TMS may reduce depression symptoms for some people when medication or therapy has not helped, with response meaning major improvement and remission meaning symptoms no longer meet active-episode thresholds.
Does TMS Work? An Honest Guide to Response and Remission in Maine
Transcranial magnetic stimulation, usually called TMS, can help some people with depression, particularly when antidepressant medicines, talking therapy or both have not brought enough improvement. It is not a guaranteed treatment, and it does not work in the same way for everyone.
When people ask whether TMS “works”, the answer depends partly on what they mean by improvement. In clinical research and everyday practice, two terms are often used: response and remission. They describe different levels of change, and understanding the difference can make treatment results easier to interpret.
TMS is a non-invasive treatment that uses magnetic pulses applied to the scalp to stimulate targeted areas of the brain involved in mood regulation. It received FDA clearance for major depressive disorder in 2008. In 2021, FDA clearance also covered depression with comorbid anxiety.
What does “response” mean?
A response means that depressive symptoms have improved substantially during treatment. In research, this is commonly measured using a recognised depression questionnaire completed before, during and after a course of TMS.
A person may be considered a responder when their score on that measure has reduced by around half. This does not necessarily mean that all symptoms have gone away. Someone may still experience low mood, tiredness, disrupted sleep or reduced motivation, but at a less severe level than before treatment.
For example, a person who had been unable to work, socialise or manage daily routines may find they can begin doing more again. Another person may notice fewer days of intense sadness or hopelessness, even if they are not yet feeling fully well.
Response can be meaningful. A substantial reduction in symptoms may make it easier to take part in therapy, return to routines, reconnect with family or friends, or make use of other treatments that previously felt difficult.
However, a response is not always the final outcome. Symptoms can continue improving towards the end of treatment or in the weeks afterwards. In other cases, a person may respond but still need ongoing care, such as medication management, psychotherapy or a maintenance plan.
What does “remission” mean?
Remission means that symptoms have reduced to a level where the person is no longer considered to be in an active depressive episode according to the rating scale being used.
It does not always mean feeling perfect, never having a difficult day, or having no anxiety at all. Depression and anxiety exist alongside ordinary stresses, health conditions, work pressures and family circumstances. Instead, remission generally means that symptoms are minimal enough that they no longer meet the usual threshold for clinical depression.
Remission is usually considered a stronger outcome than response. A person can respond to TMS without reaching remission, while people who reach remission have generally experienced a more complete reduction in depressive symptoms.
The distinction matters because it avoids an unhelpful all-or-nothing view of treatment. If a person does not reach remission, that does not mean TMS has failed completely. Equally, a smaller change that does not meet a formal definition of response may still matter to an individual, depending on which symptoms have improved and how their life has changed.
What published research can tell us
Published clinical trials have found that active TMS can improve depression symptoms for some people, with some participants reaching response and some reaching remission. Trials generally compare an active form of treatment with a sham procedure designed to resemble TMS without delivering the same therapeutic stimulation.
These studies are important, but they cannot predict exactly what will happen for any one person in Maine. Research results are averages across groups of participants. An average does not tell you whether you personally will improve, how quickly changes may happen, or which symptoms will shift first.
Outcomes can also differ between studies because researchers may use different:
- Depression rating scales and definitions of improvement
- TMS devices and stimulation protocols
- Patient selection criteria
- Treatment schedules
- Approaches to medication and psychotherapy during treatment
- Follow-up periods after the treatment course
For this reason, it is sensible to be cautious when comparing response or remission figures from different sources. A percentage reported in one study may not be directly comparable with one reported elsewhere.
A clinic should be able to explain how it monitors symptoms during treatment, which questionnaire it uses, and how it would discuss progress if the expected improvement is not happening.
Why results vary from person to person
Depression is not a single, identical condition. Two people may both receive a diagnosis of major depressive disorder but have different symptoms, histories, physical health needs and treatment experiences.
Several factors may influence the likelihood and pattern of improvement with TMS:
- Severity and duration of depression: Long-standing or more severe symptoms can be harder to treat, although this does not rule out benefit.
- Previous treatments: TMS is often considered after other treatments have not helped enough. The number and type of previous treatments may affect clinical decision-making.
- Other mental health conditions: Anxiety, trauma-related symptoms, substance use, bipolar disorder and other conditions can affect assessment and care planning.
- Physical health and medicines: A clinician will review relevant health conditions, current medicines and any factors that could affect safety or treatment planning.
- Attendance and treatment completion: TMS usually requires repeated sessions. Missing appointments can make it harder to follow the intended treatment plan.
- Changes outside the treatment room: Sleep, alcohol or drug use, major life events, therapy, medication changes and social support can all affect mood during a course of treatment.
It is also common for improvement to be uneven. Some people notice small changes in sleep, concentration or motivation before their mood improves. Others feel little difference at first and then notice progress later in the course. A clinician can help distinguish normal fluctuations from signs that the treatment plan needs review.
What a standard TMS course involves
A standard course of TMS is often around 36 weekday sessions delivered over roughly six to nine weeks. Exact schedules vary according to the treatment protocol and a person’s clinical needs.
Each session is normally carried out while the person is awake and seated. TMS does not require anaesthesia, and people can generally return to their usual activities afterwards.
Common side effects include scalp discomfort during treatment and headache. A seizure is a rare risk, which is one reason a proper clinical screening and safety review are important before starting.
Progress is usually reviewed during the course rather than judged only at the final appointment. If symptoms are improving, the clinical team may discuss what follow-up care could look like. If symptoms are not improving as hoped, they may consider whether other supports or treatments should be discussed with the person’s wider care team.
Questions worth asking a Maine TMS provider
A TMS consultation is an opportunity to discuss your own circumstances rather than rely on general outcome claims. You may wish to ask:
- How will you assess whether TMS is suitable for me?
- How will you track my symptoms throughout treatment?
- What would count as response or remission in my case?
- When would you expect to review whether treatment is helping?
- Can I continue medication or counselling while having TMS?
- What happens if I improve, partly improve, or do not improve?
- Which insurance plans do you work with, and what costs might I need to confirm?
In Maine, insurance arrangements can differ between clinics and individual plans. Carriers commonly seen include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Aetna, Cigna, Community Health Options and MaineCare. It is still important to check eligibility, authorisation requirements, network status and any out-of-pocket responsibility directly with both the provider and insurer.
TMS access in Maine
TMS Therapy Maine currently lists 16 published clinics across the state. Directory listings include clinics in South Portland, Scarborough, Camden, Portland, York, Brunswick, Brewer, Falmouth and Waterville.
Having options in different communities may make it easier to consider practical issues such as weekday travel, parking, work commitments and support from family or friends. Since a standard treatment course involves frequent appointments, location and scheduling can be just as important as a clinic’s clinical approach.
Getting help in Maine
Visit the TMS Therapy Maine clinic listings to compare local options, read the insurance guide for practical coverage questions, or use the contact page for help navigating the directory.
This is educational information, not medical advice.
This page is informational and is not medical advice.