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  • What is major depression?
    Major Depressive Disorder is a disease which lasts two or more weeks and interferes with a person’s ability to carry out daily tasks and enjoy activities that previously brought pleasure. This condition affects approximately 280 million adults worldwide and is a leading cause of disability.
  • What causes depression?
    The exact cause of depression remains unknown. Depression results from a complex interaction of social, psychological, and biological factors. People who have gone through adverse life events (unemployment, bereavement, traumatic events) are more likely to develop depression. Depression can, in turn, lead to more stress and dysfunction and worsen the affected person’s life situation, relationships, and the depression itself.
  • How prevalent is depression?
    According to the World Health Orginzation, approximately 280 million people in the world have depression. An estimated 3.8% of the population experience depression, including 5% of adults (4% among men and 6% among women), and 5.7% of adults older than 60 years. Depression is about 50% more common among women than among men. Worldwide, more than 10% of pregnant women and women who have just given birth experience depression. More than 700, 000 people die due to suicide every year. Suicide is the fourth leading cause of death in 15–29-year-olds.
  • Is depression a serious disease?
    Yes. The National Institute of Mental Health maintains that, “Depressive illness can often interfere with normal functioning and cause pain and suffering not only to those who have the disorder, but to those who care about them. Serious depression can destroy family life as well as the life of the ill person.” A national study of depression found that nearly all the respondents who reported a major depressive disorder also reported that their social and/or work lives were negatively affected by their illness. Lost productivity alone for depression and anxiety has been estimated to cost the global economy $1 trillion per year and is forecast to reach $16 trillion by 2030 Depression is a leading cause of disability worldwide, accounting for almost 20% of all years of life lost to disability and premature death. Depression can also be a lethal disease. Each year in the US, over 30,000 people die by suicide, 60% of whom suffer from depression.
  • What are the current approved treatments for depression?
    Depression is most often treated with psychotherapy (talk-therapy) and antidepressant medications. Although antidepressants can be effective for many patients, they do not work for everybody. Chances of remission with medication go down with each subsequent medication trial. Additionally, since antidepressants are typically taken by mouth, they circulate in the bloodstream throughout the body, often resulting in intolerable side effects. More than 4 million patients do not receive adequate benefit from antidepressant medications and/or cannot tolerate the side effects caused by them. For these patients, alternative treatments are available. These treatments can include: transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT) and vagus nerve stimulation (VNS).
  • What is Transcranial Magnetic Stimluation (TMS)?
    Transcranial magnetic stimulation (TMS) is an FDA aprroved, non-drug treatment for depression and anxiety. TMS uses electromagnetic pulses to stimulate nerve cells in the area of the brain thought to control mood. These pulses are thought to have a positive effect on the brain’s neurotransmitter levels as well as balancing neuropathways in the deeper structures of the brain.
  • How does TMS work?
    TMS uses short pulses of magnetic fields to stimulate the areas of the brain that are underactive in depression. The magnetic pulses work to bring brain activity back online and get neurotransmitters signaling again and brain regions communicating with each other again.
  • Is TMS covered by my insurance?
    Most commercial insurance as well as Tricare and Medicare plans cover TMS . See here for a full list of insurance plans that cover TMS. Please inquire with us directly to see if we are contracted with your insurance carrier.
  • Is TMS a good alternative for patients who cannot tolerate the side effects associated with antidepressant medications?
    TMS is non-systemic (does not circulate in the blood throughout the body), so it does not have side effects such as weight gain, sexual dysfunction, nausea, dry mouth, etc. The most common side effects reported during clinical trials were headache and temporary scalp pain or discomfort – occurring less frequently after the first week of treatment.
  • Is TMS like other alternative therapies which use magnets to treat some illnesses?
    No. TMS involves a unique method of using pulsed magnetic fields for therapeutic benefit. The intensity of the magnetic field is similar to that of magnetic resonance imaging, or MRI. These techniques differ radically from the popular use of low intensity, static magnetic fields. These products deliver weak and undirected static fields that are not capable of activating brain cells.
  • Is TMS Therapy like electroconvulsive therapy (ECT)?
    No. While both treatments are effective in the treatment of depression, there are significant differences in safety and tolerability. During TMS, the patient sits in a chair and is awake and alert throughout the entire 3-19 minute procedure – no sedation is used with TMS. Patients can transport themselves to and from treatment and return to regular daily activities after treatment. In over 10,000 active treatments with the TMS Therapy system in clinical trials, no seizures were observed. TMS Therapy was also shown to have no negative effects on memory function in these studies. In contrast, electroconvulsive therapy (ECT), intentionally causes a seizure. ECT is performed in the hospital and patients receiving ECT are sedated with general anesthesia. Recovery from an ECT treatment session occurs slowly with close monitoring for side effects. Patients require transportation to and from the procedure. Short-term confusion and memory loss are common with ECT, and long-term disruptions in memory have been shown to occur and may persist indefinitely in some people. Because of the side effects associated with ECT, a significant amount of caregiver support is required.
  • What is a typical course of TMS treatment?
    A typical course of TMS treatment is 5 times per week for 7 weeks. Each session is roughly 3-19 minutes.
  • What are the potential risks of TMS?
    TMS has been shown to be well tolerated and the Neurostar TMS Therapy system has been demonstrated to be safe in clinical trials. Throughout over 10,000 active treatments performed in clinical trials, the most commonly reported side effect related to treatment was temporary scalp pain or discomfort during active pulsing. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. Less than 5% of patients treated with NeuroStar TMS Therapy discontinued treatment due to side effects. In clinical trials, over 10,000 TMS treatments demonstrated its safety, with no occurrence of seizures. However, there is a small risk of a seizure occurring during treatment. This risk is no greater than what has been observed with some oral antidepressant medications. While TMS Therapy has been demonstrated to be safe and effective, not all patients will benefit from it.
  • Does TMS cause memory loss?
    No, TMS has been systematically evaluated for its effects on memory. Clinical trials demonstrated that TMS Therapy does not result in any negative effects on memory or concentration.
  • Does TMS hurt?
    The most common side effect related to treatment was temporary scalp pain or discomfort during active pulsing only. This side effect was generally mild to moderate, and occurred less frequently after the first week of treatment. If necessary, we treat this discomfort with an over-the-counter analgesic like Tylenol or Advil and use numbing spray at the treatment site. Less than 5% of patients treated with TMS Therapy discontinued treatment due to side effects.
  • How long does the benefit last? Will I need any TMS beyond the first treatment course?
    In a clinical trial, 2 out of 3 patients who responded to treatment maintained that response out to 12 months. 1 in 3 patients returned for ‘maintenance’ TMS sessions.
  • Can I also take antidepressant(s) if I am receiving TMS?
    Yes. In clinical trials, TMS was safely administered with and without other antidepressant medications.

Depression & TMS FAQ's


  1. Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.

  2. Greenberg PE, et al. The Economic Burden of Adults With Major Depressive Disorder in the United States (2005 and 2010). J Clin Psychiatry. 2015; 76(2):155-162.

  3. US Burden of Disease Collaborators. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA, 310(6): 591-608, 2013.

  4. Arias E, Heron M, Xu JQ. United States life tables, 2012. National vital statistics reports; vol 65 no 8. Hyattsville, MD: National Center for Health Statistics. 2016.

  5. Courtet, P. and Lopez-Castroman, J. (2017), Antidepressants and suicide risk in depression. World Psychiatry, 16: 317-318. doi:10.1002/wps.20460

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