Most people describe a tapping or knocking sensation on the scalp. It can feel odd for the first few sessions and often becomes unnoticeable after the first week. We can adjust intensity gradually to keep you comfortable.

Will I need to stop my medications?

No. TMS is typically delivered alongside your existing medications. Any changes are made by your prescriber, not because TMS requires them.

Is TMS the same as ECT?

No. Electroconvulsive therapy requires anesthesia and induces a seizure. TMS uses focused magnetic fields, requires no anesthesia or sedation, and does not cause memory loss.

How long do results last?

Many patients maintain improvement for a year or more. Some choose periodic booster sessions, and we pair TMS with therapy to make gains more durable.

Who should not receive TMS?

TMS is not appropriate for people with non-removable ferromagnetic metal in or near the head, such as aneurysm clips or cochlear implants. A history of seizures requires careful review. We screen for all of this at your consultation.

Can I drive myself to and from treatment?

Yes. There is no sedation and no cognitive after-effect, so you can drive, work, and resume normal activity immediately.

Service

Transcranial Magnetic Stimulation (TMS)

FDA-cleared, drug-free brain stimulation for depression and related conditions

Overview

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses focused magnetic pulses — the same type used in an MRI — to stimulate underactive areas of the brain involved in mood regulation.

You sit awake and comfortable in a treatment chair while a coil is positioned over the left dorsolateral prefrontal cortex (DLPFC), a region that is consistently underactive in depression. There is no anesthesia, no sedation, and no recovery time. Most people drive themselves home and return straight to work or school.

TMS is most often recommended when medication has not delivered the relief you hoped for, or when side effects have made medication difficult to tolerate.

Who it's for

Adults with major depressive disorder who have tried one or more antidepressants without adequate relief
People who cannot tolerate the side effects of psychiatric medication
Patients with treatment-resistant depression seeking a next step beyond medication changes
Adults with OCD or anxious depression looking for evidence-based, non-drug options
Veterans and first responders managing depression alongside PTSD symptoms

Symptoms it helps address

Persistent low mood or emptiness
Loss of interest in things you used to enjoy
Fatigue and low motivation
Difficulty concentrating or making decisions
Sleep disruption — too little or too much
Feelings of worthlessness or guilt
Ruminating, intrusive, or obsessive thoughts

Benefits

Non-invasive and medication-free — no systemic side effects like weight gain or sexual dysfunction
No anesthesia or sedation; you stay fully awake and alert
Sessions typically last about 20 minutes with no downtime afterward
FDA-cleared for major depressive disorder, anxious depression, OCD, and smoking cessation
Covered by most major insurance plans, including Medicare and TRICARE, when criteria are met
Durable results — many patients maintain improvement long after the treatment course ends

The treatment process

A clear path from first call to maintenance, with no step you didn't agree to.

1
Consultation and eligibility review
We review your diagnosis, treatment history, medications, and any metal implants or seizure history to confirm TMS is safe and appropriate for you.
2
Insurance verification
Our benefits team submits prior authorization and confirms your coverage, copay, and out-of-pocket cost in writing before treatment begins.
3
Brain mapping and motor threshold
At your first session we locate your individual motor threshold and map the precise coil position, so every pulse is targeted to your anatomy.
4
Daily treatment sessions
You receive treatment five days a week for roughly six weeks. Each session runs about 20 minutes while you sit, read, or listen to music.
5
Progress tracking
We re-administer standardized rating scales such as the PHQ-9 every week or two so improvement is measured, not guessed at.
6
Taper and maintenance plan
The final sessions taper down, and we build a maintenance plan combining therapy, lifestyle supports, and optional booster sessions.

How TMS works in the brain

A magnetic coil placed against the scalp generates brief, rapidly repeating magnetic fields. Those fields pass painlessly through the skull and induce a small electrical current in the cortex directly beneath the coil. Repeated over a course of treatment, this stimulation increases activity and connectivity in the mood-regulating network anchored by the DLPFC — a process closely related to neuroplasticity, the brain's ability to strengthen healthier circuits over time.

Conditions treated with TMS

Major depressive disorder
Treatment-resistant depression
Anxious depression
Obsessive-compulsive disorder (OCD)
Depression co-occurring with PTSD
Smoking cessation (FDA-cleared indication)

FDA clearance

TMS has been FDA-cleared for major depressive disorder since 2008. Clearance has since expanded to include anxious depression, OCD, and smoking cessation in adults, and adolescent depression from age 15 on certain systems. Clearance means the technology has been reviewed for safety and effectiveness in these specific uses — it is not experimental or off-label therapy.

Treatment timeline

A standard course is 36 sessions: five sessions per week for six weeks, followed by a three-week taper. Accelerated protocols compress more sessions into fewer days for select patients. Most people begin noticing changes — better sleep, more energy, less rumination — somewhere between weeks two and four, often before they consciously register a mood shift. Family members frequently notice first.

What to expect during a session

You recline in a treatment chair while a technician positions the coil using your mapped coordinates. During stimulation you'll hear a rhythmic clicking and feel a tapping sensation on your scalp. Ear protection is provided. Pulses run in short trains with brief rests between them. When the session ends you stand up and go about your day — no grogginess, no driving restrictions.

Benefits and outcomes

In clinical practice, roughly half to two-thirds of patients with treatment-resistant depression experience a meaningful response to TMS, and about a third achieve full remission — outcomes that compare favorably to adding another medication after prior antidepressants have failed. The most common side effect is mild scalp discomfort or headache during the first week, which typically fades as you acclimate.

Insurance & coverage

TMS is covered by most major commercial plans, Medicare, Medicaid plans that include the benefit, and TRICARE when medical-necessity criteria are met — usually documented trials of antidepressant medication. We handle prior authorization for you and confirm your expected out-of-pocket cost before your first session.

Insurance & payment details

Your care team

TMS at Serene Integrative Services is prescribed and supervised by our psychiatric clinician and delivered by trained TMS technicians. Every treatment plan is reviewed with your therapist and, with your permission, your outside prescriber.

Meet the practice

Patient outcomes

We measure progress with standardized rating scales at intake and throughout care, so improvement is documented rather than assumed. Patient stories are published only with written authorization — we never fabricate testimonials.

How we measure outcomes

Frequently asked questions

Conditions we treat with this service

Depression Treatment-Resistant Depression Anxiety Disorders Obsessive-Compulsive Disorder (OCD)PTSD

Individual & Family Therapy Behavioral Health Services Executive Function Coaching Veteran & First Responder Services

Start with one conversation

Tell us what you've tried. We'll confirm eligibility, verify your benefits, and map out what treatment would look like.

Schedule a consultation (208) 719-7158