M.D. Medical Director, Psychiatrist
Most articles about TMS therapy explain what it is. Fewer explain what it’s like to actually do it thirty times.
That second question is the one that decides whether people start. Five days a week for six weeks is a real commitment, and it’s hard to say yes to something you can’t picture. So here’s the picture, from a clinic on SE Sunnyside Road that runs these courses every week.
The short version of what TMS is
Transcranial magnetic stimulation delivers focused magnetic pulses — about the strength of an MRI — to a region of the brain involved in mood regulation. The pulses stimulate neurons in that area, which over a course of treatment produces changes in activity in the deeper brain structures that govern emotion.
It has been FDA-cleared for major depressive disorder since 2008.
It is not electroconvulsive therapy. No anesthesia, no sedation, no seizure. You sit upright in a chair in your own clothes, awake the whole time. You can talk, listen to music, or watch something. Our TMS therapy page covers the mechanism in more depth.
Day one: mapping
Your first appointment is longer than the rest and different from the rest.
Before treatment begins, a provider performs brain mapping. They locate the precise target on your scalp and calibrate the intensity to your individual motor threshold — the minimum pulse strength that produces a small twitch in your hand. That measurement is personal to you, and it’s why TMS dosing isn’t one-size-fits-all.
Mapping happens once. After that, every session uses your settings.
What a normal session actually looks like
Here is the honest, unglamorous version.
You arrive. You check in. You sit in a chair that reclines a little, similar to a dentist’s chair without the associations. A technician positions the coil against the side of your head and confirms it matches your mapped location.
Treatment starts. You’ll hear a clicking sound and feel a tapping sensation on your scalp — the most common description is a woodpecker. You wear earplugs. The machine runs in cycles: a few seconds of pulses, a pause, repeat.
The session runs about 20 to 40 minutes depending on your protocol. Then the coil comes off, you stand up, and you leave. No grogginess, no driving restriction, nothing to recover from. Door to door, most Clackamas-area patients budget about an hour.
People read, listen to uplifting podcasts, or chat with the technician. You cannot sleep during TMS. By week two, the overwhelming report is that it’s boring — which is the correct outcome for a medical procedure.
Week by week: what to actually expect
This is where honest expectation-setting matters most, because the shape of a TMS course surprises people.
Week one — adjustment. The scalp sensation is most noticeable now. Some patients get a mild tension-type headache after early sessions; over-the-counter pain relief usually handles it, and it typically fades within the first week or two as you acclimate. Tell your technician if it’s uncomfortable — the coil position and ramp-up can often be adjusted. Our post on TMS side effects covers the full picture.
Weeks two and three — the flat stretch. Nothing much seems to be happening. This is the point where people quietly start to wonder whether they’ve committed six weeks to nothing. It is also the most common point to drop out, and dropping out here is the single biggest avoidable reason a course fails. Expect this stretch. It’s part of the normal shape, not a sign it isn’t working. This phenomenon during treatment is also referred to as “the dip” and is common and a normal experience. Keep on going!
Weeks three and four — the turn. For many patients, this is when change first becomes noticeable. It’s rarely dramatic. It tends to look like waking up without dread, finishing something you’d have abandoned in August, or finding that a conversation didn’t cost as much as it used to. A detail worth knowing: other people frequently notice before the patient does. Partners and coworkers report the change first, because depression is bad at recognizing its own absence.
Weeks five and six — consolidation. Sessions continue through the full course. Finishing matters: the total number of treatments is related to the outcome, so stopping early because you feel better undercuts the result you’re feeling better from.
Some patients later go on to periodic maintenance sessions. Our post on TMS maintenance therapy explains how that works.
Who this is for
TMS is generally considered for adults with major depressive disorder whose symptoms haven’t improved adequately with antidepressant medication. Most insurance criteria look for documented inadequate response to two or more medication trials at an adequate dose and duration.
That describes a lot of people who don’t realize it describes them. If you’ve cycled through three or four antidepressants over several years, currently take one that takes the edge off without actually lifting the depression, and have concluded that this flattened version is simply who you are now — that’s treatment-resistant depression, a recognized clinical situation with its own treatment pathway. It isn’t a personal ceiling. Generally, if an antidepressant is going to work at an adequate dose, it should show benefit within six to eight weeks.
Who qualifies for TMS therapy walks through the criteria, and our page on treatment-resistant depression covers the broader set of options.
Does it work?
Across BestMind’s own patient population, internal outcome data from June 2022 through April 2025 showed a 72.99% response rate and a 51.38% remission rate for TMS.
Two terms worth defining, because they get used loosely. Response means a clinically meaningful reduction in depression symptoms — typically at least 50%. Remission means symptoms have fallen to a level no longer consistent with active depression.
Those are strong figures for a group that by definition has already not responded to medication. They are also population averages, not a forecast for any individual, and anyone who presents them as a personal guarantee is overselling.
Why treat in Clackamas
Over a thirty-session course, geography stops being a preference and becomes a clinical variable.
Our clinic at 9895 SE Sunnyside Road, Suite F sits just off the Sunnyside corridor near Clackamas Town Center, with surface parking and no downtown garage to deal with. For patients in Happy Valley, Milwaukie, Oregon City, Gladstone, Damascus, Boring, Canby, Estacada and West Linn, that’s a materially shorter trip than crossing into central Portland.
Twenty minutes saved each way, thirty times, is roughly twenty hours of your life. More importantly, it’s the difference between a course you finish and one you don’t — and completion is the strongest predictor of outcome we have.
There’s also a practical upside people mention unprompted: being near Town Center means the appointment can be attached to something else. Groceries, a pharmacy run, the gym. Treatment that clips onto an errand you were already doing is treatment that survives week three.
The Clackamas office also offers medication management, esketamine (SPRAVATO) and ADHD testing, so if TMS turns out not to be the right fit, the alternatives are in the same building with the same team.
Insurance and cost in Oregon
TMS is covered by most plans for patients who meet criteria. BestMind accepts Aetna, Cigna, ComPsych, Providence, Humana, United Healthcare, Kaiser Permanente and PacificSource among others; the current list is on our insurance page.
Three things worth knowing before you start:
Prior authorization is standard. Nearly every plan requires it. Our team assembles and submits the documentation.
Your medication history is the deciding document. “Some SSRI a few years back” slows approvals more than anything else. Before your evaluation, write down every antidepressant you’ve tried, the approximate dose, how long you stayed on it, and why you stopped. Your pharmacy can usually help you reconstruct it.
Coverage and cost are separate questions. Get a straight answer on your per-session copay or coinsurance, and on whether your deductible is met, before the first appointment.
How to start
Call (971) 300-0654 or request an appointment through our Clackamas scheduling page. Bring your medication history to the evaluation — it’s the single most useful thing you can prepare. Full details, hours and directions are on our Clackamas location page.
Thirty sessions is a lot to picture from the outside. From the inside it’s an hour a day, weekdays, for about six weeks — and then it’s over, which is more than most depression treatments can say.
If you are in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day.
Frequently Asked Questions
Where can I get TMS therapy near Clackamas Town Center?
BestMind Behavioral Health offers TMS therapy at 9895 SE Sunnyside Road, Suite F, Clackamas, OR 97015, just off the Sunnyside corridor near Clackamas Town Center, with surface parking. Hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. Call (971) 300-0654.
What does a TMS session feel like?
You sit upright in a reclining chair, fully awake and in your own clothes, wearing earplugs. You’ll hear clicking and feel a tapping sensation on your scalp, often described as an electric woodpecker. The machine cycles through pulses and pauses for about 20 to 40 minutes. There’s no anesthesia or sedation, no recovery period, and no driving restriction afterward.
How long before TMS starts working?
It varies, but many patients first notice change around weeks three to four of a four-to-six-week course. Weeks two and three are commonly the flattest stretch, when nothing appears to be happening — that’s a normal part of the course, not a sign of failure. Other people often notice the improvement before the patient does.
How many TMS sessions will I need?
A standard course runs five days a week for four to six weeks, roughly 20 to 30 sessions. Completing the full course matters: the total number of treatments is related to the outcome, so stopping early because you feel better tends to undercut the result.
Does TMS hurt, and what are the side effects?
The most commonly reported side effect is mild scalp discomfort during the session, which typically fades over the first week or two. Some patients get a mild tension-type headache after early sessions. Because TMS is targeted rather than systemic, it avoids common antidepressant side effects such as weight gain, drowsiness, sexual dysfunction and cognitive dulling.
Does insurance cover TMS in Oregon?
TMS is covered by most plans for patients who meet criteria — typically a major depressive disorder diagnosis and documented inadequate response to two or more antidepressant trials. Prior authorization is nearly always required, and BestMind’s team submits the documentation. Accepted plans include Aetna, Cigna, ComPsych, Providence, Humana, United Healthcare, Kaiser Permanente and PacificSource.
How effective is TMS therapy?
Across BestMind’s own patient population, internal outcome data from June 2022 through April 2025 showed a 72.99% response rate and a 51.38% remission rate. Response generally means at least a 50% reduction in depression symptoms; remission means symptoms are no longer consistent with active depression. These are population averages, not individual predictions.
