Key Takeaways
- Standard TMS therapy involves daily 20-minute sessions over 6-7 weeks, while accelerated TMS condenses treatment into multiple sessions per day over approximately 5 days.
- Both treatment models target the same brain regions and use similar technology, but differ in scheduling intensity and time commitment.
- Accelerated TMS offers faster results for those with demanding schedules, urgent treatment needs, or who cannot commit to weeks of daily appointments.
- Standard TMS may be preferable for those who want a more gradual approach or have insurance that doesn't cover accelerated protocols.
- Diamond Edge TMS, located in Vancouver, Washington, offers both standard and accelerated TMS protocols to meet the unique needs of military personnel, first responders, and their families. Schedule an appointment to learn which treatment model is right for you.
Understanding TMS Treatment Models
Transcranial Magnetic Stimulation (TMS) has transformed how we approach treatment-resistant depression, offering hope when traditional antidepressants haven't worked. As TMS technology has advanced, different treatment models have emerged to better serve patients with varying needs, schedules, and treatment goals.
Diamond Edge TMS, led by Dr. Jerald Block, a board-certified psychiatrist and Army combat veteran, understands that one size doesn't fit all. That's why we offer both standard and accelerated TMS protocols, allowing military personnel, first responders, and their families to choose the treatment model that best fits their lives and recovery goals.
Standard TMS: The Traditional Approach
Standard TMS therapy represents the original FDA-approved treatment protocol that has helped tens of thousands of patients achieve relief from treatment-resistant depression. This model involves daily treatment sessions, Monday through Friday, over the course of approximately 6-7 weeks.
How Standard TMS Works
Each standard TMS session lasts about 20 minutes. During treatment, you sit comfortably in a specialized chair while a trained technician positions a magnetic coil against your head. The device delivers focused magnetic pulses to the prefrontal cortex, the brain region responsible for mood regulation. These pulses stimulate neural activity, gradually helping to restore normal brain function.
The daily repetition over several weeks allows for gradual, sustained changes in brain activity patterns. This consistent stimulation helps create new neural pathways and strengthens existing ones, leading to lasting improvements in depression symptoms.
Benefits of Standard TMS
Standard TMS offers several advantages for patients who can accommodate the treatment schedule:
- Proven effectiveness: Decades of research support standard TMS protocols, with studies showing that 60-80% of patients experience significant symptom improvement.
- Gradual adjustment: The extended timeline allows your brain to adapt slowly to the changes, which some patients find more comfortable.
- Built-in monitoring: Daily appointments provide regular opportunities for your treatment team to assess progress and make any necessary adjustments.
- Insurance coverage: Most insurance plans, including TRICARE, readily approve standard TMS protocols since they represent the established treatment model
Who Benefits Most from Standard TMS
Standard TMS works well for patients who:
- Have relatively flexible schedules that can accommodate daily weekday appointments
- Prefer a gradual treatment approach
- Live close to the treatment facility
- Want the most extensively researched protocol
- Have insurance that specifically covers standard but not accelerated protocols
Accelerated TMS: Intensive Treatment for Faster Results
Accelerated TMS represents an innovative evolution in depression treatment, condensing the therapeutic benefits of standard TMS into a much shorter timeframe. Instead of spreading treatment over 6-7 weeks, accelerated protocols deliver multiple sessions per day over approximately 5 consecutive days.
How Accelerated TMS Differs
Accelerated TMS uses the same fundamental technology as standard treatment, but with an intensified schedule. Patients typically receive multiple treatment sessions per day, with appropriate rest periods between sessions. Each individual treatment is more intense, using “theta waves,” while also being substantially shorter. As the session might go less than 5 minutes, rather than the more standard protocol’s 23 minutes. This concentrated approach leverages the brain's neuroplasticity to achieve rapid changes in neural activity patterns.
Stanford researchers developed one prominent accelerated protocol called Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), which delivers 50 sessions over just 5 days. While the specific protocol may vary by provider, all accelerated approaches share the goal of achieving results more quickly than standard treatment.
Benefits of Accelerated TMS
Accelerated TMS offers compelling advantages for the right patients:
- Rapid results: Many patients experience significant improvement within days rather than weeks, with some studies showing response rates as high as 80-90%.
- Reduced time commitment: Completing treatment in a single week makes TMS accessible for those with demanding careers or limited availability.
- Minimal work disruption: Military personnel and first responders can often use a short leave period or vacation week to complete treatment.
- Maintained effectiveness: Research shows that accelerated protocols can be just as effective as standard treatment, with lasting results
Who Benefits Most from Accelerated TMS
Accelerated TMS is particularly valuable for:
- Military personnel facing deployment schedules
- First responders with challenging work schedules
- Patients experiencing severe depression who need rapid relief
- Individuals who cannot commit to 6-7 weeks of daily appointments
- Those who have traveled from a distance to receive treatment
- Patients who prefer intensive, focused treatment
Comparing Standard and Accelerated TMS
| Feature | Standard TMS | Accelerated TMS |
|---|---|---|
| Treatment duration | 6-7 weeks | Approximately 5 days |
| Sessions per day | One | Six to eight |
| Session length | ~20 minutes | ~5 minutes per session |
| Total sessions | ~30-36 | ~36-50 |
| Time commitment | Daily weekday appointments | Full days for one week |
| Effectiveness | 60-80% response rate | 60-90% response rate |
| Insurance coverage | Widely covered | Rarely covered |
| Best for | Flexible schedules | Urgent needs, time constraints |
TMS for Obsessive-Compulsive Disorder
The FDA approved TMS for OCD treatment in 2018, expanding treatment options beyond depression. TMS for OCD targets different brain regions than depression treatment, focusing on areas involved in compulsive behaviors and intrusive thoughts.
How TMS Treats OCD
OCD often involves hyperactivity in certain brain circuits, particularly those connecting the prefrontal cortex to deeper brain structures. TMS for OCD uses a different stimulation frequency than depression treatment—specifically, lower frequency pulses that help reduce excessive neural activity rather than increase it.
Treatment protocols for OCD typically mirror standard TMS scheduling, with daily sessions over several weeks. Research shows that many patients experience meaningful reductions in OCD symptoms, with some studies reporting average decreases of about 6 points on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
OCD Treatment Considerations
While both standard and accelerated approaches can treat depression, OCD treatment protocols are still evolving. Most research supports standard daily treatment for OCD, though accelerated protocols are being studied. Diamond Edge TMS works with each patient to determine the most appropriate protocol based on current evidence and individual circumstances.
Benefits of Accelerated TMS for Military and First Responders
Military personnel and first responders face unique challenges that make accelerated TMS particularly appealing. The compressed timeline aligns with the realities of military and emergency services careers in several important ways.
Deployment and Training Schedules
Deployment windows, training rotations, and operational requirements make extended treatment commitments difficult for military personnel. Accelerated TMS allows service members to complete treatment during a short leave period without impacting readiness or missing extended duty time.
Shift Work Compatibility
First responders often work rotating shifts that make daily weekday appointments challenging. Completing treatment in one intensive week eliminates the complexity of scheduling around unpredictable work hours over multiple months.
Career Confidentiality
The shorter treatment window of accelerated TMS can provide additional discretion for those concerned about privacy. Taking a single week away is often easier to explain than weeks of daily appointments, helping military personnel and first responders maintain the confidentiality they deserve.
Rapid Return to Duty
For those experiencing severe depression that affects job performance, accelerated TMS offers the possibility of rapid symptom relief. Getting back to full operational capacity quickly benefits both the individual and their unit or department.
Making the Right Choice for Your Recovery
Choosing between standard and accelerated TMS depends on multiple factors, including your schedule, insurance coverage, symptom severity, and personal preferences. Diamond Edge TMS provides comprehensive consultations to help you make this important decision.
Factors to Consider
- Schedule and availability: Can you commit to daily appointments for 6-7 weeks, or would an intensive week work better with your life circumstances?
- Treatment urgency: Are you experiencing severe symptoms that require rapid intervention, or is a more gradual approach acceptable?
- Insurance coverage: Does your plan cover both options, or is one protocol specifically excluded?
- Personal preference: Do you prefer intensive, focused treatment or a more gradual adjustment period?
- Distance to treatment: Do you need to travel to receive TMS, making an accelerated protocol more practical
The Diamond Edge Approach
Dr. Block and the Diamond Edge team work closely with each patient to evaluate these factors and recommend the most appropriate treatment model. Our military experience gives us unique insight into the scheduling challenges and confidentiality concerns that service members and first responders face.
We also understand that treatment plans sometimes need to adapt. If you begin standard treatment but circumstances change, we'll work with you and your insurance to explore whether switching to an accelerated protocol makes sense.
Get the Depression Treatment That Fits Your Life
Both standard and accelerated TMS offer proven, effective treatment for depression and OCD when traditional approaches haven't worked. The right choice depends on your unique circumstances, goals, and needs. What matters most is taking that crucial first step toward healing.
Contact Diamond Edge TMS today to schedule a consultation and discover which TMS treatment model can help you reclaim your mental health and return to the life you deserve.
Frequently Asked Questions
Can I switch from standard to accelerated TMS if my circumstances change?
In some cases, yes. If you begin standard TMS treatment but your circumstances change—such as an unexpected deployment or urgent work requirement—discuss options with your provider. Insurance approval and clinical appropriateness will determine whether switching protocols is possible. Diamond Edge TMS works with patients to navigate these situations while maintaining treatment effectiveness.
Is accelerated TMS more effective than standard treatment?
Some research suggests that accelerated TMS can be highly effective, with several published studies showing response rates as high as 80-90% compared to the 60-80% for standard protocols. However, accelerated treatments are relatively new to the picture, and the research into them needs replication. And, their protocols vary, so standardizing them is an important next step. This lack of clarity is why most insurers will not pay for accelerated treatments – they call them “experimental” and will continue to do so until the science is more nailed down. The 'best' option depends on your individual circumstances, symptom severity, willingness to accept risk, and ability to commit to the intensive schedule required for accelerated treatment.
Will my insurance cover accelerated TMS?
Coverage varies by insurance plan. While most insurers readily cover standard TMS protocols, accelerated TMS coverage is rarely covered. TRICARE and many private insurers are increasingly recognizing accelerated protocols, but some plans may require additional documentation or limit coverage to standard treatment. Diamond Edge TMS can help verify your specific coverage and work with your insurance provider to maximize benefits.
How quickly will I feel better with accelerated TMS?
Many patients begin noticing improvements within the first few days of accelerated treatment, with continued progress over the following weeks. Some experience dramatic relief by the end of the 5-day protocol. However, everyone's response timeline is unique. Your brain may continue forming new neural connections and improving symptoms for several weeks after treatment completion, regardless of which protocol you follow.
