Making the decision to seek help for your mental health is a significant act of strength. When traditional treatments like medication and therapy haven't provided the relief you deserve, it can feel discouraging. But there are other paths forward. Transcranial Magnetic Stimulation (TMS) therapy is an innovative, evidence-based treatment that offers new hope for individuals who feel stuck. The journey to starting a new treatment can feel overwhelming, but understanding each step can empower you to move forward with confidence.
Diamond Edge TMS is an expert provider of personalized psychiatric care in Vancouver, WA. We specialize in offering innovative treatments like TMS therapy, with a deep understanding of the unique challenges faced by civilians, military personnel, first responders, and families. Led by Dr. Jerald Block, an Army veteran with 25+ years of clinical experience, our practice is built on a foundation of respect, confidentiality, and a commitment to whole-person care.
If you’re ready to explore a different path to mental wellness, we encourage you to schedule an appointment to see how TMS therapy can make a difference.
This guide will walk you through the process of starting TMS treatment so you know exactly what to expect.
What is TMS Therapy, and Who Is It For?
Transcranial Magnetic Stimulation is a non-invasive, FDA-approved treatment that uses magnetic fields to stimulate nerve cells in the brain that are involved in mood regulation. Unlike medications that circulate throughout your body and can cause systemic side effects, TMS targets a specific area of the brain (the left prefrontal cortex), which is often underactive in individuals with depression. The treatment is performed while you are awake and alert, and it doesn't require any anesthesia or sedation.
TMS therapy is primarily for individuals who have not found sufficient relief from Major Depressive Disorder (MDD) with traditional antidepressant medications. This is often referred to as treatment-resistant depression. It is also FDA-cleared for treating Obsessive-Compulsive Disorder (OCD) and continues to show promise for other conditions like anxiety and PTSD.
You may be a good candidate for TMS if you:
- Have been diagnosed with MDD and have tried at least two different antidepressant medications without success.
- Have experienced intolerable side effects from antidepressant medications.
- Are looking for a non-medication-based approach to treatment.
- Need a treatment that won’t interfere with your ability to work, drive, or maintain daily responsibilities.
Because TMS does not involve sedating medications, it is an excellent outpatient option for military members, first responders, and pilots who need to remain mission-ready and maintain cognitive sharpness.
The Initial Consultation: What to Expect
Your journey with TMS begins with a comprehensive initial consultation. This first meeting is crucial for determining if TMS is the right treatment for you and for building a foundation of trust with your provider. At Diamond Edge TMS, this consultation is a collaborative conversation, not just a clinical assessment.
A Thorough Review of Your History
During your consultation with Dr. Block, you will discuss your mental health history in detail. This includes your experience with depression, any other diagnoses you may have, and a complete review of past treatments. Be prepared to talk about:
- The antidepressant medications you have tried, including dosages and duration.
- Your experience with psychotherapy or other talk therapies.
- Any side effects you’ve experienced from past treatments.
- How your symptoms are currently affecting your daily life, work, and relationships.
This information is vital for establishing the medical necessity for TMS, which is a requirement for insurance coverage, including Blue Cross, United, Aetna, Medicare, and TRICARE.
Personalized Assessment and Education
Your consultation with Dr. Block is a chance to learn and explore the science of TMS, understand what treatment feels like, and discuss what to expect. It’s an open, collaborative conversation designed to help you feel ready and confident. This is your opportunity to learn, explore, and ask questions in a supportive setting.
We will also review your medical history to ensure there are no contraindications for TMS. Conditions such as having metal implants in or near your head (excluding dental fillings) or a history of seizures will be carefully evaluated.
Developing Your Treatment Plan
If you and Dr. Block agree that TMS is a good fit, the next step is to develop a personalized treatment plan. This includes deciding on the treatment protocol, whether that's the standard daily sessions over several weeks or an accelerated protocol if appropriate. We will also discuss the logistics of scheduling and what to expect on your first day.
Preparing for Your First TMS Session
Once your treatment is authorized and scheduled, you can begin to prepare for your first session. TMS requires very little special preparation, but knowing what to do can help ease any anxiety.
On the day of your first session, you can eat, drink, and take your regularly prescribed medications as usual. There are no dietary restrictions or requirements to fast. It’s best to avoid alcohol or other non-prescribed substances, however.
Dress comfortably. You will be seated in a chair for about 20-30 minutes, so wearing relaxed clothing will help you feel more at ease. You are welcome to bring a book, listen to music with headphones, or simply relax during the session.
Your first appointment will be slightly longer than subsequent ones because it includes a 'mapping' session. During this process, the TMS technician and physician will identify the precise location on your head for coil placement and determine the right magnetic pulse intensity for your treatment.
To do this, single magnetic pulses will be delivered to a part of the brain that controls motor function. The doctor will watch for a slight twitch in your hand, which indicates they have found the correct area. The intensity will be adjusted to find the minimum amount of power needed to cause the twitch; this is your 'motor threshold.' This measurement is then used to determine the appropriate treatment dose for the mood-related areas of your brain. This process is painless and ensures your treatment is both safe and effective.
What Happens During a Typical TMS Treatment Session
After the initial mapping, your daily treatment sessions will be straightforward and consistent. Knowing the routine can help make the experience feel comfortable and predictable.
Getting Settled
When you arrive, you’ll be greeted and led to the treatment room. You will sit in the specialized, comfortable TMS chair. The technician will ask you a few brief questions to check on your progress and see how you’re feeling. They will then place the magnetic coil against your head in the precise location determined during your mapping session.
The Treatment Pulses
The machine will then deliver a series of short, rapid magnetic pulses. You will hear a clicking sound and feel a tapping sensation on your scalp with each pulse. The pulses are delivered in intervals, typically a few seconds of pulsing followed by a pause. A standard session lasts about 20 minutes.
During the session, you are fully awake and alert. You can chat with the technician, watch TV, listen to music, or just sit quietly. The goal is for you to be as comfortable as possible.
Immediately After the Session
Once the session is complete, the coil is removed, and you are free to leave immediately. There is no 'recovery time.' You can drive, return to work, or go about your day as planned. The most common side effect is a mild headache or some scalp discomfort, which usually subsides after the first few sessions and can be managed with over-the-counter pain relievers.
Post-Treatment Care and Tracking Progress
TMS is not a passive process; your engagement and feedback are key to a successful outcome. Consistent monitoring helps you and your provider track progress and make any necessary adjustments.
After the Full Course
The benefits of TMS are often long-lasting. Research shows that about two-thirds of individuals who respond to TMS maintain their improvement for a year or longer. However, depression is a chronic condition, and it’s possible for symptoms to return. If this happens, maintenance TMS sessions or a follow-up course of treatment can be effective in getting you back on track.
Ongoing Wellness
TMS therapy can be a powerful catalyst for change, often making it easier to engage in other healthy habits. We encourage patients to continue with psychotherapy, maintain a healthy diet, exercise regularly, and practice good sleep hygiene to support their long-term mental wellness.
Your Path to Healing Starts Here
The journey to starting TMS therapy is a structured, supportive process designed to give you the best possible chance at recovery. From the initial consultation to the final session, you are an active partner in your care. At Diamond Edge TMS, we are committed to providing you with the expertise, compassion, and respect you deserve.
If you have been struggling with depression and traditional treatments haven't worked, there is hope. TMS therapy provides a proven, non-invasive solution tailored to your individual needs. Our team is here to answer your questions and support you every step of the way on your journey to feeling better.
Don’t let treatment-resistant depression hold you back any longer. Contact Diamond Edge TMS to schedule your consultation and take the first step toward reclaiming your life with TMS therapy.
