Am I a Candidate for TMS Therapy?

Transcranial Magnetic Stimulation (TMS) is a breakthrough, non-invasive therapy for major depression. While many patients benefit, not everyone is an ideal candidate. The best outcomes come when TMS is used with the right individuals at the right stage of treatment.

This page is designed to help you understand who may benefit most from TMS — and who may need to explore other options. (For a detailed overview of how TMS works and what treatment looks like day-to-day, see our TMS for Severe Depression page).

Who Is a Good Candidate for TMS?

You may be a strong candidate for TMS if:

• You have treatment-resistant depression — meaning you’ve tried at least two antidepressant medications, at adequate doses and durations, without sufficient relief.

• You prefer a non-drug option — TMS is not a medication, so it avoids systemic side effects like weight gain, sexual dysfunction, or sedation.

• You can commit to the schedule — standard courses involve brief daily sessions (about 20–30 minutes) five days a week for six to eight weeks.

• You want to continue with holistic care — TMS is most effective as part of a broader treatment plan that may include medications, therapy, or lifestyle interventions.

Who Isn’t a Good Candidate for TMS?

Some situations make TMS unsafe or less effective. You may not be a good fit if:

• You have metal or electronic implants in or near the head
  Examples include cochlear implants, deep brain stimulators, aneurysm clips, or implanted stimulators. (Dental fillings and braces are usually fine.)

• You have a seizure disorder or history of epilepsy
  Because TMS uses magnetic stimulation, it may slightly increase seizure risk in people who are already prone to seizures. However, this is not always an absolute contraindication. In some cases — particularly when seizures are well controlled — TMS can still be considered under close medical supervision, sometimes using alternative protocols to enhance safety.

• You have unstable neurological conditions
  Active brain tumors, recent strokes, or significant head injuries may rule out TMS.

In these situations, other options such as Spravato® (esketamine) and/or medication adjustments may be more appropriate.

The Screening Process at PathWave Psychiatry

Before starting TMS, every patient at PathWave Psychiatry completes a thorough evaluation that includes a comprehensive psychiatric assessment, review of medical and neurological history, careful screening for contraindications such as implants or seizure risk, and a discussion of treatment expectations and goals. We also review insurance and coverage details up front. This process ensures that TMS is both safe and tailored to give you the best chance of success.

What to Expect if You’re a Candidate

Session length:
Each TMS treatment session typically lasts 20 to 30 minutes. During this time, you’ll be seated comfortably in a treatment chair while a specialized magnetic coil is placed gently against your scalp. The coil delivers pulses of magnetic energy that activate specific areas of the brain linked to mood regulation.

Unlike ECT or procedures done in a hospital setting, no anesthesia, sedation, or recovery time is required. You remain fully awake and alert throughout the session. Many patients read, listen to music, or simply relax during treatment. Once the session is complete, you can immediately return to your normal activities — including driving, working, or attending school.

Frequency:
TMS is usually provided five days a week over the course of four to six weeks. This daily rhythm is important because consistency helps the brain build and strengthen new neural connections. After completing the initial course which takes about six weeks, some patients may transition to a taper schedule (fewer sessions per week) or return for maintenance treatments as needed to help sustain progress over time.

 Side effects:
TMS is very well tolerated, and most patients are able to complete treatment without difficulty. The side effects that do occur are usually mild and temporary. The most common ones are: scalp discomfort or tapping sensation during treatment where the coil rests against the head, mild headaches afterward, which often lessen as the brain adjusts over the first few sessions. These side effects typically respond well to over-the-counter pain relievers (like acetaminophen or ibuprofen) and rarely lead patients to stop treatment.

Daily functioning:
One of the biggest advantages of TMS is that it fits easily into daily life. Because it is non-invasive and does not require anesthesia or recovery time, you can drive yourself to and from each appointment. Most patients return immediately to work, school, or family activities after treatment.

Many patients start noticing improvements in mood, energy, and focus within the first two to four weeks.

Not Sure if TMS Is Right for You?

If you’re wondering whether you’re a candidate, the best next step is an evaluation. At PathWave Psychiatry, we carefully guide you through the process, helping you understand your options — whether that’s TMS, Spravato®, medications, or a combination.

TMS Treatment in the East Bay

PathWave Psychiatry is located in the Elmwood neighborhood of Berkeley, California (near the border of Rockridge in Oakland) and offers TMS treatment for depression and anxiety throughout the East Bay area. We serve patients from Berkeley, Oakland, Emeryville, Piedmont, Albany, El Cerrito, Moraga, Orinda, LaFayette and neighboring communities.

We accept Medicare, Tricare/TriWest, UC Berkeley’s SHIP, and most major commercial insurance plans, including Aetna, Anthem Blue Cross, Blue Shield of California, Cigna, Magellan, Noridian, Optum, UMR, and UnitedHealthcare.

If you’re considering TMS therapy or wondering whether TMS may be right for you, contact us to schedule a consultation.