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Depression with co-occurring anxiety describes a variation of depression in which clinically significant symptoms of anxiety accompany depressive episodes. You may feel down, fatigued, and struggle with motivation, and also tense, restless, and worried.
At The Mind Grove TMS Center, we look carefully at how symptoms of anxiety relate to depression, to confirm and possibly expand your understanding of your diagnosis. This distinction between depression, depression with co-occurring anxiety, and other forms of anxiety is important not only for treatment planning, but also has implications for insurance coverage.
Dr. Bowers evaluates adults and adolescents ages 15 and older for depression-related conditions, including MDD with co-occurring anxiety. Depending on your unique history and treatment goals, care recommendations may include standard rTMS, iTBS, Accelerated TMS, augmentation with medications, or additional treatment approaches.
Depression is characterized by low mood or loss of interest in activities that used to be enjoyable, accompanied by fatigue, low motivation, low energy, difficulty concentrating, sleeping to little or too much decreased appetite, feelings of guilt or shame, low self esteem, and/or suicidal thoughts.
Anxious depression is a type of depression in which symptoms of an anxiety disorder accompany a depressive episode. This can include feeling tense, restless, or on edge, irritability, persistent and difficulty to control worry, insomnia, fatigue, and poor concentration.
Many patients with depression and anxiety who inquire about TMS have tried first line treatments, including medication and therapy. These treatments can be very effective for reducing and eliminating symptoms of anxiety and depression. However, some patients do not fully respond to medications or therapy, or cannot take medications due to other health conditions, or due to intolerable side effects. TMS is an FDA-cleared treatment for MDD with co-occurring anxiety that may be another option for qualifying patients who have not responded sufficiently to first-line interventions.
A treatment recommendation begins with a comprehensive psychiatric evaluation. Dr. Bowers will discuss symptoms of anxiety and depression with you in detail, along with your medical history, current and prior mental health treatment history, and safety considerations for TMS.
If TMS is recommended, you may then be a candidate for standard rTMS, iTBS or Accelerated TMS protocols. Augmentation with medication management, brief mindfulness interventions, or psychotherapy may also be recommended.
If you already have a prescribing clinician, Dr. Bowers will collaborate with that provider when appropriate. If you don’t have a prescribing physician, Dr. Bowers is able to prescribe medications during your treatment course.
TMS uses magnetic pulses to stimulate areas of the brain involved in broader mood-regulation networks. It does not require anesthesia or sedation, and patients remain awake during treatment.
Our TMS care may include standard rTMS, iTBS, or Accelerated TMS, depending on your diagnosis, clinical history, safety profile, and treatment goals.
Our standard rTMS course typically includes daily treatments for four to six weeks, followed by a taper phase, for a total of 36 to 40 treatments A full course usually spans eight to ten weeks, and appointments are approximately 20 minutes.
iTBS is a form of rTMS that uses rapid theta-burst stimulation patterns. Each appointment is approximately 20 minutes, with about 3-10 minutes of stimulation.
Accelerated TMS uses iTBS or standard rTMS as its delivery method. Our Accelerated TMS protocol includes five sessions per day for six treatment days within a 14 day period, followed by 2 treatments per week, for a total of 36-40 treatments. Each appointment is approximately 20 minutes, with about 3-10 minutes of stimulation. Alternative accelerated scheduled will be considered on a case-by-case basis.
TMS is FDA-cleared and generally insurance-covered for qualifying patients with major depressive disorder and co-occurring anxiety symptoms when payer criteria are met. Coverage varies by insurance plan, diagnosis, treatment history, and medical-necessity requirements.
Colorado Medicaid does not cover TMS.
Accelerated TMS protocols are not currently covered by insurance.
TMS treatment takes place in our Colorado Springs office. During treatment, you remain seated and awake while the magnetic coil is positioned near the scalp. No anesthesia or sedation is required, and patients can drive themselves after treatment.
The time commitment depends on the protocol:
Dr. Bowers monitors progress during the treatment course using standardized screening tools and adjusts treatment planning when clinically appropriate.
The Mind Grove TMS Center is physician-led by Megan Bowers, MD, PhD, a dual ABPN board-certified psychiatrist in Adult Psychiatry and Child and Adolescent Psychiatry. Her background spans developmental genetics, neurobiology, and clinical psychiatry.
At The Mind Grove, that training informs how patients are evaluated for TMS-focused care. Diagnoses are carefully considered by a specialist in clinical psychiatry, and TMS treatment and augmentation strategies are chosen based on the most recent, evidence-based protocols.
We use MagVenture technology for TMS treatment.
This page is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. TMS is not appropriate for every patient or every condition. A licensed clinician must evaluate symptoms, medical history, diagnosis, medications, and safety considerations before making treatment recommendations. If you are experiencing a medical or psychiatric emergency, seek emergency care immediately.
Anxious depression describes a form of major depressive disorder with co-occurring anxiety.
TMS is FDA-cleared for qualifying patients with MDD and co-occurring anxiety symptoms. Dr. Bowers evaluates each patient individually to determine whether TMS is clinically appropriate.
Yes. Medication can remain part of care when it supports the treatment plan. For some patients, medication management may continue alongside TMS or be adjusted as part of the overall care plan.
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