What People Get Wrong About TMS Therapy: Addressing Common Concerns for Louisville Patients

May 8, 2026

What People Get Wrong About TMS Therapy: Addressing Common Concerns for Louisville Patients

When someone has been living with treatment-resistant depression, exploring a new therapeutic option can bring as many questions as it does hope. Transcranial Magnetic Stimulation (TMS) has become an increasingly recognized approach for patients who have not responded adequately to antidepressant medications, yet misconceptions continue to surround it. For patients in Louisville, KY, who are weighing their options, misinformation can become a barrier to pursuing care that may genuinely help. One of the most common questions we hear at Hagan Health is how much does TMS therapy cost – and the assumptions behind that question often reveal deeper misunderstandings about the treatment itself. This post addresses the most persistent myths and objections we encounter so that Louisville patients can make informed decisions about their mental health care.

Myth #1: TMS Therapy Is Unaffordable for the Average Patient

Cost is consistently one of the first concerns raised by patients considering TMS. It makes sense – anyone researching a course of treatment wants to understand the financial commitment involved. However, many people assume that because TMS involves advanced technology, it must be entirely out of reach financially. This assumption often prevents patients from even initiating a conversation with their provider about whether the treatment is appropriate for them.

The reality in 2026 is that insurance coverage for TMS has expanded significantly over the past several years. At Hagan Health, TMS therapy is covered by several major insurance providers, including Aetna, Cigna, TRICARE, Medicare, Anthem, and Beacon/Carelon. For many patients in Louisville, this means that the out-of-pocket expense may be far less than they initially feared. When patients ask how much does TMS therapy cost, the answer frequently depends on their individual insurance plan and coverage details, which is why we encourage prospective patients to reach out to our office directly for personalized information.

Why Cost Assumptions Keep People From Getting Help

The danger of assuming TMS is financially inaccessible is that patients who might benefit from the treatment never explore it. Treatment-resistant depression already carries a significant emotional and financial burden – from the cost of multiple medication trials to lost productivity and diminished quality of life. Rather than ruling out TMS based on assumptions, patients are better served by consulting directly with a practice like Hagan Health, where the team can help clarify what to expect regarding their specific situation.

Myth #2: TMS Is Experimental or Unproven

Another common objection we hear from Louisville patients is the belief that TMS is still in its experimental phase. This may have been a reasonable concern in the early 2000s, but it does not reflect the current state of the evidence. TMS received FDA clearance for the treatment of major depressive disorder in 2008, and it has been the subject of extensive clinical research in the years since. By 2026, TMS is widely recognized within the psychiatric community as a legitimate, evidence-based treatment option for patients with treatment-resistant depression.

Multiple clinical studies have demonstrated that TMS may help reduce depressive symptoms in patients who have not responded to standard antidepressant medications. The treatment works by delivering targeted magnetic pulses to specific areas of the brain associated with mood regulation, with the goal of stimulating neural activity in regions that may be underactive in individuals with depression. It is important to note that outcomes vary from patient to patient, and TMS does not guarantee results for everyone. However, the body of evidence supporting its use continues to grow, and many patients experience meaningful improvement in their symptoms.

What “FDA-Cleared” Actually Means

FDA clearance is not a trivial designation. It requires manufacturers to demonstrate that a device is safe and effective for its intended use based on clinical data. The fact that TMS has maintained and expanded its clearance over nearly two decades speaks to its established role in psychiatric care. Patients in Louisville should feel confident that choosing TMS at Hagan Health means choosing a treatment with a well-documented clinical foundation – not an unproven experiment.

Myth #3: TMS Is Painful, Invasive, or Requires Sedation

Fear of the unknown is a powerful deterrent, and many patients envision TMS as a procedure that involves significant discomfort, surgical intervention, or anesthesia. In reality, TMS is a non-invasive, non-systemic treatment that does not require anesthesia or sedation. Patients remain fully awake and alert throughout each session.

During a TMS session at Hagan Health, patients sit in a comfortable chair while a device is positioned near the head. The device delivers focused magnetic pulses to targeted areas of the brain. Most sessions last between 20 and 40 minutes, and patients can return to their normal activities immediately afterward – including driving, working, and other daily routines. There is no recovery period required.

What Patients Actually Experience

Some patients report a tapping or clicking sensation on the scalp during treatment, which most describe as mild and which typically becomes less noticeable over the course of treatment. Headaches may occur after initial sessions but tend to diminish as the body adjusts. Compared to other interventions for treatment-resistant depression – such as electroconvulsive therapy, which does require anesthesia – TMS offers a notably different experience. The non-invasive nature of the treatment is one of the reasons it has become an increasingly preferred option for patients and providers alike.

Myth #4: If Antidepressants Haven’t Worked, Nothing Will

This may be the most harmful myth of all. Patients who have tried two or more antidepressant medications without adequate relief often develop a sense of hopelessness about their prospects for improvement. This is understandable – medication failure can feel deeply personal and discouraging. But the premise that medication non-response equals treatment non-response is simply not supported by the clinical evidence.

Treatment-resistant depression is a recognized clinical category, and TMS was specifically developed to address it. The mechanism of action is fundamentally different from oral medications. Rather than altering brain chemistry systemically through the bloodstream, TMS directly stimulates neural circuits in targeted brain regions. This means that a patient who has not responded to pharmacological approaches may still respond to TMS. Many patients who undergo TMS therapy report noticeable changes in their mood, energy, and overall functioning, though individual responses vary.

At Hagan Health, our focus is specifically on serving patients in Louisville who are dealing with treatment-resistant depression. We understand the frustration that comes with years of trying different medications, and we believe that exploring TMS is a reasonable and evidence-based next step for many of these individuals.

Myth #5: TMS Results Are Temporary and Not Worth the Investment

Some patients hesitate to pursue TMS because they have heard – or assumed – that any improvements will be short-lived. While it is true that depression is a chronic condition and no treatment can guarantee permanent remission, research has shown that many patients who respond to TMS maintain their improvements for months or longer after completing a full course of treatment. Some patients may benefit from periodic maintenance sessions, while others sustain their gains without additional intervention.

When evaluating how much TMS therapy costs relative to its potential benefits, it is helpful to consider the broader picture. The cumulative cost of ongoing medication trials, therapy appointments, missed work, and reduced quality of life associated with untreated or undertreated depression can be substantial. For patients who respond to TMS, the treatment may represent a meaningful shift in their trajectory – not just a temporary fix.

Setting Realistic Expectations

At Hagan Health, we believe in transparent conversations about what TMS can and cannot do. We do not promise instant relief or guaranteed outcomes. A standard course of TMS typically involves sessions five days a week over several weeks, and improvements often emerge gradually during this period. Patients should approach TMS with realistic expectations and a willingness to complete the full recommended course of treatment for the best chance of benefit.

What Louisville Patients Should Know Before Deciding

If you are a patient in Louisville, KY, considering TMS for treatment-resistant depression, the most important step you can take is to separate fact from fiction. The myths outlined above – about cost, efficacy, comfort, and durability – are among the most common barriers we see at Hagan Health, and they are largely based on outdated or inaccurate information.

Understanding how much TMS therapy costs for your specific situation, what the treatment experience involves, and what kind of outcomes are realistic requires a direct conversation with a qualified provider. Every patient’s clinical history and insurance situation is different, and generalized assumptions found online are no substitute for personalized guidance.

Take the Next Step Toward Informed Care

If you have been living with treatment-resistant depression and have questions about whether TMS may be appropriate for you, Hagan Health is here to help. Our team serves patients throughout Louisville and is committed to providing clear, honest information about what TMS therapy involves – from the clinical process to understanding how much does TMS therapy cost with your specific insurance coverage. We encourage you to contact Hagan Health to schedule a consultation and learn whether TMS may be a suitable option for your care. Making an informed decision starts with asking the right questions, and our team is ready to answer them.

smoking

Smoking Addiction

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results to help patients to quit smoking.  Known as the addiction coil, the H4 coil was specifically designed for targeting the deep areas of the brain involved in addictions.

A large study in 14 centers examined adults who had been long-term heavy smokers, all having failed prior quit attempts using medication, therapy, or other methods. Of those that completed Deep TMS treatment, 28% achieved four consecutive weeks without smoking, most of them not smoking for at least three months after treatment.  Among all participants in the study, the average number of cigarettes smoked per week over the course of treatment was reduced by 75%.  

TMS has none of the side effects commonly found in medication to treat smoking cessation. TMS is well-tolerated with years of safety data supporting Deep TMS. Patients may initially experience minor headaches or pain at the site of treatment which typically subside after the first few sessions. There is no preparation, no anesthesia, and patients are able to resume daily activities immediately after each treatment session. Treatments are done in our office. Each treatment session lasts 25-30 minutes. They are done daily on weekdays for 3 weeks followed by a weekly session for another 3 weeks.

BrainsWay Deep TMS offers a fresh approach that may help to quit smoking using cutting-edge neuroscience. Clinically proven and well-tolerated, Deep TMS is the first non-invasive technology that is FDA-cleared to treat smoking addiction.

addiction

OCD

Deep TMS has recently be approved by the FDA for treatment of obsessive-compulsive disorder (OCD).  OCD traditionally has been treated primarily with exposure psychotherapy, and while it is also treated with medication such as fluvoxamine, OCD does not respond well to medication management.  Medication improves symtpoms greater than 30% in only 50% of patients, and half of OCD patients stop taking their medication due to side effects.  And while exposure therapy might improve OCD, as many as 80% of patients continue to have symptoms after psychotherapy, according to some studies.

BrainsWay Deep TMS is a noninvasive, FDA-cleared, outpatient brain stimulation procedure with proven clinical results for improving the symptoms of OCD.  The technology stimulates the brain using its patented H-coil, known as the H7 coil, resulting in a deep and broad penetration of the magnetic field into areas of the brain that are affected in OCD. Deep TMS is safe and well-tolerated, has a very low rate of side effects, and does not require anesthesia.  

Research has proven a higher level of improvement using Deep TMS.  Almost 68% of OCD patients were able to reduce symptoms by more than 30%, and 87% of those who responded saw sustained improvement for at least a year.

depression

Depression

Major depression was the diagnosis first approved for treatment with TMS, and it is still the most commonly treated condition. Most patients are treated with TMS after failures of medications and psychotherapy, as insurance companies will pay for TMS treatment only after medication failures.  However, TMS treats depression much better than medication, and some would argue that TMS should be the first treatment instead of the last.  

When patients have not improved with medication, they are considered to be “treatment-resistant”. And in treatment-resistant depression, TMS treatment results in significant improvement, defined as more than a 50% reduction in symptoms, in more than 80% of patients.  And more than 60% of patients achieve remission.  That is a very high and a very impressive number of people who are happy for the first time in many years after TMS treatment.

TMS treatments for depression are done in a series of 36 treatments.  Patients have a 20-minute treatment 5 days a week for six weeks followed by 6 more treatments in a tapering schedule over three more weeks. No preparation is needed, and there is no recovery time.  After each treatment, patients are able to leave and go about their day.  Except for a rare seizure, which occurs in 1 of 1000 patients, TMS has only minor side effects of mild headache or scalp soreness in the first few days. 

It is said that after successful TMS treatment, that there is a 50% chance of relapse of depression within the first year.  However, at Hagan Health we consider that statistic to be too high, and our relapse rate is lower.  While treatments are done by certified and experienced treaters, Dr. Hagan is closely involved in determining the location and strengths of settings to provide the most accurate treatment.  In addition, Dr. Hagan meets with patients every week or two before and during treatment, and periodically after treatment, in order to insure the best possible results.  Depression varies from patient to patient, and it is important to get the know the patient and the thoughts, feelings, and circumstances that might lead to relapse.  Using cognitive therapy techniques, patients are taught to be aware of triggers and to be prepared with the cognitive tools used to reduce the chances of relapsing. 

TMS for Anxious Depression

Recently TMS has been cleared by the FDA for treatment of Anxious Depression.  This condition is one in which anxious distress is a major part of the clinical picture while depression remains the predominant diagnosis.  Anxiety which is treated along with depression is also significantly improved, while TMS is not currently considered appropriate for the treatment of anxiety without depression.

Dr. Hagan Bio

So the lesson Al taught me was about my lack of happiness related to feelings of inadequacy. Even though I had become a brain surgeon, I did not have a healthy self-regard. Al explained to me that my father, in his drive to succeed and to push me to succeed, would never let me savor a victory, that whenever I achieved something important, he would ask, . “How could you have done it better?” Or “what is next?”. He was setting the bar at perfection, such that nothing less than perfection was going to be good enough. Al said, “Nobody is perfect”, and that I would be much happier deciding what degree of imperfection I was going to settle for. When one sets the bar at perfection, then every effort falls short of perfection and is therefore a relative failure, it becomes yet more evidence of one’s belief that he is fundamentally flawed and inadequate. He said that we are all always doing our best, and that is not fair for my father or for me myself to tell myself that I am not good enough. It was the single most important piece of wisdom that I would learn for the next several decades, and I have told this story many times to those who, like me, grew up to have similar issues.

After seeing Al for a year, another year or two went by. One day at church I was listening to a talk from a psychotherapist who had grown up in a family in which his mother was an alcoholic and his father was a workaholic. His story sounded so much like mine that I decided to see him professionally to “learn more about this garbage in my head”. I saw Paul for two years.

A few years later, life had become quite stressful. I was married with three small children, practicing neurosurgery full time and doing some farming on the side. It was at this time that I started seeing my third therapist, the one that I would see for most of the next 10 years. Keith was a psychiatrist, an MD like me, who did only psychotherapy. A few months after starting my therapy with Keith, I realized that I liked what he did better than what I did. The process of therapy is that of developing an increasing awareness of how one got to be the way he or she is, starting with childhood issues. Specifically, this type of therapy is called “psychodynamic psychotherapy”.

Dr_Hagan
Terry

Three years into my experience with Keith, I made the final decision that I would rather be a psychiatrist, because I came to love the process of developing insight into one’s own psychology. As I closed my neurosurgery practice and completed a residency in psychiatry, I was so grateful the entire time for the opportunity to turn myself into a psychiatrist. “Who gets to do that?!” Years later a patient was looking at the books on my bookshelf and asked, “So you were a neurosurgeon; did you like it?” I had been asked many times why I decided to give up neurosurgery to become a psychiatrist, but no one had ever asked if I liked neurosurgery. The answer had to be that no, I did not. I did not like who I was. But I have loved psychiatry from the very beginning, and I really appreciate the contribution it has had in my own personal development.

But because of my heavy early experience in psychotherapy, I also became proficient and experienced in both psychodynamic psychotherapy and in cognitive behavioral therapy (CBT). And I attended the Cincinnati Psychoanalytic Institute for a year to take my psychotherapy skills to a higher level.

During the 17 years that I have been practicing psychiatry, I have continued to grow. The most gratifying experiences I have had have been when I have settled into a psychotherapy relationship with a patient, while there have been many, others with whom I have combined psychiatry with psychodynamic therapy, practicing psychodynamic psychiatry.

Terry
Dr. Hagan Bio

During these same years, I have also been on several mission trips, which have given me perspectives that I would never have learned otherwise. The concepts of loving your neighbor, giving of your time and resources, being kind and gentle and gracious, have come to define me.

I have always been at the head of my own practice, managing my own business. I have experience with other businesses as well, such as being a successful alpaca breeder for 10 years. “They do not teach business in medical school.” In a growing psychiatry practice, running the business is something you learn from necessity.