The gentle tapping sound reminds me of a woodpecker-rhythmic and purposeful. I'm observing a transcranial magnetic stimulation (TMS) session, watching as magnetic pulses target specific regions of the brain, much like a precisely focused beam of light. The patient remains awake and alert throughout the treatment. Wearing earplugs, they sit comfortably in what looks like a dentist's chair, scrolling through their phone while the device does its work. There's no anesthesia, no medication, no recovery time needed.
"My patients come in for their twenty-minute treatment sessions daily -- some even on their lunch breaks. " says Dr. Melissa Fickey, who has used NeuroStar TMS systems in her Tampa practice for nearly six years. "They can drive themselves in, get their treatment, and return to work or school with no down time. It is remarkably ordinary, considering what is happening in their brains."
What's happening is anything but ordinary. TMS uses magnetic fields -- similar to those used in MRI machines -- to stimulate nerve cells in the brain regions linked to mood regulation. For the twenty-one million American adults experiencing major depressive disorder (MDD) annually, this FDA-approved treatment offers hope, especially for the six-point-four million who haven't found relief through traditional methods. Beyond depression, TMS has also been FDA-cleared to treat obsessive-compulsive disorder (OCD) and anxious symptoms associated with MDD.
Heidi Shafland was one of them. After years of trying various antidepressants, she felt trapped in a cycle of medication adjustments and side effects. "I began to feel hopeless and powerless," she shares. "When you've tried everything, and nothing seems to work, you start to wonder if you'll ever feel better."
The statistics support Heidi's experience. According to the largest clinical depression trial ever conducted (STAR*D Study), first-line antidepressants are only 27.5 percent effective at treating to remission. Even more concerning, each subsequent medication attempt further decreases a patient's chance for remission.
But for Chrissy Zavala, who found herself in an emergency room at age twelve due to severe depression, TMS offered a different path. "After beginning treatment, I started to feel like myself again," she says. "I rediscovered my passion for archery, drawing, and writing." Today, the teenager proudly shares that she recently got her driver's permit-a milestone that once seemed unreachable through the fog of depression.
The treatment's effectiveness is compelling: according to NeuroStar's Outcomes Registry, the largest in the world for depression, up to eighty-three percent of patients respond to treatment, with many starting to see improvement within two to three weeks.
For adolescents specifically, seventy-eight percent showed clinically meaningful improvement in clinical studies -- significant given it's currently the only FDA-cleared TMS device for treating depression in patients aged fifteen to twenty-one.
But perhaps the most telling sign of TMS's legitimacy is the shifting insurance landscape. Most major insurance companies, including Medicare and Tricare, now cover the treatment -- a dramatic change from just a few years ago when patients often had to pay out of pocket.
"The insurance coverage and reimbursements reflect what we've been seeing in practice," Dr. Fickey explains. "TMS isn't 'experimental' anymore; it is a mainstream treatment option that is helping people reclaim their lives from depression."
As a therapist and executive coach who's written about mental health for years, I find it striking how many people still don't know about TMS, often confusing it with electroconvulsive therapy (ECT). Unlike ECT, TMS doesn't require anesthesia or induce seizures. It's more like an MRI focused on specific brain regions, delivered in outpatient sessions that fit into daily life.
"Considering the option of [TMS], which has no side effects or downtime, I urge anyone who has struggled with mental health issues to reach out to someone and learn more about it," Heidi emphasizes. "You deserve to explore every possible path to feeling better."
As winter approaches and seasonal depression rates rise, that message feels particularly relevant. In a world where mental health treatment often defaults to medication, TMS offers a different approach-one that's gradually reshaping how we think about treating depression.
For those interested in learning more about TMS, the first step is consulting with a healthcare provider to determine if it might be an appropriate treatment option. As with any medical decision, it's essential to discuss individual circumstances, insurance coverage, and treatment goals with a qualified professional.
"What we're seeing with TMS is just the beginning," says Dr. Fickey. "We're finally moving beyond the one-size-fits-all approach to depression treatment. It's not merely progress in practice, it has been revolutionary in mental health care."