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Frequently Asked Questions

How does it work?

“So TMS has been around FDA-approved for ten years. With actually, over 15,000 studies looking at the utility of TMS therapy. At this point, there is no longer a debate on whether or not it works. It's covered by insurance, it’s covered by Medicare in all 50 states.” - Dr. Geoffrey Grammer. 

“I really just think it's that people haven't heard of it because it's so new. I have had many people ask me about it more and more over the years. So it's gaining in popularity as far as people knowing about it” - Dr. Misty Borst


“I would say TMS really does treat depression. It helps alleviate patient symptoms, it will keep those symptoms gone for a substantial period of time.” - Dr. Geoffrey Grammer “Looking down the road after that; there's a chance depression can come back but 80% of people who have had a good response the first time around will have a good response the second time around” - Dr. Misty Borst.  “Remission is possible and I don't really consider myself finished until we've done everything we can to get there. Even if medications are partially successful, if people are not completely well then I think TMS is actually an excellent idea.” - Dr. Will Sauvé.

“Okay, that one's an easy one. ECT and TMS are both good treatments, but TMS is a lot safer, it's a lot more convenient and it's done in the outpatient setting.” - Dr. Don DuBose. “TMS works differently than an electric compulsive therapy. It's a very specific targeting of areas of the brain responsible for depression. Whereas in shock therapy, you're inducing a seizure over the entire brain.” - Dr. Geoffrey Grammer.  “ECT has to be done in the hospital that requires anesthesia. You're going to have to have someone drive you to and from just like same-day surgery. TMS on the other hand is done in an outpatient setting. People drive themselves, there is no particular recovery time afterward; people retain their normal level of consciousness throughout.” - Dr. Will Sauvé.

“I tried counseling and it wasn't for me. If I sign up for TMS, does that mean I have to sit around and talk about my feelings? I'm happy to tell you the answer is no. No, you don't.” - Dr. Will Sauvé. “We don't do therapy as part of the TMS procedure. But, if you want to be left alone to watch TV, to rest you can do that. If you want to talk to the TMS technician about your day, you can do that.” - Dr. Geoffrey Grammer. “And that's also another thing I love about TMS. Because the machine is really there to do the work, and it'll either help or it won't. It will never be because you didn't share enough.” - Dr. Will Sauvé.

IS THIS RIGHT FOR ME?

“How much does it cost to get TMS therapy? Another big benefit of Greenbrook TMS is because TMS is all we do, we're pretty adept at handling the entire insurance question. So I've always been very proud and pleased that people that come to me to find out about TMS, can have all of the insurance stuff answered for them. And that is usually completely wrapped up before anybody starts treatment.” - Dr. Will Sauvé. “Most insurance plans now cover TMS therapy. Medicare covers TMS therapy in all 50 states, so in those circumstances, it’s whatever your copay would be.” - Dr. Geoffrey Grammer.

“Tell me about your typical patient; how old they might be or how depressed they might be. As far as how depressed a person might be they should have a moderate or severe major depressive disorder. - Dr. Misty Borst. “There is no typical patient. If you're suffering, if you think you may have depression; it's important to present for care. Most likely we will be able to help you.” - Dr. Geoffrey Grammer.  “I would say that the chance of benefit is high and that in almost every case it's worth doing.” - Dr. Will Sauvé.


“I'm considering TMS therapy. What things should I be looking for? Is it safer if it takes place in a hospital? Or do I need to be put under anesthesia? So you definitely do not need to be put under anesthesia and you don't need to be in a hospital.” - Dr. Misty Borst. “ TMS is most often provided in an outpatient setting so that it is convenient for patients to receive. Most clinics will have safety mechanisms in place, should there be a problem with the TMS therapy.”- Dr. Geoffrey Grammer. “So I would definitely look for a facility that has done a lot of TMS. It feels friendly and that you have a good gut reaction to when you're there and that is accessible” - Dr. Misty Borst.


“Why do patients end up trying TMS? Most patients come to us for TMS therapy, because other treatments have not offered them the relief that they were hoping for.” - Dr. Geoffrey Grammer. “They want to feel better, and what they've been trying hasn't been able to help them feel better or feel as good as they should be feeling.” - Dr. Misty Borst. “TMS can help you get all the way better. The goal of depression treatment is remission, not just walking through life in a fog. So if you haven't gotten better with your medications, you're still doing therapy, you haven't gotten over the hump; TMS is a novel way to help people get better when everything else has failed. - Dr. Don DuBose.

“I used to be so depressed that I could barely get out of bed. I started medication, I am doing better, but I still have some days that are pretty bad. Should I look into TMS? It makes me think of how when you ask somebody how they were doing they say, ‘oh I'm fine’. And certainly a person who is just a little bit depressed might believe they're

fine. But that's not a reason to not try to feel better, or less depressed than they currently feel.” - Dr. Misty Borst. “A lot of times when patients start medication for their depression it will help them feel better, but they don't feel cured. The goal here is complete remission of your symptoms. And a lot of times if we add TMS therapy to the medication that's had a partial effect, then the combination of the two is enough to completely relieve someone's symptoms.” - Dr. Geoffrey Grammer. So if you haven't gotten better with your medications, you definitely should consider TMS.” - Dr. Don DuBose.

“Is TMS only for people who are chemically messed up with natural depression? I lost my job, got a divorce, and had a parent pass away all in the same two-year period. So I'm not truly depressed, it's just these bad factors bringing me down right now. Can TMS help me? There's a difference between being sad and being depressed. What depression is, is when you're sad even when you should not be.” - Dr. Geoffrey Grammer. “There are plenty of times in our lives where we have a lot of unfortunate things, or stressful things happening all at the same time; that makes us feel depressed, but it also can change our brain and how our brain works and make us have a depressed brain.” - Dr. Misty Borst. “A treatment that could resolve the major

depressive disorder is not necessarily going to fix those problems in someone's

life, but they might finally have the ability to maybe have a chance to make

their life more like what they want.” - Dr. Will Sauvé.

“How can you tell if TMS would even work for me? The only way to really know is to

try the treatment and see if it helps. What I can tell people is that the odds are good”  Dr. Will Sauvé.

“TMS works differently than any other therapy that's out there.” - Dr. Geoffrey Grammer. “We're not just trying to raise neurochemicals with pills. And it’s very specific for depression because we are working on a part of the brain that regulates mood. You don't have to worry about things just not working for you because TMS is powerful. It's been proven on FDA trials to be successful for a large percentage of patients. “ - Dr. Don DuBose. “So I would encourage you that if you're thinking about it, give us a call. Let us see if we can help you.” - Dr. Geoffrey Grammer.

TYPICAL COURSE OF TREATMENT

“I've tried so many meds and seen so many therapists. Some things work but only for a while, other things don't work at all. Why did these other treatments fail and why would TMS be any different? TMS is not at all like medications and not at all like therapy. It works through a completely different mechanism of action.” - Dr. Geoffrey Grammer. “So with medications, they're not quite as customizable as TMS is. And sometimes the problems with medications might be that they either don't work because of genetic reasons or potentially they cause side effects and it's just a person is just not able to stay on them.” - Dr. Misty Borst. “So TMS is very different from everything you've probably tried before. It is very specific for depression because we are working on a part of the brain that regulates the mood. And you don't have to worry about all the side effects from the medications.” - Dr. Don DuBose

“Does TMS therapy hurt? and what does it feel like? The only thing that people typically feel when they're undergoing TMS treatment is a tapping sensation typically right under the electromagnetic coil that is placed, you know, right there against their scalp. That sensation is from the magnetic field actually stimulating the muscles and the nerves in your scalp right under the skin. Nothing is actually physically tapping on your head.” - Dr. Will Sauvé. “Many patients take a nap in the middle of TMS. A lot of people watch TV, they surf the web on their phone, they'll talk to friends or family. So for the vast majority of patients, it is a very comfortable procedure.” - Dr. Geoffrey Grammer.

“How would I know TMS is working? So that's a great question obviously we want results. What often happens early on in the treatment if a person is responding is that they will have some physical changes. Things like their energy being different or their sleep changing for the better.” - Dr. Misty Borst. “You'll have less depressed days and more interest in activities around you. Better appetite, a better sense of well-being.” - Dr. Geoffrey Grammer. “Often what I would see next is family members or coworkers or friends would notice some positive changes and how a person seems. And then often around like the four-week mark, maybe three and a half weeks, people will notice that their mood is actually less depressed. They feel less sad, they have more motivation, they're enjoying things more and not isolating themselves as much.” - Dr. Misty Borst.

“How do you know the TMS is getting to the correct part of my brain and what happens if you zap the wrong part? The first day of your treatment, we do what's called the brain mapping where we figure out exactly where on an individual's brain we need to do the treatment.” - Dr. Misty Borst. “There are parts of the brain that control the body, that control the movement of the limbs, so when we are determining if the machine is in the right position we are able to make the thumb twitch.” - Dr. Don DuBose. “If you are doing TMS in an area of the brain that is already working correctly, it won't really do much. Think of it like this, if you take Motrin because your knee hurts the pain goes away. If you take Motrin and your knee feels fine, your knee will continue to feel fine. TMS is a lot like that.”- Dr. Geoffrey Grammer.

“If I get TMS therapy, does that mean that I can stop taking medication? I think it's perfectly possible that medications could be reduced, or even stopped if someone has had a good benefit from TMS therapy.” - Dr. Will Sauvé. “Whether or not to stop medication is a very individualized decision. Your TMS psychiatrist will work with your primary provider in deciding what is best for you and you are part of that process.” - Dr. Geoffrey Grammer. “However, the combination of TMS and medications work best together. And in my opinion, the goal is getting you better. So whatever we need to do to get you there that's what we do.” - Dr. Don DuBose

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