11|2026
Robert J. Johnson, SAP, MAC, LAC
When Medication Isn’t Enough
You tried the first antidepressant. Then a second. Maybe a third, with a dose adjustment, a new side effect, and another six weeks of waiting to see if anything would change. For many people living with depression, that cycle is exhausting. Hope wears thin.
There is another option.
Transcranial magnetic stimulation, better known as TMS therapy, is a non-invasive, FDA-cleared treatment that works directly on the brain circuits involved in mood regulation. No anesthesia. No systemic medication. No recovery time. Patients drive themselves to their appointment, sit in a comfortable chair, and return to work or home afterward.
If you live in Centennial, Colorado, or anywhere along the south Denver metro corridor, this guide explains what TMS therapy is, how it works, who tends to be a good candidate, what to expect in the treatment room, and how to take the first step toward an evaluation.
What Is Transcranial Magnetic Stimulation, and How Does It Work?
Depression is not simply a chemical imbalance. It is also a problem of communication.
Brain imaging research has repeatedly pointed to reduced activity in a region called the dorsolateral prefrontal cortex (DLPFC), an area involved in mood, motivation, and emotional regulation. When this region goes quiet, the networks connected to it can fall out of rhythm. TMS therapy is designed to wake those circuits back up.
Here is the basic mechanism. A coil placed against the scalp generates brief, focused magnetic pulses, similar in strength to those used in an MRI scanner. Those pulses pass painlessly through the skull and induce small electrical currents in the targeted neurons. Repeated over many sessions, this stimulation encourages underactive brain cells to fire and helps strengthen the connections between them. Clinicians call this neuromodulation. Patients often describe it more simply: their brain starts to feel like it is working with them again.
Standard TMS vs. Deep TMS
Not all TMS devices are built the same. First-generation systems, available since 2008, use a figure-8 coil that stimulates a relatively small, shallow area. BrainsWay Deep TMS, which earned FDA clearance for depression in 2013, uses a patented H-coil housed inside a cushioned helmet. Its magnetic field reaches broader and deeper brain regions, which reduces the targeting challenges of older equipment. It is the technology Colorado TMS Services uses in Centennial.
The key distinction from medication? TMS acts locally, on specific brain structures. Nothing circulates through the bloodstream, so the systemic side effects many people associate with antidepressants, such as weight gain or sexual dysfunction, are not part of the picture.
Who May Benefit From TMS Therapy?
The core FDA indication is clear. BrainsWay Deep TMS is cleared to treat depressive episodes in adults with Major Depressive Disorder (MDD) who have not achieved satisfactory improvement from antidepressant medication during their current episode.
In plain terms, you may be a strong candidate if:
- You have been diagnosed with major depression and at least one antidepressant has not delivered the relief you hoped for.
- Medication side effects have been difficult to tolerate, or you would prefer a non-drug approach.
- Your symptoms continue to affect work, relationships, sleep, or motivation despite therapy and medication.
- You want an effective option that does not involve anesthesia or the memory concerns sometimes linked with electroconvulsive therapy (ECT).
Deep TMS has also received FDA clearance for several related conditions, including anxious depression, late-life depression in older adults, obsessive-compulsive disorder (OCD), and short-term smoking cessation. Whether one of these applies to you is a question for your evaluation.
What do the outcomes look like? According to BrainsWay’s real-world data on more than 1,300 patients, roughly four in five people who completed at least 30 sessions achieved a clinical response, and about two in three reached remission. Individual results vary, of course, which is exactly why a careful assessment matters.
Who may not be a fit
TMS is not appropriate for everyone. People with non-removable metal in or near the head, such as aneurysm clips, cochlear implants, or certain stimulators, are generally not candidates. A history of seizures, other neurological conditions, or specific medications will also be reviewed closely before treatment is recommended.
What Happens During a TMS Session?
Many first-time patients picture something dramatic. The reality is surprisingly ordinary.
- Your first visit and mapping. At the start of treatment, the clinician finds the right magnetic strength for your brain, usually by delivering a few pulses and watching for a slight, involuntary movement of your hand. This personalized setting guides every session that follows.
- Settling in. You sit in a reclining chair, fully awake. Earplugs are provided. A padded helmet containing the H-coil is fitted comfortably over your head.
- The treatment itself. The device delivers rhythmic pulses. Expect a tapping sound and a tapping or pressure sensation on the scalp. A standard Deep TMS session for depression lasts about 20 minutes.
- Back to your day. No sedation means no downtime. You can drive yourself home or head straight back to work.
How long does a full course take?
Consistency is what drives results. A typical Deep TMS plan involves daily weekday sessions over roughly four weeks, followed by periodic maintenance sessions to help sustain improvement.
For those with tight schedules, there is also an accelerated option. The FDA-cleared SWIFT Deep TMS protocol compresses the acute phase from four weeks into six days, with five 10-minute sessions per day spaced at least 50 minutes apart. Colorado TMS Services offers SWIFT, and your care team can help you decide which schedule fits your life.
Common Side Effects: What to Realistically Expect
Does TMS hurt? For most people, no. It can feel unfamiliar at first, though, and honest expectations make the first week easier.
The most frequently reported side effects are local and temporary. In BrainsWay’s data, site pain affected about 25% of patients, site discomfort about 19%, and jaw pain about 10%. Some people also notice a mild headache after treatment. A smaller number report lightheadedness or trouble sleeping.
The good news? These effects typically fade after the first week as your scalp adjusts. An over-the-counter pain reliever often helps. If discomfort lingers, your technician can reposition the helmet or temporarily lower the intensity.
What about serious risks? Seizures are the most significant risk associated with any form of TMS, but they are rare. Their reported rate is comparable to, or lower than, the rate seen with antidepressant medication. Careful screening before treatment reduces that risk further.
How to Request a TMS Evaluation in Centennial, CO
Getting started is simpler than most people expect. You do not need to have every answer before you call.
- Take a quick self-check. Colorado TMS Services offers a free online depression questionnaire that takes only a few minutes. It is not a diagnosis, but it can help you put your symptoms into words.
- Gather your history. List the antidepressants you have tried, approximate doses, how long you took each, and why you stopped. This record often plays a central role in insurance approval.
- Book a complimentary consultation. The team will review your history, answer questions, and confirm whether TMS is a safe, appropriate fit.
- Verify coverage. BrainsWay reports that Deep TMS for depression is covered by Medicare and most private insurers. Colorado TMS Services also accepts TriCare/TriWest and VA Community Care referrals and offers financing options.
The clinic is located at 9200 E Mineral Ave, Suite 250, Centennial, CO 80112, and is open Monday through Friday, 7:00 a.m. to 6:00 p.m. Those early and evening hours make daily sessions realistic, even with a full-time job.
Take the Next Step Toward Relief
Depression narrows the world. TMS therapy may help widen it again.
If medication has not given you the results you deserve, schedule a TMS consultation with Colorado TMS Services today. Call 720-671-0533 or request your complimentary consultation online.
If you are in crisis or thinking about suicide, call or text 988 to reach the Suicide & Crisis Lifeline.
Sources
BrainsWay: Major Depressive Disorder treatment
Colorado TMS Services: Does TMS therapy hurt?
Categories:: Anxiety, Depression, Trauma/PTSD