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Major depressive disorder can affect every part of daily life: sleep, appetite, energy, concentration, motivation, relationships, school, work, and the ability to feel like yourself. When depression has persisted despite trying first-line treatments, it is reasonable to want a more careful look at what comes next.
At The Mind Grove TMS Center, Megan Bowers, MD, PhD evaluates adults and adolescents ages 15 and older with major depressive disorder. Dr. Bowers may recommend standard rTMS, iTBS, Accelerated TMS, augmentation with medications, or other interventions, depending on your diagnosis, treatment history, safety considerations, and current care plan.
Major depressive disorder, often called MDD, is a psychiatric condition characterized by low mood or inability to enjoy previously enjoyable activities, accompanied by changes in sleep, appetite, cognitive functioning and energy levels that cause impairments in daily functioning.
Common symptoms may include:
If you are in immediate danger or may act on thoughts of self-harm, seek emergency care right away or contact a local crisis line. A routine TMS consultation is not a substitute for emergency psychiatric care.
No two patients experience depression in exactly the same way. That is one reason Dr. Bowers takes a comprehensive and individualized approach to treatment planning. . This may include a combination of TMS, augmentation with medications, and other interventions, when it supports your treatment goals.
Treatment resistant depression (TRD) is a severe form of MDD that does not sufficiently respond to medications or evidenced-based psychotherapy. For individuals with TRD, medications and/or therapy may not improve symptoms of depression at all, or they may improve, but are still present and interfering with daily functioning.
Treatment intolerance describes the experience of not being able to tolerate therapeutic doses of medications due to co-occurring medical conditions or intolerable side effects. For individuals with treatment intolerance, medications could be effective, however they are no longer a treatment option, and other strategies need to be explored.
TMS is an FDA-cleared treatment for Major Depressive Disorder for individuals who have not responded to medications, including individuals with treatment intolerance and treatment resistant depression.
At The Mind Grove TMS Center, Dr. Bowers provides a comprehensive evaluation of individuals with depression, and may recommend TMS, augmentation with medications, or other interventions, depending on your unique history and treatment goals.
A recommendation for TMS begins with a comprehensive psychiatric evaluation. Dr. Bowers reviews your diagnosis, current symptoms, treatment history, medications, medical history, and any safety considerations that could affect care.
The goal of this evaluation is to choose a treatment plan that is suitable for your unique history and mental health goals. Some patients may be better suited for standard rTMS, and others may be candidates for iTBS or Accelerated TMS. Some patients may benefit from augmentation with medication or other interventions alongside TMS.
TMS uses magnetic pulses to stimulate targeted areas involved in broader mood-regulation networks. It does not require anesthesia or sedation, and patients remain awake during treatment.
At Mind Grove, TMS care may include standard rTMS, iTBS, or Accelerated TMS.
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, and is considered non-inferior to standard high-frequency rTMS for adults with depression. 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 schedules will be considered on a case-by-case basis.
The Mind Grove does not consider TMS as a replacement for every other form of psychiatric care. Medication can remain part of treatment when it supports the patient’s treatment goals.
For some patients, that may mean continuing medication during TMS. For others, medication adjustments or additional supports may be clinically appropriate before, during, or after treatment. If you already have a prescribing clinician, Dr. Bowers will collaborate with that provider rather than replacing an existing care relationship.
TMS is FDA-cleared and generally insurance-covered for qualifying patients with major depressive disorder that has not responded to medications. Coverage varies by insurance plan, diagnosis, treatment history, and medical-necessity requirements.
Colorado Medicaid does not cover TMS.
Coverage for a specific TMS protocol should be reviewed before treatment begins.
TMS treatment takes place in the 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 led by Megan Bowers, MD, PhD, a dual ABPN board-certified psychiatrist in Adult Psychiatry and Child and Adolescent Psychiatry.
Dr. Bowers’ background spans developmental genetics, neurobiology, and clinical psychiatry. She completed medical and graduate training at NYU School of Medicine, a postdoctoral research fellowship in Neurobiology at the University of Zurich, Adult Psychiatry residency at Georgetown University Hospital, and Child and Adolescent Psychiatry fellowship at Georgetown University Hospital.
That background shapes how The Mind Grove approaches TMS care. Depression treatment is not handled as a generic protocol. Diagnosis, medication history, safety screening, protocol selection, and progress monitoring all inform the recommended treatment plan.
The Mind Grove uses 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.
Treatment-resistant depression is a severe form of major depressive disorder that does not respond sufficiently to medications and/or psychotherapy.
Yes. Medication can remain part of care when it supports the treatment plan. Dr. Bowers may incorporate augmentation with medication alongside TMS when clinically appropriate.
National Institute of Mental Health. “Depression.”
Blumberger, D. M., Vila-Rodriguez, F., Thorpe, K. E., Feffer, K., Noda, Y., Giacobbe, P., Knyahnytska, Y., Kennedy, S. H., Lam, R. W., Daskalakis, Z. J., Downar, J., & others. “Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): A randomised non-inferiority trial.” The Lancet, 391(10131), 1683–1692.
Vida, R. G., Sághy, E., Bella, R., Kovács, S., Erdősi, D., Józwiak-Hagymásy, J., Zemplényi, A., Tényi, T., Osváth, P., & Vörös, V. “Efficacy of repetitive transcranial magnetic stimulation adjunctive therapy for major depressive disorder after two antidepressant treatment failures: Meta-analysis of randomized sham-controlled trials.” BMC Psychiatry, 23, 545.
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