M.D. Medical Director, Psychiatrist
Quick answer: TMS therapy is an FDA-cleared, non-invasive treatment for depression that hasn’t improved after two or more antidepressants. Northeast Portland residents can get TMS through BestMind Behavioral Health. Treatment runs about 20 to 40 minutes a day, five days a week, for four to six weeks, with no anesthesia or recovery time. Most insurance plans cover it for patients who qualify.
If you live in Northeast Portland and you’ve tried two, three, or five antidepressants without feeling like yourself again, you are not unusual. A large share of people with depression don’t reach remission on their first or second medication. Many of them are never told that this is a recognized clinical situation with its own set of treatments. TMS therapy is one of them.
This guide covers what “hasn’t responded to meds” means clinically, how TMS works, what a course of treatment looks like for someone in Hollywood, Laurelhurst, or Rose City Park, and how insurance handles it.
When depression hasn’t responded to medication
Doctors use the term treatment-resistant depression for major depression that hasn’t improved enough after at least two antidepressant trials, each taken at an adequate dose for an adequate length of time. Usually that means six to eight weeks or more on a therapeutic dose.
That definition matters for two reasons. First, it shifts the question from “what’s wrong with me” to “what’s the next option.” Second, it’s the threshold most insurance plans use to approve TMS.
A medication “didn’t work” if any of these were true:
- Your symptoms improved a little but never lifted
- You improved at first, then slipped back while still taking it
- Side effects were bad enough that you had to stop before it had a fair trial
All three count as part of your history, so it helps to write them down. More on that below.
How TMS therapy works
TMS stands for transcranial magnetic stimulation. A magnetic coil placed against the scalp sends brief magnetic pulses to the left dorsolateral prefrontal cortex, a region involved in mood regulation that tends to be underactive in depression. Over repeated sessions, the stimulation is thought to strengthen activity in the brain networks involved in mood.
What a session is like:
- You’re awake and seated upright in a reclining chair
- No anesthesia, sedation, or IV
- You’ll hear a clicking sound and feel a tapping sensation on your scalp
- Sessions take roughly 20 to 40 minutes, depending on the protocol
- You can drive yourself home and go back to work the same day
The most common side effect is scalp discomfort or a mild headache during the first week or two, which usually fades as treatment continues. Because TMS doesn’t circulate through the body like a medication, it doesn’t cause the weight gain, sexual side effects, or drowsiness that lead many people to stop antidepressants. Our article on TMS side effects covers the details.
What a course of TMS looks like
Standard TMS runs five days a week for four to six weeks, followed by a short taper. It’s a real time commitment, so most people plan around it before starting:
Week 1. A mapping session finds the right spot and the right strength for your treatment. Daily sessions begin.
Weeks 2 to 4. Daily sessions continue. Some people notice changes in sleep, energy, or motivation before their mood lifts. Others notice nothing until later in the course, which is common and doesn’t mean it isn’t working.
Weeks 5 to 6. Your provider reviews your progress with standardized depression scales and decides with you on a taper.
At BestMind, 72.99% of TMS patients responded to treatment and 51.38% reached remission, based on BestMind patient outcomes from June 2022 to April 2025. Individual results vary.
BestMind also offers accelerated TMS protocols that compress treatment into fewer days for patients who qualify.
Getting TMS from Northeast Portland
TMS is delivered at our Northeast Portland office at 1547 NE 40th Ave, Suite B, in the Hollywood District. For patients in Hollywood, Laurelhurst, Alameda, Rose City Park, Grant Park, and Beaumont, that keeps a daily appointment close to home, which matters when you’re coming in five days a week.
Insurance and prior authorization
Most major Oregon insurance plans cover TMS for patients who meet criteria. BestMind accepts Aetna, Cigna, ComPsych, Providence Health Plan, Humana, United Healthcare, Kaiser Permanente, and PacificSource, among others. See our insurance page for the current list.
Coverage almost always requires prior authorization. Plans typically look for:
- A diagnosis of major depressive disorder
- Documented trials of two or more antidepressants that didn’t adequately help
- In some plans, a trial of psychotherapy
Our team handles the submission. Your part is the medication history.
Before your first appointment: write down your medication history
The single most useful thing you can bring is a list of every antidepressant you’ve tried. For each one, note roughly when you took it, the highest dose, how long you stayed on it, and why you stopped. If you can’t remember details, your pharmacy or primary care office can usually print a history.
That list helps your provider decide whether TMS is the right next step, and it’s the core of the prior authorization request.
Frequently Asked Questions
Is TMS therapy available in Northeast Portland?
Yes. BestMind Behavioral Health offers TMS therapy to Northeast Portland residents, with an office at 1547 NE 40th Ave, Suite B, in the Hollywood District. [Reviewer note: match this answer to Version A or B above.]
Who qualifies for TMS therapy?
Adults with major depressive disorder who haven’t improved enough after two or more antidepressant trials are typical candidates. A psychiatric evaluation confirms whether TMS fits your history. People with certain metal implants near the head may not be eligible.
How long does TMS take to work?
Some people notice changes in sleep or energy within two to three weeks. Mood improvement often builds through weeks four to six. A full course is usually five sessions a week for four to six weeks.
Does insurance cover TMS in Oregon?
Most major Oregon plans cover TMS for patients who meet criteria, usually a major depression diagnosis and two or more antidepressant trials that didn’t work. Prior authorization is required, and BestMind submits it for you.
Can I keep taking my antidepressant during TMS?
Often, yes. Many patients continue their current medication during TMS. Your provider will review your medications before treatment begins and recommend whether to make any changes.
Find out if TMS is right for you
If you’ve been cycling through medications and wondering whether this is as good as it gets, a consultation can answer that. Contact us or call (971) 300-0654 to schedule, or visit our Northeast Portland location page.
If you are in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7.
