Transcranial Magnetic Stimulation (TMS) | MI Counseling

If depression or anxiety has made it hard to work, sleep, or enjoy life, you may feel stuck—especially if medicines have not helped or caused side effects. Transcranial Magnetic Stimulation (TMS) in Michigan is a non-surgical treatment that uses gentle magnetic pulses to help areas of the brain linked to mood. TMS does not require anesthesia, and you can return to normal activities after each visit. It is often for people with depression who have tried therapy and medication but still do not feel better.

TMS is done in an outpatient clinic by trained medical professionals. The goal is to improve mood, focus, and daily function over a series of sessions. Many patients like that TMS is targeted to the brain and does not affect the whole body the way some medicines can.

Signs You Might Benefit

TMS is not for everyone, but it can be a strong option when symptoms do not improve with standard care. You may be a good fit if you have one or more of the signs below.

• Depression that does not lift: sadness, numbness, or hopelessness most days
• Low energy and motivation: even small tasks feel too hard
• Sleep problems: trouble falling asleep, staying asleep, or sleeping too much
• Changes in appetite: eating much more or much less than usual
• Brain fog: poor focus, slow thinking, or trouble making decisions
• Loss of joy: you do not enjoy hobbies, friends, or family like you used to
• Medication side effects: weight gain, sexual side effects, nausea, or feeling “flat”

Possible benefits of TMS can include a better mood, less negative thinking, improved sleep, and more ability to handle everyday stress. Some people notice changes within a few weeks, while others need the full course to feel a clear difference.

Evidence-Based Approach

Our approach is based on what research shows works best, plus what is safest for you. Major medical sources describe TMS as an evidence-based treatment for major depressive disorder, especially when other treatments have not helped enough (National Institute of Mental Health, n.d.). Large reviews also support TMS as an effective option for depression, with ongoing study for other conditions (Lefaucheur et al., 2020).

How TMS works (simple explanation)

TMS uses a magnetic coil placed near your scalp. The coil sends short magnetic pulses. These pulses create tiny electrical changes in brain cells. This can help “wake up” underactive brain networks involved in mood and thinking. The treatment is focused and does not go through the whole body.

Personalized targeting and clinical reasoning

Before treatment, we review your symptoms, your treatment history, and your goals. We then choose settings that match your needs, such as the stimulation site and intensity. Your clinician will also watch for things that may change the plan, like sleep loss, medication changes, or increased anxiety.

Coordination with your care team

TMS works well when paired with strong support. If you have a therapist, psychiatrist, or primary care clinician, we can coordinate care (with your written permission). Many patients continue therapy and/or medication during TMS, depending on what is safest and most helpful.

Safety and Michigan standards

TMS is provided under medical oversight and follows Michigan licensing and scope-of-practice standards for healthcare professionals. We also follow clinic safety protocols, informed consent rules, and device safety guidance. During your intake, we screen for conditions that may make TMS unsafe, such as certain metal implants in or near the head.

What to Expect

Knowing what will happen can lower stress. Here is a clear view of the process.

Step 1: Intake and eligibility screening

Your first visit includes a full review of symptoms and past treatment. We ask about medications, therapy, sleep, substance use, medical history, and any implants or past seizures. You will also complete brief rating scales so we can track progress in a measurable way.

• Review of depression and anxiety symptoms
• Review of past medication trials and therapy
• Safety screening (implants, neurologic history, pregnancy status when relevant)
• Discussion of goals and expected timeline

Step 2: Mapping (finding the right dose)

At the first treatment session (or a separate visit), we do a “mapping” process. This helps us find the best spot and the right intensity for your brain. You will be awake and seated in a comfortable chair. You may feel tapping on the scalp and hear clicking sounds from the device.

Step 3: Treatment sessions

Most people do TMS five days per week for several weeks. Each session typically lasts around 20–40 minutes, depending on the protocol used. You can drive yourself to and from treatment, and most patients go back to work or school the same day.

• During the session: you may feel a tapping sensation; mild headache or scalp soreness can happen
• After the session: you can return to daily activities; no recovery room needed
• Progress checks: we measure symptoms regularly and adjust the plan when needed

Common side effects and safety notes

The most common side effects are mild and temporary, like scalp discomfort or headache. Serious side effects are rare, but we still take them seriously. We review risks with you before starting and monitor you throughout treatment.

Insurance

Many insurance plans cover TMS for depression when certain criteria are met. Coverage rules can feel confusing, especially when you are already not feeling well. Our team can help you understand benefits and next steps.

What costs may include

• Copay: a set amount you may pay per visit
• Deductible: the amount you may need to pay before coverage begins
• Coinsurance: a percentage of the visit cost that you may share with your plan

Medical necessity and prior authorization

Insurers often require proof that depression has not improved after trying other treatments, such as multiple antidepressant trials and therapy. Many plans also require prior authorization before sessions begin. We can submit clinical records and rating scales to support medical necessity.

Mental health parity

Mental health parity laws are meant to prevent unfair limits on mental health coverage compared with medical coverage. Even so, plans can still have criteria. If coverage is denied, we can discuss appeal options and provide clinical documentation when appropriate.

FAQ

Is TMS painful?

TMS is usually not painful, but it can feel strange at first. Most people describe it as tapping on the head. If you feel discomfort, we can adjust positioning and settings while keeping the treatment effective.

How soon will I feel better?

Some people notice small changes in sleep, focus, or mood in the first 2–3 weeks. Others need more time. We track your symptoms during treatment so you can see progress, even if it feels slow day to day.

Can I stay on my depression medication during TMS?

Many patients continue medications and therapy during TMS. Your clinician will review your full medication list for safety. If any changes are needed, we will coordinate with the prescriber (with your permission).

Who should not get TMS?

TMS may not be safe if you have certain metal or electronic implants in or near the head (for example, some aneurysm clips or implanted stimulators). A history of seizures may also change eligibility. We screen carefully during intake to keep you safe.

References: National Institute of Mental Health. (n.d.). Brain stimulation therapies. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/topics/brain-stimulation-therapies

Lefaucheur, J.-P., Aleman, A., Baeken, C., Benninger, D. H., Brunelin, J., Di Lazzaro, V., Filipović, S. R., Grefkes, C., Hasan, A., Hummel, F. C., Jääskeläinen, S. K., Langguth, B., Leocani, L., Londero, A., Nardone, R., Nguyen, J.-P., Nyffeler, T., Olivier, E., Padberg, F., … Ziemann, U. (2020). Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018). Clinical Neurophysiology, 131(2), 474–528.