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TMS: A Drug-Free Solution for Stubborn Depression

Oct 16, 2025
TMS: A Drug-Free Solution for Stubborn Depression
Depression can be tough to treat. When meds don’t cut it, there’s another path. TMS offers a drug-free way to treat stubborn depression, with growing evidence behind its safety and effectiveness.

Dealing with depression that doesn’t improve despite trying medications and therapy is … depressing.

At Holistic Behavioral & TMS Therapy in Chicago and Aurora, Illinois, and Las Vegas, Nevada, Lawrence Abah, PMHNP-BC, and our team help many people who’ve felt that way. If you’re stuck between options and want something beyond pills, transcranial magnetic stimulation (TMS) might be the drug-free solution you’ve been looking for.

The science behind TMS

TMS uses magnetic pulses to stimulate nerve cells in specific areas of your brain, especially the dorsolateral prefrontal cortex, a region often less active in people with depression, according to neuroimaging studies. Unlike medications, which work systemically through your whole body, TMS delivers stimulation locally and noninvasively.

Recent trials, including a 2023 meta-analysis study, show that TMS significantly reduces depressive symptoms in people with treatment-resistant depression (TRD). In this study. 63% of the participants responded to the TMS treatment, and 42% achieved remission. 

Side effects are generally mild, usually limited to scalp discomfort or brief headaches that diminish over time.

When is TMS indicated, and who may benefit most?

TMS tends to be recommended when:

  1. You’ve tried at least one or more antidepressants at an adequate dose and duration with little or no relief.
  2. You’re experiencing depression that’s persisted for many months despite therapy and medications.
  3. You want to avoid or minimize medication side effects, such as weight gain, sexual dysfunction, sedation, or cognitive fog.
  4. You’re looking for a non-drug alternative due to personal preference, prior medication tolerability issues, or medical contraindications.

Clinical studies — including the ASCERTAIN-TRD study published in Molecular Psychiatry — have shown that people who fit those criteria often see improvements in mood, energy, concentration, and overall quality of life with TMS.

What to expect during a TMS treatment course

The process is outpatient, typically administered five days a week over four to six weeks, although accelerated protocols are now showing promising results under supervision. Each session lasts about 20-40 minutes. You sit in a comfortable chair, a coil is placed over part of your head, and you hear clicking sounds and feel tapping sensations, all tolerable for most people.

Your care team will monitor progress regularly. If needed, adjustments can be made in pulse strength or frequency to optimize response. After the acute course of treatment, maintenance sessions or tapering schedules may be used to sustain improvements.

Safety of TMS: What research tells us

Safety is one of TMS’s strongest qualities. Because TMS doesn’t introduce chemicals into your body, many systemic side effects common with meds are avoided. Large-scale reviews find very low risks of serious side effects. 

The most serious risk, seizures, is extremely rare when screening guidelines are followed. Scalp discomfort, mild headache, and transient twitching are far more common and typically resolve quickly.

TMS has been found safe even in older adults and in patients with certain comorbidities, though people with metallic implants in or near the head (e.g., cochlear implants, aneurysm clips) are usually not candidates.

How TMS fits into a treatment plan: Integrating care

TMS often works best when paired with other therapeutic strategies. At Holistic Behavioral & TMS Therapy, we work with you to build a treatment plan that may include psychotherapy, lifestyle modifications (sleep, stress management, exercise), or medication adjustments, depending on your history.

Because TMS is noninvasive and doesn’t require anesthesia, there’s minimal interruption to daily life. Many people notice improved mood, reduced relapse rates, better sleep, and clearer thinking.

Is TMS the right choice for you?

If you’ve tried medications and therapy already, and you’re still living with persistent depression, TMS may offer an evidence-backed path forward. 

If you’re curious about whether TMS could work for you, we’d love to help. Call Holistic Behavioral & TMS Therapy or request an appointment online today to schedule a consultation so we can review your history, answer your questions, and explore whether this drug-free path fits your mental wellness journey.