What Is TMS Therapy?

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that treats various mental health conditions, including depression, obsessive-compulsive disorder (OCD), anxiety, and post-traumatic stress disorder (PTSD). It involves using magnetic pulses to stimulate nerve cells in the brain, specifically targeting areas associated with mood regulation. TMS has been FDA-approved for treating major depressive disorder, OCD, and smoking cessation. However, our board-certified psychiatrist, Dr. Nicholle Peralta, also uses this therapy to help patients with PTSD, anxiety, and other conditions. TMS is a highly effective treatment for restoring mental wellness and improving quality of life.

What Is TMS Therapy?

Transcranial magnetic stimulation (TMS) is a non-invasive procedure that treats various mental health conditions, including depression, obsessive-compulsive disorder (OCD), anxiety, and post-traumatic stress disorder (PTSD). It involves using magnetic pulses to stimulate nerve cells in the brain, specifically targeting areas associated with mood regulation. TMS has been FDA-approved for treating major depressive disorder, OCD, and smoking cessation. However, our board-certified psychiatrist, Dr. Nicholle Peralta, also uses this therapy to help patients with PTSD, anxiety, and other conditions. TMS is a highly effective treatment for restoring mental wellness and improving quality of life.

Table Of Contents

What Conditions Can TMS Treat?

Types of TMS Therapy

Initial Consultation

What to Expect During TMS Therapy

Recovery and Side Effects

Is TMS Therapy Right for You?

Contraindications

Benefits of TMS Therapy

Cost of TMS Therapy in Greeley, CO

We Accept Most Insurance Plans

What Makes Our TMS Therapy Different From Others?

Table Of Contents

What Conditions Can TMS Treat?

Types of TMS Therapy

Initial Consultation

What to Expect During TMS Therapy

Recovery and Side Effects

Is TMS Therapy Right for You?

Contraindications

Benefits of TMS Therapy

Cost of TMS Therapy in Greeley, CO

We Accept Most Insurance Plans

What Makes Our TMS Therapy Different From Others?

What Conditions Can TMS Treat?

Treatment-Resistant Depression (TRD)

TRD is a form of major depressive disorder that does not respond adequately to medications and psychotherapy. Patients with this condition often experience persistent feelings of sadness, hopelessness, and loss of interest in daily activities. TMS has shown promising results in alleviating symptoms of TRD by stimulating areas of the brain associated with mood regulation. It offers hope to people who have not found relief through traditional treatments.

Obsessive-Compulsive Disorder (OCD)

OCD is a mental health condition characterized by recurring, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels compelled to perform to alleviate anxiety. TMS treatment for OCD targets specific brain circuits involved in the disorder, particularly the cortico-striato-thalamo-cortical (CSTC) network. By modulating neural activity in these areas, TMS can help reduce the frequency and intensity of obsessions and compulsions, improving the quality of life for individuals with OCD.

Anxiety Disorders

Anxiety disorders encompass a range of conditions characterized by excessive worry, fear, and apprehension. These can include generalized anxiety disorder, panic disorder, and social anxiety disorder. TMS treatment for these conditions focuses on regulating activity in brain regions associated with emotional processing and fear responses, such as the prefrontal cortex and amygdala. By modulating these neural circuits, TMS can help reduce anxiety symptoms and improve overall emotional regulation.

Post-Traumatic Stress Disorder (PTSD)

PTSD is a mental health condition that may develop after experiencing or witnessing a traumatic event. Symptoms include intrusive memories, nightmares, hypervigilance, and avoidance behaviors. TMS treatment for PTSD targets brain areas involved in fear processing and emotional regulation, such as the dorsolateral prefrontal cortex and the anterior cingulate cortex. By modulating activity in these regions, TMS can help alleviate PTSD symptoms, reduce emotional reactivity, and improve overall functioning for individuals struggling with the aftermath of trauma.

Single-Pulse TMS

This type of TMS involves delivering an individual magnetic pulse to stimulate a specific part of the brain. It is used to map brain functions and assess connectivity between neural regions. Single-pulse TMS is utilized for diagnostic purposes.

Repetitive Transcranial Magnetic Stimulation (rTMS)

TMS is a therapeutic application of TMS that involves delivering multiple magnetic pulses to targeted brain regions over a set period. It can be provided in two primary forms:

High-frequency rTMS (10 Hz) is generally used to increase cortical excitability. It is often utilized to treat depression by stimulating the left dorsolateral prefrontal cortex. This is the standard option for most patients undergoing therapy.
Low-frequency rTMS (1 Hz) decreases cortical excitability and has shown promise in healing depression, anxiety, and PTSD.

The choice between these protocols depends on the disorder and the desired neurophysiological effect.

Theta Burst Stimulation (TBS)

TBS is a more recent form of rTMS that mimics the brain’s natural theta rhythm, delivering three pulses at 50 Hz stimulation. There are two main types of TBS:

Intermittent TBS (iTBS) involves triplets of 50 Hz pulses for 2 seconds and then an 8-second pause, continuing for approximately 3 minutes. It is generally used to increase cortical excitability and to treat depression.
Continuous TBS (cTBS) involves uninterrupted trains of bursts (repeated every 0.2 seconds) and is typically used to decrease cortical excitability.

TBS has gained attention due to its potential to produce the same effects with shorter treatment sessions (3-9 minutes) than traditional rTMS protocols (20-40 minutes).

Deep Transcranial Magnetic Stimulation (dTMS)

This advanced form of TMS uses specially designed coils to reach deeper brain structures than conventional methods. It stimulates brain regions previously inaccessible with standard TMS, potentially expanding the range of treatable conditions. dTMS has been FDA-approved for treating OCD and short-term smoking cessation. It shows great promise in addressing many neuropsychiatric conditions.

Types of TMS Therapy

Initial Consultation

Before beginning TMS, we schedule a consultation to determine if this procedure is appropriate. Dr. Peralta reviews the patient’s medical history to rule out any conditions that could make TMS unsafe, such as seizures or magnetic-sensitive metal implants in or near the head. She also evaluates the patient’s symptoms using standardized diagnostic tools.

If the person is eligible for TMS, Dr. Peralta will discuss the details of the procedure and offer the most suitable treatment protocol, which may include:

What to Expect During TMS Therapy

Brain Mapping

During the initial session, Dr. Peralta determines the motor threshold to pinpoint the brain region involved in the patient’s symptoms. She uses single-pulse TMS to find the area that triggers involuntary movements of the right thumb and then determines the required energy levels and other parameters to achieve the desired results. Careful mapping helps ensure that pulses are directed to the appropriate neural circuits and the correct dose.

Brain Stimulation

The patient remains awake and alert, sitting in a reclined chair. An electromagnetic coil (see picture below) is positioned over the mapped scalp location. It delivers short pulses of magnetic energy to the targeted brain areas, stimulating nerve cells. This helps to regulate brain networks and neurotransmitter levels, such as serotonin, which play a crucial role in mood regulation. Patients might feel a light tapping sensation on their scalp during the procedure. If this effect causes discomfort, our TMS provider can adjust the parameters and reduce intensity to make the procedure more comfortable for you.

Repeat Sessions

Patients usually undergo daily sessions lasting 3-20 minutes, where they comfortably receive targeted magnetic pulses. Their progress is monitored throughout treatment, with adjustments made as needed. TMS therapy typically spans 6-9 weeks, with sessions held five days a week. An accelerated protocol with 5-10 intense daily procedures can achieve the same results in a much shorter period.

Recovery and Side Effects

Patients usually undergo daily sessions lasting 3-20 minutes, where they comfortably receive targeted magnetic pulses. Their progress is monitored throughout treatment, with adjustments made as needed. TMS therapy typically spans 6-9 weeks, with sessions held five days a week. An accelerated protocol with 5-10 intense daily procedures can achieve the same results in a much shorter period.

Diagnosed With Depression

Patients being considered for TMS therapy should have a formal diagnosis of major depressive disorder. This diagnosis is based on an assessment of symptoms, such as depressed mood, loss of interest in activities, changes in appetite and sleep, fatigue, and suicidal thoughts.

Failed One or More Antidepressant Medications

Typically, patients pursue TMS therapy after trying one or more antidepressant medications without adequate relief. These drugs may have caused intolerable side effects or did not improve depression symptoms despite a sufficient trial period.

Unresponsive to Psychotherapy

Most candidates for TMS have undergone various forms of psychotherapy, such as cognitive behavioral therapy and interpersonal therapy, without significant improvement in their major depression. Even with regular sessions, their symptoms persist.

Patients With Other Mental Health Disorders

TMS therapy can address many conditions, including OCD, PTSD, anxiety, and smoking addiction. It may also address depressive symptomatology in patients with bipolar disorder. Dr. Peralta determines whether an individual is eligible after a thorough consultation and assessment.

Is TMS Therapy Right for You?

Contraindications

Patients undergoing an evaluation for repetitive TMS therapy must be carefully screened for any contraindications that would preclude them as candidates. TMS utilizes powerful electromagnetic fields to stimulate nerve cells in the brain, so safety considerations are paramount. An extensive assessment covers a broad range of potential contraindications:

Metallic Implants & Devices: Any magnetic-sensitive, non-removable metallic implants in the head or neck within 12 inches of the TMS magnetic coil are a major contraindication. This includes cochlear implants, electrodes, aneurysm clips or coils, stents, bullet fragments, ocular implants, and facial tattoos with metallic ink. If exposed repetitively to electromagnetic fields, they pose risks of shifting position, heating, or operational disruption.
Seizures & Neurological Disorders: Patients are screened for any personal or family history of seizures, epilepsy, brain surgery, stroke, brain tumors, or other neurological illnesses. TMS has the potential to increase risk for seizures.
Substance Abuse: Active substance abuse involving stimulants, hallucinogens, or excessive alcohol would need to be resolved or in sustained remission before initiating TMS therapy. Withdrawal from benzodiazepines, opiates, or other substances that lower the seizure threshold can raise the risks of adverse reactions.

Benefits of TMS Therapy

FDA Approved

TMS therapy is FDA-approved for treating major depressive disorder and OCD. Its efficacy is backed by extensive research, clinical studies, and practical evidence.

50% to 80% Success Rate

TMS has high success rates for depression, OCD, PTSD, and anxiety. Research also suggests it may be beneficial for chronic pain from fibromyalgia, migraines, and phantom limbs in individuals who have not responded to other procedures.

Non-Invasive

Unlike electroconvulsive therapy (ECT), TMS does not require sedation or anesthesia. It offers a non-invasive alternative to traditional surgical options for depression treatment.

Fast Sessions

With quick sessions, TMS therapy fits seamlessly into busy schedules, requiring minimal time commitment.

Minimal Side Effects

Common side effects include mild scalp discomfort, headaches, lightheadedness, and sensory changes. They are usually well-tolerated and diminish over a few hours.

Cost of TMS Therapy
in Greeley, CO

The total out of pocket cost, without any insurance coverage, for TMS therapy in Greeley ranges from $8,000-10,000 for a full course of treatment. Patients should consider several factors, including insurance coverage and the number of sessions required.

The exact cost of therapy can be determined after a consultation with Dr. Peralta. She will evaluate your needs, medical history, and goals. Based on this assessment, Dr. Peralta will develop a personalized treatment plan and our billing experts can provide a more accurate cost estimate.

We accept most Insurance Plans

Our friendly team helps patients navigate insurance coverage questions. We accept most plans and minimize out-of-pocket expenses. Insurance companies typically require the following from patients:

If you don't have insurance, we also offer financing options

What Makes Our TMS Therapy Different From Others?

Mindset TMS is a team of experienced professionals committed to innovative mental healthcare. Our practice is led by board-certified psychiatrist Dr. Nicholle Peralta MD, who brings over a decade of expertise and takes a comprehensive approach to treating depression, anxiety, OCD, and other conditions. Her team includes certified TMS technicians, nurse practitioners, and an office manager, all dedicated to guiding patients through their healing journey. Our mission is to revolutionize mental healthcare through personalized treatment plans and cutting-edge therapies. Mindset TMS provides a supportive and safe environment for patients seeking to overcome challenges with maximum comfort and effectiveness.