Ten years of trying everything
Sarah was 24 when depression first took hold. She remembers the exact week — mid-October, second year teaching third grade in Portland, Oregon. The joy she’d always found in her classroom just vanished. Getting out of bed became a negotiation every morning.
“I kept telling myself it was burnout,” she says. “Teachers are tired. That’s normal. But this was different. I couldn’t feel anything. Not happiness, not sadness. Just… nothing.”
Her primary care doctor started her on sertraline. It took the edge off for about eight months, then quit working. Over the next decade, Sarah cycled through four antidepressants — sertraline, bupropion, venlafaxine, duloxetine. Same arc every time: a few months of partial improvement, then a slow slide back into the fog.
She tried therapy too. CBT helped her develop coping strategies. She credits her therapist with keeping her functional during the worst stretches. But functional and well are two very different things.
The suggestion she almost ignored
In early 2025, Sarah’s psychiatrist mentioned TMS therapy during a routine medication review. She’d never heard of it. He explained the basics — non-invasive, magnetic pulses, specific brain regions, FDA-cleared for treatment-resistant depression.
“I smiled and nodded and completely dismissed it,” Sarah admits. “After ten years of trying things that didn’t work, I was done getting my hopes up.”
Three months later, a bad episode kept her out of school for two weeks. Her sister sent her a link to this site. She spent an evening reading about how TMS works and the success rates for people in her exact situation — people who’d tried multiple medications without lasting relief.
“The numbers weren’t magical. It wasn’t ‘100% of people are cured.’ It was honest. About half of treatment-resistant patients respond, and a third reach remission. Something about that honesty made me trust it.”
Finding a clinic
Sarah used TMS List to find clinics in the Portland area. She looked for providers who took her insurance — Blue Cross Blue Shield — and who had experience with treatment-resistant cases. She narrowed it to three clinics, visited two for consultations, and chose one based on the psychiatrist’s experience and their use of NeuroStar equipment with neuronavigation.
Insurance required prior authorization. The clinic staff handled most of the paperwork. Sarah had to provide documentation of her four failed medication trials. The process took about two weeks.
What treatment was actually like
Sarah’s protocol: 36 sessions over six weeks, Monday through Friday. Each session lasted about 19 minutes using the theta burst stimulation protocol her doctor recommended.
“The first session was the weirdest. They put this thing against my head and there’s this tapping sensation. Not painful, but strange. Like someone flicking your skull from the inside. They adjusted the intensity until it was uncomfortable but tolerable.”
The first two weeks? Unremarkable. Sarah drove to the clinic before school, sat in the chair, felt the tapping, drove to work. Mild headaches after the first three sessions — manageable with ibuprofen. No other side effects.
“I kept waiting for something to happen. My husband would ask every night, ‘Do you feel different?’ And every night I said no.”
Week three — the first crack of light
It happened on a Tuesday. Sarah was standing in her classroom, watching her students work on a reading assignment. She noticed something she hadn’t felt in months.
She was enjoying it.
Not just tolerating the day. Not pushing through. Actually feeling a small, genuine spark of pleasure.
“I didn’t want to jinx it. I didn’t tell anyone for three days. But it kept happening. Little moments of — I don’t even know what to call it — aliveness? I could feel things again.”
By the end of week three, the changes were hard to ignore. Better sleep. Energy after work instead of collapsing on the couch. She caught herself laughing at something a student said and realized she couldn’t remember the last time she’d laughed like that.
The climb to remission
Weeks four and five brought steady improvement. Sarah’s PHQ-9, which had been hovering around 18 (moderately severe) for years, dropped to 11. Then 7. Her psychiatrist was cautiously optimistic.
“He kept saying, ‘Let’s not get ahead of ourselves.’ But I could feel it. This was different from medication. With meds, everything felt muffled — the depression was quieter but so was everything else. With TMS, it felt like the volume on life was turning back up.”
By the end of week six, her PHQ-9 was 3. Clinical remission.
“I cried in the clinic that last day. The technician gave me a hug. I don’t think she was supposed to, but she did.”
Life after TMS
That was fourteen months ago. Sarah still sees her psychiatrist every three months. She stayed on a low dose of bupropion as maintenance, and her doctor mentioned maintenance TMS sessions as an option if symptoms returned. So far, they haven’t.
“I’m not going to pretend everything is perfect. I still have bad days. But a bad day now is what a good day used to be. I can feel sadness without drowning in it. I can feel joy without wondering when it’s going to disappear.”
She went back to teaching full-time within days of finishing treatment. She’s taken on mentoring new teachers — something she wouldn’t have had the energy for a year ago.
“If you’re reading this and you’ve tried medications that didn’t work — I get it. The exhaustion of hoping and being disappointed. TMS isn’t magic. But for me, it was the thing that finally worked. And I wish someone had told me about it five years sooner.”
Sarah’s advice for people considering TMS
- Don’t expect overnight results. It took three weeks before she noticed anything.
- Keep going to sessions even when nothing seems to be happening. The process is cumulative.
- Ask your clinic about theta burst protocols. Shorter sessions made it possible to fit treatment into her work schedule.
- Find a clinic that handles insurance paperwork. It made a stressful process much easier.
- Talk to your support system. Her husband’s patience during those first two weeks of “nothing’s happening” mattered more than she realized at the time.
Names and identifying details have been changed to protect patient privacy. This story is based on composite experiences reported by TMS patients and is presented for educational purposes only. It is not medical advice. Talk to a qualified specialist about whether TMS is right for your situation.
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Ten years of trying everything
Sarah was 24 when depression first took hold. She remembers the exact week — mid-October, second year teaching third grade in Portland, Oregon. The joy she’d always found in her classroom just vanished. Getting out of bed became a negotiation every morning.
“I kept telling myself it was burnout,” she says. “Teachers are tired. That’s normal. But this was different. I couldn’t feel anything. Not happiness, not sadness. Just… nothing.”
Her primary care doctor started her on sertraline. It took the edge off for about eight months, then quit working. Over the next decade, Sarah cycled through four antidepressants — sertraline, bupropion, venlafaxine, duloxetine. Same arc every time: a few months of partial improvement, then a slow slide back into the fog.
She tried therapy too. CBT helped her develop coping strategies. She credits her therapist with keeping her functional during the worst stretches. But functional and well are two very different things.
The suggestion she almost ignored
In early 2025, Sarah’s psychiatrist mentioned TMS therapy during a routine medication review. She’d never heard of it. He explained the basics — non-invasive, magnetic pulses, specific brain regions, FDA-cleared for treatment-resistant depression.
“I smiled and nodded and completely dismissed it,” Sarah admits. “After ten years of trying things that didn’t work, I was done getting my hopes up.”
Three months later, a bad episode kept her out of school for two weeks. Her sister sent her a link to this site. She spent an evening reading about how TMS works and the success rates for people in her exact situation — people who’d tried multiple medications without lasting relief.
“The numbers weren’t magical. It wasn’t ‘100% of people are cured.’ It was honest. About half of treatment-resistant patients respond, and a third reach remission. Something about that honesty made me trust it.”
Finding a clinic
Sarah used TMS List to find clinics in the Portland area. She looked for providers who took her insurance — Blue Cross Blue Shield — and who had experience with treatment-resistant cases. She narrowed it to three clinics, visited two for consultations, and chose one based on the psychiatrist’s experience and their use of NeuroStar equipment with neuronavigation.
Insurance required prior authorization. The clinic staff handled most of the paperwork. Sarah had to provide documentation of her four failed medication trials. The process took about two weeks.
What treatment was actually like
Sarah’s protocol: 36 sessions over six weeks, Monday through Friday. Each session lasted about 19 minutes using the theta burst stimulation protocol her doctor recommended.
“The first session was the weirdest. They put this thing against my head and there’s this tapping sensation. Not painful, but strange. Like someone flicking your skull from the inside. They adjusted the intensity until it was uncomfortable but tolerable.”
The first two weeks? Unremarkable. Sarah drove to the clinic before school, sat in the chair, felt the tapping, drove to work. Mild headaches after the first three sessions — manageable with ibuprofen. No other side effects.
“I kept waiting for something to happen. My husband would ask every night, ‘Do you feel different?’ And every night I said no.”
Week three — the first crack of light
It happened on a Tuesday. Sarah was standing in her classroom, watching her students work on a reading assignment. She noticed something she hadn’t felt in months.
She was enjoying it.
Not just tolerating the day. Not pushing through. Actually feeling a small, genuine spark of pleasure.
“I didn’t want to jinx it. I didn’t tell anyone for three days. But it kept happening. Little moments of — I don’t even know what to call it — aliveness? I could feel things again.”
By the end of week three, the changes were hard to ignore. Better sleep. Energy after work instead of collapsing on the couch. She caught herself laughing at something a student said and realized she couldn’t remember the last time she’d laughed like that.
The climb to remission
Weeks four and five brought steady improvement. Sarah’s PHQ-9, which had been hovering around 18 (moderately severe) for years, dropped to 11. Then 7. Her psychiatrist was cautiously optimistic.
“He kept saying, ‘Let’s not get ahead of ourselves.’ But I could feel it. This was different from medication. With meds, everything felt muffled — the depression was quieter but so was everything else. With TMS, it felt like the volume on life was turning back up.”
By the end of week six, her PHQ-9 was 3. Clinical remission.
“I cried in the clinic that last day. The technician gave me a hug. I don’t think she was supposed to, but she did.”
Life after TMS
That was fourteen months ago. Sarah still sees her psychiatrist every three months. She stayed on a low dose of bupropion as maintenance, and her doctor mentioned maintenance TMS sessions as an option if symptoms returned. So far, they haven’t.
“I’m not going to pretend everything is perfect. I still have bad days. But a bad day now is what a good day used to be. I can feel sadness without drowning in it. I can feel joy without wondering when it’s going to disappear.”
She went back to teaching full-time within days of finishing treatment. She’s taken on mentoring new teachers — something she wouldn’t have had the energy for a year ago.
“If you’re reading this and you’ve tried medications that didn’t work — I get it. The exhaustion of hoping and being disappointed. TMS isn’t magic. But for me, it was the thing that finally worked. And I wish someone had told me about it five years sooner.”
Sarah’s advice for people considering TMS
- Don’t expect overnight results. It took three weeks before she noticed anything.
- Keep going to sessions even when nothing seems to be happening. The process is cumulative.
- Ask your clinic about theta burst protocols. Shorter sessions made it possible to fit treatment into her work schedule.
- Find a clinic that handles insurance paperwork. It made a stressful process much easier.
- Talk to your support system. Her husband’s patience during those first two weeks of “nothing’s happening” mattered more than she realized at the time.
Names and identifying details have been changed to protect patient privacy. This story is based on composite experiences reported by TMS patients and is presented for educational purposes only. It is not medical advice. Talk to a qualified specialist about whether TMS is right for your situation.