
Your CMH provider monitors progress throughout treatment and makes adjustments as needed to ensure comfort and safety.
Comparing TMS with other treatments
TMS vs. ECT: Both target brain activity, but ECT uses electrical currents under anesthesia and may cause temporary memory loss. TMS uses magnetic pulses while clients remain awake and alert. It does not require sedation or recovery time.
TMS vs. medication: TMS targets mood centers directly without introducing chemicals into the bloodstream. Many clients combine both treatments for optimal outcomes.
Insurance and access
Most major insurance providers, including Medicare, cover TMS for depression when standard criteria are met. Coverage typically includes about 30 sessions. Columbia Mental Health assists clients with verification and paperwork to help avoid unexpected costs.
A new path forward
For people who have not found relief from medication, TMS offers a noninvasive way to address depression at its source. Treatment is safe, effective, and supported by years of clinical evidence.
At Columbia Mental Health, our team combines advanced NeuroStar® TMS technology with a client-centered approach. We work with you to create a plan that fits your needs, supports recovery, and helps you regain balance.
For new clients, please click here to schedule an appointment. For existing clients, please click h ere and find your office location to contact your office directly.
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