How Long Do TMS Results Last? A Maine Guide to Follow-Up Care

How Long Do TMS Results Last?

Transcranial magnetic stimulation (TMS) can help some people with major depressive disorder achieve a meaningful reduction in symptoms after a full course of treatment. A common course involves about 36 weekday sessions over six to nine weeks, although an individual plan may vary.

A natural question after finishing treatment is: how long will the improvement last?

There is no single answer. Some people continue to feel well for a long time after their initial course. Others notice symptoms returning sooner, particularly during periods of stress, illness, disrupted sleep, medication changes or major life events. Depression can be a recurring condition, so a return of symptoms does not necessarily mean that TMS “failed”. It may mean that further support, review or treatment is needed.

Planning follow-up care before the final TMS session can make it easier to respond early if symptoms begin to return.

What “lasting results” can mean

TMS results are usually discussed in terms of response and remission.

A response generally means that depressive symptoms have improved noticeably. Remission means symptoms have reduced to a level where they are minimal or no longer causing significant day-to-day difficulty. These terms can be useful clinically, but your own experience matters too.

You may notice durable improvement in areas such as:

• mood and hopefulness
• sleep and energy
• concentration and decision-making
• motivation to work, study or socialise
• ability to manage ordinary responsibilities
• reduced frequency or intensity of depressive thoughts

Progress is not always completely linear. It is possible to have occasional low days without having a full depressive relapse. The important question is whether symptoms are becoming more frequent, more intense or more difficult to manage over time.

Your TMS provider may use questionnaires alongside regular conversations to track symptoms. Keeping a record of mood, sleep, medication changes and major stresses can also give you and your clinician a clearer picture after treatment ends.

Relapse: why symptoms can return

Relapse means that clinically significant depressive symptoms return after improvement. The risk and timing vary widely from person to person.

Depression is influenced by many factors beyond TMS treatment. These may include a history of recurrent depression, ongoing anxiety, substance use, chronic pain, physical health conditions, bereavement, work pressures, family responsibilities and changes in routine. Stopping or changing medication without medical guidance can also affect symptoms.

TMS is an established non-invasive treatment for depression. It received FDA clearance for major depressive disorder in 2008, with clearance expanded in 2021 for depression with comorbid anxiety. However, it is not generally considered a permanent guarantee against future depression. Instead, it can be one part of a longer-term care plan.

For many people, the most useful approach is to think ahead: if symptoms return, what will happen next, who should be contacted, and how quickly can support be arranged?

Maintenance TMS and re-treatment

Two terms are often used after an initial course: maintenance TMS and re-treatment.

Maintenance TMS refers to planned sessions given after the main course has finished. These may be scheduled at intervals chosen by the treating clinician, rather than waiting for a full return of symptoms. The aim is to support continued wellbeing for people who appear likely to benefit from ongoing treatment.

There is not one maintenance schedule that suits everyone. Some people may not need maintenance sessions at all. Others may discuss occasional treatment sessions, a short series of sessions, or a more structured plan. The decision should take account of your treatment response, previous depressive episodes, other treatments and practical circumstances.

Re-treatment, sometimes called a booster course, is different. This usually means returning for further TMS when symptoms have clearly begun to come back after an earlier helpful course. A re-treatment plan may be shorter or may resemble the original course, depending on the clinician’s assessment and the reason symptoms have returned.

Ask your provider how they distinguish between an expected temporary dip in mood, a need for maintenance treatment and a possible relapse requiring re-treatment.

Planning your follow-up before treatment ends

A follow-up plan should not be an afterthought. Before completing TMS, ask for a clear discussion about what happens next.

Useful questions include:

• When will my first follow-up appointment take place?
• Who will monitor my mood after my final session?
• Should I continue seeing my psychiatrist, GP, therapist or counsellor?
• Which symptoms should prompt me to call the clinic?
• How are maintenance sessions decided?
• If I relapse, can I return to this clinic for assessment?
• What is the process for a re-treatment course?
• Will my medication plan stay the same?
• What should I do if my mental health worsens outside clinic hours?

It can help to put the answers in writing, especially if depression has previously made organisation or decision-making difficult.

If you work with more than one clinician, ensure they know that you have completed TMS. Your prescribing clinician, therapist and primary care team may each have a role in supporting recovery. With your consent, coordination between services can reduce confusion about medication, appointments and changes in symptoms.

Supporting results between appointments

TMS follow-up is often most effective when it sits alongside other parts of mental health care. Your clinician may recommend continuing medication, talking therapy, or both. Do not stop prescribed medication simply because you feel better after TMS unless the clinician managing it advises you to do so.

Practical routines can also support recovery. These are not a replacement for treatment, but they can help you notice changes early:

• keep a reasonably regular sleep and waking routine
• attend follow-up and therapy appointments
• take medication as prescribed
• plan manageable activity, social contact and meals
• limit alcohol or substances that affect mood or sleep
• tell someone you trust when you are struggling
• identify early warning signs in advance

Early warning signs differ between people. They may include sleeping much more or less than usual, withdrawing from others, losing interest in daily activities, increased anxiety, low motivation, irritability or a return of hopeless thoughts.

Try to act on these signs early rather than waiting until daily life becomes unmanageable. Contacting your clinician promptly may allow a treatment plan to be adjusted before symptoms become more severe.

Practical follow-up considerations in Maine

Follow-up care should be realistic as well as clinically appropriate. Maine’s geography, winter weather, work patterns and travel distances can all affect attendance. When considering maintenance or re-treatment, ask how appointments could fit around transport, family care and employment.

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. Availability, referral requirements and follow-up arrangements can differ by provider, so it is sensible to ask each clinic directly about continuity of care.

Insurance is another practical consideration. Carriers commonly seen in Maine include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Aetna, Cigna, Community Health Options and MaineCare. Coverage for an initial TMS course, maintenance sessions or re-treatment may depend on your individual plan and clinical circumstances. Ask both the clinic and insurer about authorisation, referral requirements and any expected out-of-pocket costs before arranging further treatment.

When to seek urgent help

TMS follow-up is not a substitute for urgent mental health support. If you have thoughts of harming yourself, feel unable to stay safe, or are experiencing a mental health emergency, seek immediate help through emergency services or an urgent crisis service. Do not wait for a routine TMS appointment.

Getting help in Maine

Use the TMS Therapy Maine clinic listings to find providers in your area, review the insurance guide before contacting your carrier, and visit the contact page if you need help using the directory.

This article is educational information, not medical advice.