What a “Good Candidate” for TMS Actually Looks Like

When people begin researching Transcranial Magnetic Stimulation (TMS), one of the most common questions is: “Am I a good candidate for this treatment?”

It’s an important question — and the answer is more nuanced than simply having a rough week or feeling emotionally overwhelmed after a difficult life event. TMS is designed for individuals whose depression is persistent, clinically diagnosed, and resistant to standard treatments, not for temporary emotional dips that naturally improve with time and support.

Understanding what truly qualifies someone for TMS helps protect patients, sets realistic expectations, and ensures that advanced treatment is used responsibly and effectively.

Depression Must Be Persistent — Not Temporary

Everyone experiences periods of sadness, stress, or emotional strain. These responses are part of being human, especially after events like job loss, relationship challenges, or major life changes.

For TMS to be appropriate, symptoms must be:

• Present continuously for several weeks or longer

• Ongoing rather than tied only to a short-term situation

• Not resolving on their own with time, rest, or lifestyle adjustments

TMS is not meant for brief emotional lows. It is intended for individuals whose symptoms do not lift and continue to interfere with daily life.

Neurovegetative Symptoms: A Key Clinical Indicator

As psychologists and psychiatric providers, we also look closely at what are called neurovegetative symptoms of depression. These are biological and behavioral changes that reflect how deeply depression is affecting the brain and body — not just mood.

Common neurovegetative symptoms include:

• Changes in sleep (insomnia or sleeping excessively)

• Changes in appetite or weight

• Low energy or persistent fatigue

• Slowed thinking or movement, or feeling mentally “foggy”

• Difficulty concentrating or making decisions

• Loss of interest or pleasure in activities (anhedonia)

These symptoms are important because they suggest that depression is not only situational or emotional, but also affects the brain’s regulatory systems for sleep, motivation, energy, and cognition.

When neurovegetative symptoms are present and persistent, they often indicate a more biologically driven depressive process — which is exactly what treatments like TMS are designed to target.

Meeting Formal Diagnostic Criteria Matters

A good candidate for TMS must meet official clinical criteria for Major Depressive Disorder or related depressive conditions. This determination is made through a structured psychiatric evaluation. 

Clinicians assess:

• Type and pattern of symptoms

• How long symptoms have been present

• Severity and consistency of emotional distress

• Functional impact on work, relationships, and daily responsibilities

• Presence of neurovegetative symptoms and cognitive changes

This careful diagnostic process ensures that treatment is based on medical necessity, not momentary emotional states.

Prior Treatment Attempts Are an Important Factor

TMS is typically recommended when depression has not responded adequately to standard treatment approaches.

A qualified candidate has usually:

• Tried at least two different antidepressant medications

• Taken them at appropriate doses and for sufficient duration

• Experienced limited or no lasting improvement, or significant side effects

This is referred to as treatment-resistant depression, and it is the primary group for whom TMS has been shown to be most effective.

This step is important not because medication is “required forever,” but because it helps determine whether less intensive treatments have already been given a fair trial before moving to neuromodulation therapies like TMS.

Symptoms Should Significantly Affect Daily Life

Another key consideration is how much depression interferes with everyday functioning.

TMS may be appropriate when symptoms:

• Disrupt work performance or school responsibilities

• Strain personal relationships

• Reduce motivation, energy, or ability to enjoy daily activities

• Affect sleep, concentration, or emotional stability

The goal of treatment is not only symptom reduction, but helping patients regain stability, clarity, and quality of life that has been difficult to achieve through other methods.

Why Careful Assessment Is So Important

Responsible mental health care does not rush people into advanced treatments based on short-term distress. At Southeastern Psychiatric Associates TMS Center, the focus is on determining whether symptoms are truly persistent, clinically significant, and resistant to standard therapies.

This protects patients from:

• Receiving unnecessary interventions

• Developing unrealistic expectations

• Overlooking other treatment options that may still be effective

TMS works best when used for the right individuals, at the right time, with the right clinical oversight.

What Treatment Looks Like If You Are a Candidate

For patients who do qualify, TMS is a non-invasive, medication-free treatment that targets specific areas of the brain involved in mood regulation.

Two TMS Options Available at Our Center

At our TMS center, we offer both standard TMS and Accelerated Theta Burst Stimulation, allowing treatment to be tailored to each patient’s clinical needs and scheduling constraints.

Accelerated TMS – TMS Accelerated (Modified SAINT) Protocol 

This advanced form of TMS involves:

• Sessions lasting approximately 9 minutes

• 10 treatments a day for 5 days 

• Treatments performed in-office

• No anesthesia or recovery time

• Immediate return to normal activities

This option is helpful for patients who need shorter appointment times and faster daily sessions.

Standard TMS (Insurance-Covered)

We also offer traditional TMS protocols, which:

• Are fully covered by most insurance plans for qualifying patients

• Involve longer sessions, typically around 15 minutes 

• 1 treatment a day for 36 days 

• Treatments performed in-office

• No anesthesia or recovery time

• Loss of libido (sex drive) 

• Suicidal thoughts or a wish to not be alive 

• Immediate return to normal activities

For many patients, standard TMS is an effective and accessible option when insurance coverage is an important part of treatment planning. Our team works closely with each patient to navigate both the clinical and insurance aspects of care, so treatment remains appropriate, effective, and financially realistic.

We would be honored to support you as you explore your next steps. Hope matters — and we understand how heavy and isolating depression can feel. You do not have to navigate this alone, and our team is here to support you with care, respect, and clinical guidance every step of the way.

Learn more about TMS