Patients who are exploring Transcranial Magnetic Stimulation (TMS) often come into my office curious, hopeful, and sometimes a little unsure. Many have tried multiple medications without meaningful relief. Others are simply looking for a treatment that feels more aligned with their needs and values. No matter where they’re starting from, I’ve found that clear, compassionate education helps patients feel empowered and confident as they consider TMS.

Below are the questions I’m asked most frequently — and how I answer them in practice.

1. “What exactly is TMS?”

I explain that TMS is a non‑invasive, FDA‑cleared treatment for major depressive disorder that uses magnetic pulses to activate the parts of the brain involved in mood regulation. It does not involve anesthesia, memory loss, or systemic side effects. Most importantly, it offers patients a new pathway forward when traditional treatments haven’t worked well enough.

2. “How does TMS for depression work?”

TMS uses focused magnetic pulses — similar to the type used in MRI machines — to stimulate specific areas of the brain. These pulses help “reawaken” neural pathways involved in mood, which can gradually reduce depressive symptoms. I emphasize that the treatment is targeted, measurable, and supported by decades of clinical research.

3. “What does a TMS session feel like?”

I describe it as a tapping or clicking sensation on the scalp. Most patients acclimate within the first few sessions. They remain fully awake, can listen to music or chat with our technicians, and resume normal activities immediately afterward — including driving.

4. “Is TMS safe?”

Yes — it has a strong safety profile. The most common side effects are mild scalp discomfort or headache during the first few treatments. We monitor patients closely and adjust settings to ensure comfort. TMS is also medication‑free, which makes it a promising option for those who experience side effects from antidepressants.

5. “How long does TMS take to work?”

I share that many patients begin noticing improvement after the first few weeks, though everyone’s timeline is unique. A full treatment course typically lasts nine weeks, with sessions occurring five days per week. We check in regularly and use rating scales to track progress objectively.

6. “Will TMS work for me?”

While no treatment works for everyone, TMS has strong evidence behind it — especially for patients with treatment‑resistant depression. I explain what factors influence response and walk patients through our evaluation process to determine whether TMS is a good fit for their symptoms and history.

7. “Can I continue my medications or therapy?”

Absolutely. Many patients continue their current regimen while adding TMS. I collaborate closely with therapists and prescribers to ensure a unified, patient‑centered treatment plan.

8. “What should I expect day‑to‑day during treatment?”

Consistency is key. Sessions are brief, and patients quickly settle into a routine. Our clinic environment is warm and supportive — our team gets to know patients well during their treatment course. We also provide guidance for managing schedules and any early‑session discomfort.

9. “Is TMS for depression covered by insurance?”

Yes — most major insurance plans cover TMS for depression and obsessive compulsive disorder (OCD) when basic criteria are met. These typically include:

• A diagnosis of major depressive disorder
• Inadequate response to a certain number of antidepressant trials
• Participation in psychotherapy (varies by insurer)

Our team helps patients navigate the approval process, gather documentation, and understand their benefits. I reassure patients that we work closely with insurers and advocate on their behalf to make treatment as accessible as possible.

A Note for Fellow Clinicians

By proactively addressing these questions, we can reduce uncertainty, improve engagement, and set realistic expectations from the start. TMS is a powerful, evidence‑based tool — and when patients understand the “why” behind it, they participate more confidently and experience treatment more fully.

Conclusion

TMS has opened a meaningful new door for many of my patients. By answering their questions clearly and compassionately, I help them feel informed, supported, and hopeful about the path ahead. As providers, our ability to communicate effectively about TMS is just as important as the treatment itself.

Written by Karen Giles, MD, is a physician at Breakthru specializing in advanced mental health treatments, including Transcranial Magnetic Stimulation (TMS). Breakthru partners with industry-leading technology providers like MagVenture, a trusted TMS device manufacturer, to deliver innovative, non-invasive care.