Treating Depression When Medication Doesn’t Work

JUN. 22, 2018

By Scott West, M.D.


The recent, tragic deaths of Kate Spade and Anthony Bourdain are a reminder of the battle so many of us are fighting, often silently. Depression doesn’t discriminate, and even celebrities are a part of the 320 million people around the world living with depression. I’ve met many of these individuals in my line of work and I strive to do everything I can to bring them relief and joy.

Treating depression is historically a slow process. Individuals often start their treatment journeys by using the trial-and-error process with medication, dealing with unwanted side effects as they wait to see if the medicine is working. But unfortunately, 5.5 million adults in the United States are treated for depression and unable to achieve remission with antidepressant medication.

I have a patient who is part of that 5.5 million—a young violin teacher, who we’ll call Casey. When I met Casey, she had tried every class of depression medication at the highest doses available and saw no mood improvement. She didn’t have the energy to pursue her passion of music, her friends and family worried about her and she was quickly losing hope.

But there is hope, and I’ve found that it doesn’t always come in the form of a prescription. 

The Power of TMS

Transcranial magnetic stimulation (TMS) treatment is a therapy that uses magnetic pulses to stimulate areas of the brain that are underactive in patients with depression. It is a non-drug, non-invasive option. 

Despite being a lesser-known treatment method, TMS is a proven one. Since 2010, the American Psychiatric Association has recommended TMS as a second-line treatment for adults with depression who have not benefitted from antidepressants.

I’ve treated more than 375 people with TMS since it became FDA-approved eight years ago. And I’ve watched as TMS transformed many of their lives—Casey was one of them. She was on the verge of checking herself into a hospital when we began her treatment, and now credits TMS with saving her life.

How Does It Work?

TMS is not electroconvulsive therapy; it does not apply electricity directly to the brain or induce seizures. TMS allows people to remain completely awake during treatment. The latest-generation of TMS takes between 19 minutes to 37 minutes, and it’s usually administered five days a week for four to six weeks. Many of my patients choose to spend the session reading, talking or listening to music. 

The majority of people who benefited from treatment experienced clinically meaningful, long-lasting improvement. Among people followed for 12 months after acute treatment, 68% retained their response.

To date, 1.7 million treatments have been administered to approximately 50,000 patients in the U.S. Of those individuals, 58% experienced significant improvement of their symptoms and 37% achieved remission of their depression symptoms.

There is hope for people like Casey who are struggling and not finding relief from medication. If medications aren’t helping you or a loved one, talk to your doctor and consider TMS therapy. The light at the end of the tunnel is waiting for you.


Dr. West is the Medical Director at ThriveLogic TMS + Neurohealth in Nashville, Tennessee and Nashville NeuroCare Therapy in Franklin.


We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices

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SEP, 19, 2018 10:21:50 PM
I love the advice of mac. The tragic reality for people with major depression is that they don't have the energy or self discipline to do all the things they know would help. Especially if like me they have no friends or family to help, and not enough money to pay someone to help. Most days I can't manage to get dressed or brush my teeth, let alone eat much. It's a vicious cycle that spirals down and feels hopeless after years of trying. Even though I know lots of great things that would help I haven't been able to sustain any progress that I do occasionally make. It would be a miracle if someone found a treatment that really worked. Especially if it didn't cost $12,000!

AUG, 22, 2018 10:55:57 PM
I had TMS treatment in November 2017 and I have been in remission ever since. It has been remarkable and my family and friends have told me they haven't seen me this happy in many years. For anyone thinking about it, TMS is definitely worth trying. It doesn't work for everyone but it sure worked for me. Keep the faith

AUG, 22, 2018 10:46:55 PM
To Lahela Rose

I noticed that approximately 2 months ago you stated that there is one provider in Indiana. You might find it helpful to know that I have identified a provider in Merrillville, Newburgh, Indianapolis and Fishers. I hope you find this helpful and find relief as soon as you can.

JUL, 31, 2018 12:24:10 PM
Eman Liame
From the American Psychological Association's website:
"A typical course of TMS therapy involves 20 to 30 sessions, generally given in three to five treatments per week for four to six weeks. The full course of therapy with the pricey machines can cost $6,000 to $12,000."

JUL, 27, 2018 05:49:44 AM
Marva Jefferson
Trying to understand Bipolar
Disorder-Scizophreina. I've studying all night in an effort to relate better to my daughter. She's 54, & very depressed.

JUL, 22, 2018 12:14:15 PM
Edna Hernandez
I have Bipolar II Disorder and my son Schizofrenia. I need a support group in Arlington, Virginia.

JUL, 15, 2018 11:58:15 AM
Cindy Hernandez
Great information that I will definitely look into. Hopeful.

JUL, 04, 2018 06:01:22 PM
Thank you for this information. It's so great to hear that there is help and hope still out there. Bless you.

JUL, 03, 2018 02:58:42 AM
mary nethercutt
I only want to help others who could need help that is the only REASON that I Post this on my Face Book Page SO that IF any One is Having a PROOBLEM they could see SOMETHING I would POST That could FIND a ANSWER to a PROBLEM THE MIGHT HAVE

JUL, 01, 2018 08:32:50 AM
karen robeson
our daughter is currently halfway through her tms treatment

JUN, 30, 2018 10:14:17 AM
Happiness is not something you postpone for the future; it is something you design for the present.
This is an awesome blog , also we always have to look for a cure..
heres what i found. Fight depression and
Get social.
Leave the hell habit of self-talking and self-advise, for a while.
Tell him to read motivational stories, watch inspiring videos,
Adopt a healthy lifestyle,
Meditate and calm his mind.
Relax his neurons, go for a diet change.
Eat the important superfoods and practice yoga regularly this will help him to concentrate and focus his energy to bring out positive results.
if you find it beneficial you can know more at

JUN, 29, 2018 10:28:08 AM
Nice article. your viewers will surely find this helpful.
Can I cure my depression without any medication?
Yes, you can cure the mental illness by simple home remedies such as
Eating healthy foods (diet change),
yoga and meditation, adopt a healthy lifestyle. These steps look simple and easy but they need a disciplined approach to bring results. Furthermore, there are few cases in which you will require professional help.
if u find itt helpful you may know more @

JUN, 28, 2018 06:04:27 PM
are there any gene therapy medical trials either current or in the recent past dealing with mental illness

JUN, 27, 2018 10:02:54 PM
Trisha King

JUN, 26, 2018 05:55:56 PM
What if, like in my case, TMS doesn’t work?

JUN, 26, 2018 12:26:02 PM
Should treatment not start with TMS...instead of starting w meds/Rx??

JUN, 26, 2018 07:37:20 AM
Lahela Rose
While this is a hopeful treatment option, it is not available to all, especially those who may be low income.
I am one such person with treatment resistant depression who has looked into the availability of TMS, however one of the hurdles I've found is insurances may not be willing to cover it and that not all providers accept the insurances which do. For example, I had Anthem BCBS with the Healthy Indiana Plan (through the Medicaid Expansion), with a referral from my doctor, however the sole provider of TMS in my state does not accept my insurance provider. Hopefully as it becomes more widely available, it will become more accessible as well.

Submit to the NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.

Check out our Submission Guidelines for more information.