If you’ve tried medication and therapy but still don’t feel like yourself, you’re not alone, and you’re not out of options. At Phoenix Mental Health in San Antonio and Seattle, we offer transcranial magnetic stimulation (TMS), including deep TMS (dTMS), as evidence-based, noninvasive treatments that can help re-tune the brain circuits involved in mood, anxiety, and compulsive behaviors.
What is TMS and dTMS?
TMS uses a magnetic coil placed on the scalp to deliver brief, focused magnetic pulses. These pulses create tiny electrical currents that modulate activity in specific brain networks. No anesthesia, no surgery; you sit comfortably in a chair, awake and alert, and most sessions last 20–30 minutes. The most common side effects are temporary scalp discomfort or a mild headache; the serious risks (such as seizure) are rare, and we screen carefully to minimize them.
Deep TMS is a form of TMS that uses a different coil design to stimulate broader and deeper brain pathways compared to standard (often called “repetitive”) TMS. In the U.S., deep TMS coils have specific FDA clearances beyond depression, including for obsessive-compulsive disorder (OCD) and smoking cessation.
How TMS Helps
Mood and behavior don’t come from just one “switch” in the brain—they’re shaped by a whole network of areas working together. In depression, some of these areas can be underactive while others are overactive, and the communication between them doesn’t flow as it should. TMS helps by sending gentle, repeated pulses that encourage these brain circuits to work in a healthier, more balanced way. Over a series of treatments, this can help “reset” the system and improve mood. While the science behind it is complex, what’s important to know is that large clinical studies and expert guidelines agree that TMS is a safe and effective option for people who haven’t found relief from medication or therapy alone.
Does it work? What the evidence shows
No single treatment works for everyone, but TMS is supported by randomized controlled trials and real-world data.
- In a sham-controlled randomized trial of deep TMS for depression, response and remission rates were significantly higher with deep TMS than with sham (placebo) stimulation after five weeks. This demonstrates that the benefits aren’t just expectancy; they’re tied to active stimulation of brain circuits.
- More recent clinical programs—including in older adults, a group often under-represented in trials—have also shown strong outcomes with deep TMS after a typical 20–30 session course. Individual results vary, but response and remission can emerge by the second to fourth week, which is why sticking with the schedule matters.
- Consensus reviews continue to conclude that TMS is both safe and efficacious for depression, with newer schedules (including accelerated protocols in some centers) aiming to improve convenience without compromising outcomes.
A Closer Look at Depression: Why TMS is a Fit for Many
Depression affects motivation, energy, sleep, appetite, and concentration because it shifts how your brain prioritizes and processes information. Standard TMS typically targets the left dorsolateral prefrontal cortex (DLPFC), a hub tied to cognitive control and mood regulation, while deep TMS engages a wider, deeper network that can include medial prefrontal and cingulate regions implicated in rumination and negative bias. By restoring more balanced activity across these circuits, TMS may lift mood, ease anhedonia (loss of pleasure), and improve cognitive symptoms like slowed thinking or indecision.
Who’s a good candidate? People with treatment-resistant depression (for example, inadequate benefit from one or more antidepressants), those who cannot tolerate medication side effects, or those preferring a non-systemic option (TMS doesn’t cause weight gain, sedation, or sexual side effects). Contraindications include certain metal implants in or near the head and a history that substantially raises seizure risk—we review this carefully with you before starting.
Why choose deep TMS vs. standard TMS?
Both are excellent options. Standard TMS is highly targeted and well-tolerated; deep TMS reaches broader and deeper networks with specialized H-coils and has additional FDA clearances for OCD and smoking cessation. In the clinic, the choice depends on your diagnosis, symptom profile, and prior treatment response. We’ll explain the trade-offs in plain language and recommend a plan with you—not to you.
Two Convenient Locations. Same Standard of Care
Whether you visit us in San Antonio or Seattle, you’ll receive the same thoughtful, data-informed approach. If you split time between the cities, we can plan a seamless handoff so your treatment continues without interruption.
Is TMS right for you?
If you’re curious about TMS or deep TMS, the next step is a conversation. We’ll help you weigh benefits, risks, and alternatives in your specific situation, and we’ll be transparent about what the evidence supports today. Many patients tell us they appreciate that TMS is noninvasive, precise, and doesn’t add systemic side effects, and that the routine of daily sessions actually becomes a steady path back to feeling like themselves. Contact us to schedule an appointment and learn more about the safety and effectiveness of TMS and deep TMS.
