Beyond Medication: TMS Therapy for Treatment-Resistant Depression

Living with depression can feel like carrying a weight you can’t put down. For some people, standard treatments like medication and therapy help lift that weight. But for others, depression stubbornly remains, even after trying several treatments. When depression doesn’t respond to usual care, it’s called treatment-resistant depression (TRD). Fortunately, there’s hope beyond medication—one promising option is Transcranial Magnetic Stimulation (TMS).

Here at Goolsby and Associates, we see many clients who experience TRD. They turn to our expertise to help treat this condition because of transcranial magnetic stimulation, a revolutionary FDA approved treatment option for those who suffer with TRD. In this post, we’ll explain what treatment-resistant depression is, the traditional ways it’s treated, and why TMS therapy might be a good fit for those who feel stuck. We’ll also touch on accelerated TMS, an emerging approach aiming to bring relief faster.

What is Treatment-Resistant Depression?

Let’s start by understanding the term. Treatment-resistant depression generally means that someone has tried at least two different antidepressant medications (taken correctly and for a long enough time) and still feels significant depression symptoms.

This can feel frustrating and isolating. People with TRD may experience:

Ongoing sadness or hopelessness
Loss of interest in activities they used to enjoy
Trouble sleeping or sleeping too much
Low energy and fatigue
Difficulty concentrating
Thoughts of self-harm or suicide

It’s important to know that TRD doesn’t mean depression is untreatable. It simply means that different strategies might be needed. For this reason, we want you to spread the word about TMS and accelerated TMS treatment protocols. TMS can be a game changer for those enduring treatment resistant depression.

Traditional Treatments for Depression

Most people who experience depression start with traditional treatments. These include:

Antidepressant Medications

Doctors often prescribe medications like:

SSRIs (Selective Serotonin Reuptake Inhibitors) — e.g., sertraline (Zoloft), fluoxetine (Prozac)
SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors) — e.g., venlafaxine (Effexor), duloxetine (Cymbalta)
Atypical antidepressants like bupropion (Wellbutrin)

These medications aim to balance brain chemicals that affect mood.

Psychotherapy (Talk Therapy)

Cognitive Behavioral Therapy (CBT) and other talk therapies help people identify and change negative thinking patterns. Therapy can teach coping skills and improve how people handle stress, relationships, and emotions.

Lifestyle Changes

Doctors often recommend:

Regular exercise
Healthy eating
Better sleep habits
Mindfulness and relaxation techniques
Reducing alcohol or drug use

Changes in lifestyle can go a long way when it comes to assisting with the treatment of depression. While creating and maintaining lifestyle changes can be challenging, they are beneficial when combined with other treatment modalities.

Combination Therapy

Sometimes, medication and therapy are combined for better results.

Why Do Standard Treatments Sometimes Fall Short?

Depression is complex. Brain chemistry, genetics, life events, stress, and medical conditions can all play a role. Even with the best efforts, some people’s symptoms persist despite trying different medications or therapy.

Some reasons why standard treatments might not work include:

Side effects that make people stop medications
Medications not effectively targeting the brain areas involved in their depression
Underlying medical conditions complicating treatment
Unique brain patterns that don’t respond well to medication alone

For people with TRD, continuing the same treatment plan may not be enough. That’s where TMS therapy comes in. Here is where we must pause and let you know that although you are following all the traditional treatment protocols, your depression may persist. And this is not your fault! At Goolsby and Associates, we understand the complexities of a depression diagnosis and work with you to help you find your best course of action. Please remember that depression can be pervasive and complex. If you don’t find relief from medication and psychotherapy, there isn’t something intrinsically wrong with you. You may just need another treatment option.

What is TMS Therapy?

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment cleared by the FDA for depression. Instead of medication, TMS uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation.

Here’s how it works:

A coil is placed gently against your scalp.
Magnetic pulses pass through your skull into brain tissue beneath.
These pulses help “wake up” underactive parts of the brain linked to depression.

TMS is:

Non-invasive (no surgery)
Drug-free (no systemic side effects like weight gain or sexual dysfunction)
Performed in an outpatient setting—you’re awake and alert during the session
Usually requires no anesthesia

Many people describe TMS as feeling like a light tapping or tapping sensation on the scalp. Sessions at Goolsby and Associates typically last around 5 to 30 minutes, five days a week, over four to six weeks.

Why TMS Might Be a Good Fit for Treatment-Resistant Depression

If traditional medications or therapies haven’t helped, TMS can offer another option. Here’s why it’s appealing:

Effective for many with TRD: Studies show that about half of people with TRD respond positively to TMS, and about a third achieve full remission.
Minimal side effects: Unlike medications, TMS doesn’t usually cause weight gain, sexual side effects, or grogginess. Some people experience temporary scalp discomfort or mild headaches.
Targeted treatment: TMS focuses on specific brain regions linked to mood, rather than affecting the whole body like medication.
No memory loss: Unlike electroconvulsive therapy (ECT), TMS doesn’t cause memory issues.

For those who feel they’ve run out of options, TMS can be life-changing. People often describe experiencing clearer thinking, lifted moods, and renewed hope.

What is Accelerated TMS?

Traditional TMS involves daily sessions over several weeks. But researchers and clinicians are exploring accelerated TMS protocols, which deliver multiple sessions per day over a shorter period—sometimes just a week or two.

Early research suggests accelerated TMS may:

Speed up symptom relief
Offer similar effectiveness to standard TMS protocols
Provide quicker treatment for people in severe distress

However, accelerated TMS is still being studied and may not be available everywhere. If you’re interested, talk Goolsby and Associates about whether it’s right for you. We will work with you to determine if accelerated TMS is a good fit for you.

Is TMS Right for You?

If you’ve tried at least two antidepressants without significant relief—or can’t tolerate medication side effects—TMS might be worth exploring. A mental health provider can:

Review your medical history
Evaluate your depression symptoms
Determine if TMS is a good fit

Remember: TMS isn’t an instant cure. It’s part of a broader treatment plan. Many people continue therapy, lifestyle changes, or even medication alongside TMS to stay well long-term.

A Message of Hope

Treatment-resistant depression can feel overwhelming. But it’s important to know there are options beyond medication. TMS offers a safe, drug-free alternative that can help many people reclaim their lives.

If you’re struggling and feel like nothing has worked, please reach out to Goolsby and Associates. We are a leading provider of TMS in the North Georgia region and welcome any questions you may have. We want to see you living your best life and TMS may be a treatment protocol to help you do just that.