TMS

When depression keeps hanging on, there’s a proven next step.

If medication and talk therapy haven’t brought the relief you hoped for, you’re not out of options. Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive, drug-free treatment that uses gentle magnetic pulses to stimulate brain areas involved in mood regulation. It’s FDA-cleared for major depressive disorder, well-tolerated for most people, and often covered by insurance when medical criteria are met.

At BrainCare Performance Center Carlsbad, we start with qEEG brain mapping and EKG to understand how your brain is communicating. Then we deliver an rTMS plan aimed at restoring healthier activity patterns, so you can think clearer, feel steadier, and get back to being yourself.

What is TMS, and how does it work to relieve depression symptoms?

rTMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain involved in mood regulation.

We place a coil near the head to generate brief magnetic pulses, which feel like gentle taps. These pulses pass through the skull and stimulate brain cells in areas thought to be involved in mood regulation (often the left dorsolateral prefrontal cortex).

The stimulation increases the release of neurotransmitters like serotonin, dopamine, and norepinephrine, which can improve mood and relieve depression.

By stimulating nerve cells, rTMS promotes neuroplasticity, the brain's ability to change and adapt to new experiences.

At BrainCare Carlsbad, we personalize your treatment with EEG-guided rTMS, tailoring it to your brain's exact neurological condition. This helps us monitor your response, making the rTMS treatment even more effective.

What conditions do you treat with TMS?

At BrainCare Performance Center Carlsbad, we recommend rTMS to treat:

• Depression
• Major depressive disorder (MDD)
• Treatment-resistant depression (MDD that doesn't respond to antidepressants)
• Adolescent depression
• Postpartum depression
• Persistent depression with anxiety
• Post-traumatic stress disorder (PTSD) with depression

What types of TMS treatment do you offer?

Not all TMS is delivered the same way. At BrainCare Performance Center, we offer three approaches to transcranial magnetic stimulation — standard TMS, accelerated TMS, and theta burst TMS — so we can tailor your treatment plan to your symptoms, your schedule, and your goals. Here's how they differ.

Standard TMS

Standard TMS (also called conventional or standard rTMS) is the original, most extensively studied form of the treatment. It delivers magnetic pulses at a steady, moderate pace during each session, which typically runs 20 to 40 minutes. A full course usually means five sessions a week for four to six weeks — about 30 sessions in total.

Because it has the longest track record, standard TMS is often the starting point for patients who want the most researched protocol available, or whose schedule allows for a daily visit over several weeks. It's FDA-cleared for major depressive disorder and is backed by decades of clinical data on both safety and effectiveness.

Theta Burst TMS

Theta burst stimulation (TBS) uses a different pulse pattern — short, rapid bursts that mimic the brain's natural theta rhythm — to deliver a similar dose of stimulation in a fraction of the time. A theta burst session takes about 3 to 10 minutes, compared to 20 to 40 minutes for standard TMS.

Clinical research has found theta burst to be just as effective as standard TMS for depression, which is why it's FDA-cleared for the same use. It's a good fit for patients who want the full benefit of TMS but need shorter appointments to fit around work, caregiving, or a busy schedule.

Accelerated TMS

Accelerated TMS compresses an entire course of treatment — normally spread across four to six weeks — into a much shorter window, sometimes just five days to two weeks. This is done by delivering multiple sessions per day (often using theta burst pulses, since their short length makes multiple daily sessions practical) with a rest period built in between.

Accelerated protocols were developed for patients who need faster symptom relief or who can't commit to daily visits over a month or more, such as those with an upcoming life event, a demanding schedule, or a more urgent clinical need. Studies on accelerated protocols have shown meaningful improvement in depression symptoms in as little as five days.

Which Option Is Right for You?

The right protocol depends on your diagnosis, your symptom severity, and what fits realistically into your life. During your consultation, we'll walk through these options together and recommend the approach most likely to help you feel better, on a timeline that works for you.

What are some benefits of TMS treatment?

rTMS has many benefits, particularly when compared to other depression treatments like medications. These include:

• rTMS treatment is medication- and anesthesia-free and performed on an outpatient basis.
• The treatment has no or few side effects. Any side effects are usually mild (like a headache or scalp discomfort) and can be relieved by taking painkillers or adjusting the stimulation parameters.
• rTMS works when medications don't. 70-80% of patients experience relief after treatment, compared to 27.5% after the first-line medication, down to 6.9% with the fourth-line medication.
• The results from this treatment are lasting. 50% of patients completing rTMS achieve a total remission of their depression. The results last at least two years in 90% of patients who improve with rTMS, while approximately 35% need an occasional maintenance session.
• We can deliver rTMS as a standalone treatment or with medications.
• Treatment for depression with rTMS is covered by most insurance.
• rTMS is FDA-approved for depression, and we follow all FDA-approved protocols.

Who is a good candidate for TMS?

You may be a strong candidate if you:

• Have tried antidepressant medications and/or psychotherapy without enough relief
• 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 to confirm that rTMS is appropriate.

What happens during TMS care?

1. First visit: qEEG/EKG
   We perform a quantitative EEG (qEEG) to map your brainwaves and an EKG to assess heart–brain timing. (We do this for both rTMS and MeRT patients.)
2. Results & plan
   At your follow-up, we review your maps and outline your rTMS plan.
3. Two-week treatment blocks
   Sessions are typically scheduled five days a week for two weeks. We then repeat qEEG/EKG and check symptoms. If you’re improving, we continue in two-week intervals until you and your clinician are satisfied with progress.

What does a TMS session feel like?

You’ll sit comfortably while the coil rests against your scalp. Most people feel a tapping sensation and hear clicking sounds during the brief pulses. There’s no anesthesia and no downtime; you can drive yourself and return to normal activities right away.

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 your questions before you begin.

How soon may I notice changes?

Everyone’s timeline is different. Some people first notice improvements in sleep, energy, or mental clarity, followed by mood changes over the next few weeks. We track progress with brief questionnaires and repeat qEEG/EKG to guide next steps.

Is TMS covered by insurance?

rTMS for depression is covered by many major insurance plans when medical criteria are met. Our team will verify your benefits and outline any out-of-pocket costs before you start. We also accept CareCredit for flexible financing, and you can use your HSA/FSA.

Can I combine TMS with psychotherapy or medications?

Yes. Many patients continue working with their prescribing providers and benefit from psychotherapy during rTMS. In fact, we often combine rTMS with psychotherapy here at our clinic as it's proven to get even better results than either treatment alone. With your consent, we coordinate care to support durable, real-life gains.

How do I get started?

Call BrainCare Performance Center today for a free consultation, or request an appointment online to talk with our New Patient Coordinator about rTMS treatment for depression. You’re not alone. There is real hope, and we’re here to help you feel like yourself again.

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