TMS for Depression: What It Is, How It Works, and What to Expect at Bluegrass Advanced Mental Health

"If antidepressants haven’t given you your life back, TMS offers a different path. Instead of medication that circulates through your whole body, TMS uses targeted magnetic pulses to stimulate the specific brain circuits involved in mood regulation. No pills, no sedation, no systemic side effects, and for many people with treatment-resistant depression, real relief when other approaches haven’t worked."

If you’re reading this, you’ve probably already tried more than one antidepressant. Maybe the first one did nothing. Maybe the second one worked for a while and then stopped. Maybe the side effects, the weight changes, the emotional flatness, the fatigue, cost you as much as the depression did. That frustration is exactly why TMS exists as an option.

Transcranial magnetic stimulation (TMS) is an FDA-cleared, noninvasive treatment that uses a magnetic coil to deliver gentle pulses to the brain regions that regulate mood, most often the left dorsolateral prefrontal cortex. In people with depression, this region often shows reduced activity than in people without depression. Repeated stimulation over a full treatment course can help restore healthier activity in that circuit.

At Bluegrass Advanced Mental Health (BAMH), TMS is delivered using the BrainsWay Deep TMS H1 Coil, under the direct supervision of Dr. David Roth, a triple board-certified physician in Adult Psychiatry, Child & Adolescent Psychiatry, and Pediatrics.

Two ways to complete treatment: Standard or Accelerated

Not every patient’s life fits the same schedule. Bluegrass AMH offers two protocols using the same BrainsWay technology, so the choice comes down to what fits your life, not a one-size-fits-all default.

Standard TMS

• Acute phase: 5 sessions per week for 4 weeks (20 sessions), each session about 20 minutes
• Continuation phase: 2 sessions per week for 8 weeks (16 sessions)
• Total: 36 sessions over 12 weeks
• Ideal for patients who want a steady, once-daily routine and don’t need to compress treatment into a short window

Accelerated TMS (BrainsWay SWIFT™)

• Acute phase: 5 sessions per day for 6 days (30 sessions) over the span of 2 weeks, each session is 10 minutes with a 50 minute rest period between sessions.
• Continuation phase: 2 sessions per week for 4 weeks (8 sessions), recommended to help lock in improvements
• Total: 38 sessions, with the intensive phase compressed into just 6 days
• FDA-cleared, and according to BrainsWay’s published data, a more effective and time-efficient alternative to traditional TMS without compromising safety or quality of care.
• Ideal for patients with tighter timelines, travel constraints, or a preference to complete the most intensive phase of treatment quickly

The clinicians at BAMH will help you determine which protocol fits your situation during your evaluation. Some patients start standard and later choose accelerated for a future course; others go straight to accelerated because of scheduling. There’s no wrong choice, only the one that fits your life.

Who’s a good candidate for TMS?

TMS is generally considered for adults and adolescents (ages 15 and older) at Bluegrass AMH) with moderate to severe depression that hasn’t responded adequately to medication. Signs it may be worth discussing with Dr. Roth include:

• You’ve tried one or more antidepressants without enough relief
• Side effects from medication have been difficult to tolerate
• You want a non-medication option that can be used alone or alongside your current treatment
• You can commit to the treatment schedule, standard or accelerated

Who may not be a good candidate

TMS isn’t right for everyone. It may not be recommended if you have certain non-removable metal implants or devices near the head (like cochlear implants or aneurysm clips), an active substance use disorder, or other conditions that could affect safety. Dr. Roth reviews your full medical history during your evaluation to determine whether TMS is appropriate.

What a session actually feels like

Whether you choose standard or accelerated TMS, the in-session experience is the same:

• You’re seated comfortably, fully awake, no sedation and no anesthesia
• You can listen to music, watch relaxing videos, read, meditate, or simply rest during your session
• You’ll feel a light tapping sensation on your scalp and hear a clicking sound as the pulses are delivered
• When the session ends, you drive yourself home or back to work and resume your day immediately, no downtime
• Mild scalp discomfort in the first few sessions is common and typically fades quickly as you continue treatment.

How effective is TMS?

Clinical data on BrainsWay’s accelerated SWIFT protocol shows an ~88% response rate and a 78% remission rate (Hanlon et al., Brain Stimulation, 2026). This is third-party, peer-reviewed research that the Bluegrass protocol is built on; Bluegrass AMH was not a site in this particular trial.

Here’s what those terms mean in practice:

• Response - means your symptoms improve significantly, often at least 50%. You may notice more energy, more motivation, or an easier time getting through your day.
• Remission - means your symptoms improve enough that you no longer meet the clinical criteria for depression. Improvement is often gradual. Some patients notice changes within the first couple of weeks; for others, it takes longer. Completing the full course, including the continuation phase, gives treatment the best chance to work.
• Side effects - TMS is generally well tolerated. The most common side effects include mild scalp discomfort or tenderness (most noticeable in the first few sessions), headache, or temporary lightheadedness. Serious side effects, including seizure, are rare. Dr. Roth reviews your medical history before treatment begins to confirm TMS is a safe option for you.
  

Is TMS covered by insurance?

Most major insurance plans, including Aetna, Anthem, Cigna, Medicare, Tricare, and UnitedHealthcare, cover TMS for treatment-resistant depression when certain criteria are met. Our team handles insurance verification, prior authorization, and qualification on your behalf from start to finish. Accelerated TMS is currently not covered by insurance, Bluegrass AMH has self-pay and financing options available.

Key takeaways

• TMS is an FDA-cleared, non-invasive treatment using magnetic pulses to stimulate mood-regulating brain circuits
• Bluegrass Advanced Mental Health offers two protocols: Standard (36 sessions over 12 weeks) and Accelerated SWIFT (38 sessions, with the acute phase compressed into 6 days)
• No sedation or anesthesia required for either protocol; you drive yourself home the same day
• Clinical data on the accelerated protocol shows an ~88% response rate and 78% remission rate (Hanlon et al., Brain Stimulation, 2026)
• Most major insurance plans cover TMS for treatment-resistant depression when criteria are met

Frequently asked questions

• How long does a full TMS course take? Standard TMS spans 12 weeks total: 4 weeks of daily sessions (5 days a week) followed by 8 weeks of twice-weekly continuation sessions, 36 sessions in all. Accelerated TMS compresses the most intensive phase into 6 days (5 sessions a day), followed by a 4-week continuation phase of 2 sessions a week, 38 sessions total.
• Is TMS painful? Most patients describe it as a tapping sensation rather than pain. Mild scalp discomfort is common in the first few sessions and typically fades as treatment continues.
• Can I keep taking my antidepressant during TMS? Yes. Combining TMS with an existing antidepressant is a normal part of care at Bluegrass. Dr. Roth will discuss your specific situation during your evaluation.
• What if TMS doesn’t work for me? Bluegrass Advanced Mental Health also offers Spravato® and comprehensive medication management, so if TMS isn’t the right fit, it isn’t the end of the road.

Ready to find out if TMS is right for you? See If You Qualify and our care team will verify your insurance and walk you through both protocol options.