TMS benefits can vary and depression may return, so follow-up monitoring and ongoing care, including medication or therapy, may be needed after treatment.
How Long Do TMS Results Last?
Transcranial magnetic stimulation (TMS) is a non-invasive treatment most often used for major depressive disorder. It was cleared by the FDA for major depressive disorder in 2008, and for depression with comorbid anxiety in 2021.
A common question after completing treatment is how long the benefits may continue. There is no single answer. Some people continue to feel well after a course of TMS, while others notice symptoms returning over time and may need further support. The durability of a response can depend on the person’s depression history, current stresses, other treatments, physical health, sleep, substance use and whether they have had previous episodes of depression.
TMS is not usually viewed as a one-time cure for depression. Instead, it can be part of a longer-term care plan that may also include medication, talking therapy, lifestyle support and regular review with a mental health professional.
For Delaware residents, planning follow-up before the final TMS session can make it easier to recognise changes early and decide what support may be needed.
What happens after a standard TMS course?
A standard course of TMS commonly involves about 36 weekday treatment sessions, usually delivered over six to nine weeks. During the course, the treatment team will normally review symptoms, side effects and progress.
The final session should not necessarily be the final point of contact with mental health care. Before treatment ends, it is sensible to discuss a follow-up plan with the clinician overseeing care. This plan may cover:
- when to have the first follow-up appointment;
- who will monitor depression symptoms after TMS;
- whether medication or therapy will continue;
- what early warning signs to watch for;
- what to do if symptoms return; and
- how to contact the clinic or another care provider if support is needed.
Some people finish TMS feeling a clear improvement in mood, motivation, sleep or day-to-day functioning. Others may have a partial response and need to consider next steps with their clinician. It is important not to judge long-term benefit only by the final day of treatment. Ongoing functioning and symptom patterns over the following weeks and months also matter.
Can depression return after TMS?
Yes. Depression can relapse or recur after TMS, just as it can after medication, therapy or a period of recovery without either treatment. A return of symptoms does not mean that TMS “failed” or that the initial improvement was not meaningful.
Depression often follows a changing course. A person may have periods of stability, followed by symptoms linked to stress, bereavement, changes in work or family circumstances, physical illness, disrupted sleep, stopping medication, or no obvious trigger.
It can help to distinguish between a difficult day or week and a more sustained return of depression. Warning signs may include:
- low mood that does not lift;
- loss of interest in usual activities;
- changes in sleep, appetite or energy;
- withdrawing from friends, family or work;
- increasing hopelessness or irritability;
- difficulty concentrating; or
- thoughts of self-harm or suicide.
People who have experienced depression before may recognise their own early signs. Sharing these with a partner, family member, therapist or prescriber can make it easier to seek help promptly.
If someone has thoughts of harming themselves or feels unable to stay safe, they should seek urgent help through emergency services or a crisis service rather than waiting for a routine TMS follow-up.
Maintenance TMS and re-treatment
Maintenance TMS means planned sessions after the initial treatment course, intended to help support an ongoing response. Re-treatment, sometimes called a new course or repeat course, means returning for TMS when depression symptoms have returned or worsened after an earlier benefit.
There is no single maintenance schedule that suits everyone. Some people may not need additional TMS sessions after their initial course. Others may discuss occasional maintenance sessions or a repeat course with their clinician. The right approach depends on the individual’s history, response to the first course, other treatments and practical circumstances.
A clinician may consider questions such as:
- How much improvement followed the original course?
- How long did the improvement continue?
- Are symptoms returning gradually or quickly?
- Is the person continuing medication, therapy or both?
- Have there been major changes in health or life circumstances?
- Would a repeat course be appropriate, or are other treatments needed first?
Do not assume that maintenance treatment will automatically be offered, or that it will be funded in the same way as an initial course. Availability and insurance requirements can differ between providers and plans. Ask the clinic to explain its approach, the likely review process and any administrative steps before committing to further sessions.
Planning follow-up care in Delaware
A practical follow-up plan should fit ordinary life. This is especially relevant when treatment requires travel, time away from work, childcare arrangements or coordination with several providers.
TMS Therapy Delaware lists 22 published clinics across the state. Wilmington has the largest number of listed clinics, with seven, followed by Newark with three. Dover, Lewes and Rehoboth Beach each have two listed clinics. There are also directory listings in Bethany Beach, New Castle, Smyrna, Millsboro, Claymont and Middletown.
Location may matter if follow-up includes in-person appointments or if a repeat course becomes necessary. However, convenience is only one consideration. Patients may also wish to ask whether their TMS provider communicates with their psychiatrist, primary care clinician, therapist or other members of their care team.
Before completing treatment, consider writing down answers to these questions:
- Who is my main point of contact after TMS?
- When should I schedule my next medication or therapy review?
- What symptoms mean I should call sooner?
- If symptoms return, should I contact the TMS clinic, my prescriber or both?
- Are virtual follow-up appointments available where appropriate?
- How will my treatment records be shared with my other clinicians?
- What is the clinic’s policy on maintenance sessions or re-treatment?
Keeping a simple mood and symptom record can also be useful. This does not need to be complicated. A weekly note about mood, sleep, anxiety, energy, activity and medication changes may help identify a pattern before symptoms become more severe.
Medication and therapy after TMS
Some people continue antidepressant medication during and after TMS. Others may also continue or begin psychological therapy. Decisions about medication should be made with the prescribing clinician, rather than stopping or changing medicines because TMS has helped.
TMS, medication and therapy can each have different roles. TMS may help reduce depressive symptoms; therapy may help someone manage difficult thoughts, relationships or recurring stress; and medication may remain part of relapse prevention for some people. The most suitable combination is individual.
If medication changes are being considered after TMS, ask about timing, monitoring and what to do if symptoms reappear. Sudden changes can make it harder to understand whether a shift in mood is linked to depression, medication effects or another cause.
Insurance and practical questions
Insurance arrangements for follow-up, maintenance or re-treatment may not be identical to arrangements for an initial TMS course. Coverage can depend on the plan, clinical documentation, prior authorisation requirements and the provider’s network status.
In Delaware, patients commonly encounter plans from Highmark Blue Cross Blue Shield Delaware, Aetna, Cigna, UnitedHealthcare, AmeriHealth Caritas Delaware, Delaware Physicians Care, Humana and Medicare. It is worth contacting both the clinic and insurer to ask clear, specific questions before treatment begins or resumes.
Useful questions include whether the provider is in network, whether prior authorisation is required, what records may be needed, and whether maintenance or repeat TMS is considered separately from an initial treatment course.
Getting help in Delaware
Use the TMS Therapy Delaware clinic listings to find published providers across Delaware, then consult the directory’s insurance guide and contact page for further practical support.
This article is educational information, not medical advice.
This page is informational and is not medical advice.