TMS request form. Currently accepting Blue Cross Blue Shield PPO and self-pay options.

The self pay options are extremely competitive and is less costly than using many of the high deductible plans. Self pay also allows for leeway to use newer, proven, and better tolerated treatment protocols. These protocols may allow us to accelerate treatment to half the time that is normally required.

After filling the form below, we’ll arrange a call with the purpose of explaining the procedure, answering questions, and assessing appropriateness. If indicated, we’ll invite you in for an in-person evaluation. The cost of this evaluation would be rolled into the treatment and, if appropriate, you can elect to receive your first TMS treatment (no added cost, even if not covered by insurance). The first treatment is gentle and we use this treatment to assess likelihood of issues down the line (where we would determinate protocol pacing, what and whether to add an augmenting treatment, etc).

The TMS treatment at Able Psychiatry has flexibility since it’s being followed by a literature-competent, TMS experienced psychiatrist. It is likely, in the future, there will be more varying protocols for certain disorders. Since we’re a smaller office, we also allow for greater transportation and appointment flexibility (allowing for drop-ins during the day).

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General Information

Sometimes medication and therapy can help no more past a point for some people. Transcranial Magnetic Stimulation (TMS) uses a magnetic field which in turn lightly stimulates parts of the brain responsible for thinking and control of mood. The treatment is very well tolerated and has very few side effects. The procedure does not require protective covering.

If you'd like to see space and machine, feel free to come in. We can discuss day to day issues like parking, etc. 

Although practice standards have only approved stimulation over the left dorsolateral prefrontal cortex, there are alternate treatment protocols we can add to enhance your results (this is in addition to your treatment, safe, and at no additional cost if we feel like it would be effective).

It has been approved by the FDA for treatment resistant depression since October 2008 (situations where multiple medication and therapeutic failures to effectively manage depressive symptoms).

There is evidence that TMS can be effective for conditions other than major depression but for which is not FDA (food and drug administration) approved or covered by insurances. These conditions include obsessive compulsive disorder (OCD), bipolar disorder, tinnitus, migraine, and others. 

The interest in magnetic fields started in the mid 1980’s for evidence began showing they possessed potential therapeutic value. The first controlled trials in North America started in 1999 and since then many subsequent trials and clinical experiences have further elucidated the therapeutic value of using Transcranial Magnetic Stimulation as a tool in the treatment of depression. In December 2010 the American Psychiatric Association guidelines in the treatment of depression were modified to include TMS as an appropriate treatment to consider after failing at least one adequate trial of antidepressants, (although some insurance companies require at least 4 failed medication/therapeutic trials).

The FDA recommended treatment for depression is 30-36 sessions (more or less) usually performed 5 days a week for typically 4-6 weeks. We may be able to do a rapid protocol based on need, schedule, etc to bring the time to remission to within a couple weeks.

What to expect during a TMS treatment

It feels like someone is lightly tapping on your head with their fingers at its gentlest. If the treatment is not considerately delivered, it may be painful, like a rubberband snapping exposed skin. The way we deliver the treatment is such that it is painless while retaining efficacy.

The intensity of the tapping depends on the machine level and can always be adjusted to ensure comfort. You direct the level. The typical first remark from people's first experience with TMS relates to how ordinary it feels.

There are no noticeable changes in thought or emotion during a treatment.

You can perform your normal daily activities prior and subsequent to the treatment with no restriction of eating, drinking or driving. If you are on regular medications make sure you keep the same schedule whether they are psychiatric or non-psychiatric medications. If you take medications as needed for anxiety or pain make sure you mention it to the doctor prior to treatment; there are typically no restrictions.

If you wish to have a family member or a friend sit with you during the treatment you are welcome to invite them. You will be fully awake and alert through the treatment and can communicate at all times.

What to expect after a treatment session

No major changes in awareness, thoughts, or mood occur immediately after treatment. Often, after a treatment (even after the first), people report feeling brighter, more engaged. Others may report difficulty sleeping.

Because your head muscles have been lightly stimulated, you may experience a very mild and dull, and very treatable headache (usually a tylenol or ibuprofen is enough to subdue the discomfort). This headache is likely only an issue during the first 2-3 treatment sessions, until you adapt.

What to expect over time

Benefits can take a while to hold. Results are often felt after treatment is finished. Neurons take a while to fully respond to an intervention. In fact, some people report feeling temporarily worse, before they feel improvement. Some report ongoing benefit starting early and maintaining throughout treatment.

"Things are brighter", "I feel more present", "Thinking isn't as effortful", and "I can sustain good moods and thinking better" are things we've heard.

Do I still need to take medication?

The treatment often augments current medication regimens. It can fully or paritally replace some. It can allow some medications to be used in different ways. This issue is a case by case basis and should be discussed with your medication provider.