Anxiety

WHEN YOUR ANXIETY IS STUCK IN HIGH GEAR—OR TANGLED UP WITH DEPRESSION—THERE'S A PRACTICAL NEXT STEP

Everyone experiences anxiety from time to time. It's a normal part of life and can help us deal with stressful work or life situations. In cases like these, the anxiety resolves fairly rapidly. But what about when the anxiety doesn't go away? Or when it shows up alongside depression, leaving you both keyed up and exhausted at the same time? That can be overwhelming and can make it impossible to get through the day.

If worry, tension, and restless sleep keep running your day, you're not out of options. Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive, drug-free treatment that uses gentle magnetic pulses to help regulate the brain networks involved in anxiety and mood. Many patients use rTMS alongside psychotherapy and their prescriber's guidance for a comprehensive plan.

What is rTMS for anxiety?

rTMS uses a small coil placed on the scalp to deliver precisely targeted magnetic pulses to brain regions involved in stress and emotion regulation. The goal is to nudge overactive or underactive circuits toward a healthier rhythm, often easing reactivity, worry, and physical tension over time.

What is anxious depression, and how is it different?

Anxious depression—sometimes called depression with anxious distress—is a recognized form of major depressive disorder in which depressive symptoms (low mood, fatigue, loss of interest, hopelessness) occur alongside significant anxiety symptoms (restlessness, tension, racing thoughts, fear that something bad is about to happen).

It's more than depression and anxiety happening at the same time. Anxious depression tends to:

• Feel more agitated and physically activated than in typical depression
• Involve persistent worry that compounds the low mood
• Respond less reliably to medication alone
• Carry a higher risk of treatment resistance

This combination is one of the most common presentations we see, and it's an area where rTMS is especially well-suited. The same brain networks involved in mood regulation also play a role in calming the anxiety response, so addressing both at once is often more effective than treating them separately.

What types of anxiety do you treat?

Common presentations we see include:

• Anxious Depression: Depression with significant anxiety symptoms (a recognized subtype of major depressive disorder)
• Generalized Anxiety Disorder (GAD): Persistent, hard-to-control worry across many areas of life
• Panic Disorder: Sudden, intense surges of fear (panic attacks), chest tightness, shortness of breath
• Social Anxiety Disorder: Fear of judgment or embarrassment in social or performance situations
• Specific Phobias: Marked fear of a particular situation or object (e.g., flying, needles)
• Trauma- and stressor-related symptoms (e.g., PTSD features): Anxiety linked to a past traumatic event
• OCD-related symptoms: Intrusive thoughts and compulsive behaviors (we’ll discuss whether rTMS, psychotherapy, or referral is the best fit)

Your clinician will clarify your diagnosis and tailor a plan, often rTMS alongside psychotherapy, to match your goals.

What are common symptoms of anxiety?

• Restlessness, feeling “on edge,” irritability
• Racing thoughts, difficulty concentrating, mental fatigue
• Sleep problems (trouble falling or staying asleep)
• Muscle tension, tight chest, rapid heartbeat, stomach upset
• Shortness of breath, dizziness, sweating (especially during panic)
• Avoidance of people, places, or activities that trigger fear or worry

If symptoms are lasting or interfering with daily life, reach out. If you’re in crisis or thinking of harming yourself, call or text 988.

How does rTMS help with anxiety and anxious depression?

Anxiety can reflect overactive arousal networks and under-engaged regulatory networks. In anxious depression, those same circuits are tangled up with the mood networks responsible for motivation and emotional resilience. By stimulating targeted areas, rTMS supports neuroplasticity—the brain's ability to strengthen helpful connections—which can make it easier to calm the body, focus the mind, lift mood, and sleep more soundly.

Who is a good candidate for rTMS?

You may be a fit if you:

• Have ongoing anxiety, anxious depression, or depression that hasn't improved enough with therapy and/or medications
• Prefer a non-invasive, drug-free option
• Can attend frequent sessions over several weeks

Your clinician will review your history, current medications, and safety considerations.

What roles do psychotherapy and medications play?

We often combine rTMS with psychotherapy—such as CBT, ACT, exposure-based strategies, mindfulness, and skills coaching—to reinforce gains in daily life. Many patients also continue working with their prescribing provider. With your consent, we coordinate care so everything works together.

What happens during care?

1. First visit: qEEG/EKG. We complete a quantitative EEG (qEEG) to map brainwaves and an EKG to review heart–brain timing.
2. Second visit: results & plan. We explain your findings and outline a plan — usually rTMS plus psychotherapy — tailored to your goals.
3. Two-week treatment blocks. rTMS sessions typically run five days per week for two weeks, followed by a repeat qEEG/EKG and brief symptom check. If you're improving, we continue in two-week intervals until you and your clinician are satisfied with progress.

What does an rTMS session feel like?

You'll sit comfortably while the coil rests against your scalp. Most people feel a light tapping and hear clicking during the pulses. There's no anesthesia and no downtime; you can drive and return to your day.

Are there side effects or risks?

rTMS is generally well-tolerated. The most common effects are temporary scalp discomfort or a mild headache, which usually lessen with time. Your clinician will review rare risks and answer all questions before you begin.

How soon will I notice changes?

Timelines vary. Some patients first notice shifts in sleep, physical tension, or reactivity, followed by improvements in worry and avoidance over the next few weeks. We track progress with brief questionnaires and repeat qEEG/EKG to guide next steps.

Will insurance cover rTMS for anxiety?

• Anxious depression and depression: rTMS is FDA-cleared for major depressive disorder, including patients with anxious depression, and is often insurance-covered when criteria are met.
• Primary anxiety (without depression): Coverage is variable (off-label). We'll verify your benefits and explain any out-of-pocket costs before you start. We also accept CareCredit for flexible financing.

How do I get started?

Call BrainCare Performance Center today, or request an appointment online, to talk with our New Patient Coordinator about rTMS for anxiety and anxious depression. You're not alone. There's a calmer way forward, and we're here to help.

📞 Contact Us today to speak with a member of our team.