Transcranial Magnetic Stimulation uses targeted magnetic pulses—similar in strength to those used in MRI imaging—to stimulate specific areas of the brain involved in mood regulation, emotional processing, and the systems that drive symptoms of depression, OCD, anxiety, and other conditions. The magnetic pulses pass painlessly through the skull and induce small electrical currents in the underlying brain tissue, which over the course of treatment helps restore the activity of brain circuits that have become underactive in mental health conditions.
Unlike medication, TMS doesn’t work by changing brain chemistry through drugs that affect the whole body. It works locally, on specific brain circuits, with no systemic effects—no weight gain, no sexual side effects, no fatigue, no cognitive blunting, no daily medication to remember. For many patients, this is the difference between treatment they can sustain and treatment they end up stopping.
TMS has been studied for more than 40 years and has gained significant clinical traction in the past decade. It is one of the most extensively researched mental health treatments available, with strong evidence for its safety and effectiveness in depression specifically and growing evidence for other conditions. Serenity Mental Health Centers considers TMS our signature treatment—it’s the option we reach for most often when traditional approaches haven’t been enough.
TMS is most established for major depressive disorder, with growing applications across other mental health conditions:
Major Depressive Disorder (MDD). This is the primary FDA-approved indication and the most extensively studied use of TMS. TMS is particularly valuable for patients with treatment-resistant depression—those who haven’t responded fully to one or more antidepressant medications—and for patients who can’t tolerate medication side effects. It’s also FDA-approved for depression with anxious distress, which is one of the most common patterns we see.
Obsessive-Compulsive Disorder (OCD). TMS is FDA-approved for OCD using a specific protocol that targets brain circuits involved in obsessive thoughts and compulsive behaviors. For patients with OCD who haven’t responded fully to SSRIs and exposure-and-response-prevention therapy, TMS provides a meaningful additional option.
Anxiety disorders. While not separately FDA-approved for generalized anxiety disorder, TMS shows meaningful benefit for anxiety symptoms, particularly when anxiety co-occurs with depression. The FDA-approved indication for “depression with anxious distress” addresses one of the most common clinical presentations: patients whose depression and anxiety are intertwined.
Post-Traumatic Stress Disorder (PTSD). Growing clinical evidence supports TMS for PTSD, particularly in veterans and patients with treatment-resistant trauma symptoms. The Department of Veterans Affairs has incorporated TMS into VA mental health care for some patients, including through the Rocky Mountain Regional VA Medical Center in Aurora.
Seasonal patterns. While TMS isn’t separately FDA-approved for seasonal affective disorder, the underlying depression that worsens during Colorado winters responds well to TMS. For Denver-area patients whose mood drops with the shortening days, TMS can be a valuable addition to or replacement for the standard SSRI/light-therapy approach.
Other conditions. TMS is also used for smoking cessation (a specific FDA-approved indication), bipolar depression (under appropriate care), and other conditions where standard treatments haven’t been adequate. Whether TMS is right for your specific situation is a conversation we have during evaluation.
For most patients, TMS is much less involved than they expect. Here’s what happens:
You arrive and sit down. Sessions take place in a comfortable chair, similar to a dental chair, in our Penthouse Suite office. You don’t change clothes, you don’t get an IV, you don’t take any medication, and you don’t need anyone to drive you.
The coil is positioned. A magnetic coil is positioned against the side of your head, targeting specific brain areas based on your diagnosis and treatment protocol. Initial mapping during your first session determines the exact placement and intensity, and after that, the placement is consistent session to session.
Treatment begins. Brief magnetic pulses are delivered through the coil. You’ll feel a tapping sensation at the treatment site—most patients describe it as similar to someone tapping on the side of your head with a pencil. Some patients find this mildly uncomfortable in the first session or two, and most adjust quickly. Treatment cycles between pulses and rest periods over the course of the session.
You’re awake and aware the whole time. Patients can read, watch something on a phone or tablet, listen to music, or just rest. There’s no sedation, no altered mental state, no fog. Many patients use the time to catch up on email or watch a show.
Sessions typically last 19 to 37 minutes depending on the protocol for your condition. The newest TMS protocols are at the shorter end of that range; older protocols are at the longer end.
You leave and go about your day. No recovery time, no driving restrictions, no work restrictions. You can drive yourself home, return to work, head to the trail, get to a workout—whatever your normal day involves. This matters in Denver, where active outdoor lives are part of why people choose to live here.
A standard course of TMS involves daily sessions (Monday through Friday) over 4 to 6 weeks—typically 30 to 36 sessions total. This is the most significant practical consideration with TMS, and it’s worth being honest about: daily clinic visits for over a month is a real commitment.
Why it works this way. The treatment effect builds with repeated sessions over time. The brain circuits TMS targets need repeated stimulation to shift toward a more typical activity pattern, and the treatment course is designed to deliver enough stimulation to produce durable change. Shorter courses don’t work as well.
What patients typically notice during the course. Most patients begin to notice some improvement in the second or third week, though some notice changes earlier and some later. Sleep often improves first. Mood and energy typically follow. The full benefit of treatment is usually clear by the end of the standard course.
Scheduling. We schedule sessions to fit around work, school, and family commitments. Sessions can be early morning (we open at 6:00 AM), during long lunch breaks, or late afternoon and evening. Our Cherry Creek location is accessible from downtown, the Anschutz/Aurora medical corridor, the Denver Tech Center, and the southern suburbs—a 15-25 minute drive from most metro neighborhoods, weather permitting.
Denver winter weather considerations. Snowstorms occasionally affect daily scheduling. We work with patients on the practical realities—rescheduling during major storms, building in flexibility around forecasted weather, and making up sessions as needed. The treatment course can absorb a few weather-related reschedules without significantly affecting outcomes.
After the initial course. Some patients respond well to the initial course and don’t need further TMS for an extended period. Others benefit from periodic maintenance sessions—every few weeks or months—to sustain the gains. The pattern that works best for you becomes clear over time, and we adjust accordingly.
Our Cherry Creek location serves a Denver-area patient population whose lives, work, and recreation are shaped by Colorado-specific realities. Several reasons TMS often fits well:
Treatment that doesn’t interfere with active life. Denver-area patients are often outdoor-active in ways patients in less active regions aren’t—hiking, climbing, skiing, running, cycling, mountain weekends, training for events. Many antidepressants produce fatigue, weight gain, or cognitive blunting that interferes with this active life. TMS doesn’t. Patients can drive themselves home after a session and meet friends for a trail run that evening if they want to.
Treatment that doesn’t show up on prescription records. Cherry Creek and the broader Denver metro are home to healthcare workers at Anschutz Medical Campus, UCHealth University Hospital, Denver Health, Children’s Hospital Colorado, National Jewish Health, Rose Medical Center, and the surrounding hospital systems, many of whom have specific concerns about prescription records, credentialing, and DEA registrations. TMS sidesteps those concerns entirely. Treatment is in-clinic, ends when the course ends, and doesn’t generate the pharmacy data that some patients prefer to avoid.
Treatment for Colorado winter depression. Denver gets more sunny days than most of the country, which sometimes leads to under-recognition of winter depression. But Colorado winters are still long, the days are still short, and the snow-cover months still drive seasonal mood patterns in susceptible patients. For patients whose mood drops every December through March, TMS can be a meaningful addition to or replacement for the SSRI/light therapy approaches that often aren’t enough.
Treatment for treatment-resistant depression. The largest TMS patient population is people who’ve tried multiple antidepressants without sustained relief. About a third of depression patients don’t respond fully to the first medication tried, and many cycle through two, three, or more before finding (or not finding) sustained benefit. For these patients, TMS represents a fundamentally different mechanism—not another pill, but a different approach to the underlying brain circuit dysfunction.
Treatment for new mothers preserving breastfeeding. Postpartum depression is common, and many new mothers want to avoid antidepressants while breastfeeding. TMS doesn’t involve any systemic medication, doesn’t pass to the baby, and is compatible with breastfeeding throughout the treatment course.
Treatment for older adults on multiple medications. The retirement-community areas around Cherry Creek—Hilltop, Crestmoor, Belcaro, Polo Club, and the broader south Denver suburbs—include many older adults already on multiple prescriptions for medical conditions. Adding an antidepressant introduces drug-drug interaction risks. TMS sidesteps that concern entirely because it isn’t a drug, and it’s well-tolerated in older adults.
Treatment for veterans. Denver has a substantial veteran population, served in part by the Rocky Mountain Regional VA Medical Center in Aurora. TMS has growing evidence for PTSD and treatment-resistant depression in veterans, and we accept Champ VA and Tricare alongside private insurance. Many of our veteran patients have tried VA medication management and want to add or substitute TMS.
Colorado winter depression is real, even in a state known for sun. Days shorten substantially from late October through February, snow-cover months reduce outdoor activity for many patients, and the contrast with Colorado summers—where outdoor time and movement are naturally abundant—can make the winter drop feel particularly sharp. For patients prone to seasonal patterns, every winter brings a recognizable decline that standard approaches sometimes can’t fully address.
The standard treatments for seasonal depression include light therapy (bright light boxes used in the morning), behavioral activation, and antidepressant medication. These work well for many patients, but not for everyone. When SSRIs produce side effects, when light therapy isn’t enough, or when winter depression overlaps with treatment-resistant depression more broadly, TMS becomes a meaningful option. We see patients each fall who want to start TMS before the worst of winter hits, and the timing can be planned around the seasonal pattern.
TMS and medication aren’t competing options—they’re different tools that serve different patient situations, and many patients use both at different points in their treatment. A few key differences:
How they work. Medications work by changing the balance of neurotransmitters throughout the brain (and the body—which is where side effects come from). TMS works locally on specific brain circuits, stimulating activity in regions that have become underactive in mental health conditions. The result is improvement without systemic effects.
Time to effect. Antidepressants typically take 4-8 weeks to show full effect, and patients often don’t know during those weeks whether the medication is going to work. TMS produces gradual improvement during the treatment course, and patients can often feel changes by week 2 or 3.
Side effects. Medication side effects are common and often disabling enough that patients stop treatment before it’s had time to help. TMS side effects are minimal—occasional headache or scalp discomfort during sessions, both of which typically resolve quickly.
Duration of effect. Antidepressants work only as long as you take them daily. TMS produces effects that last beyond the treatment course—often months or longer—and some patients maintain remission for extended periods with occasional maintenance sessions or no additional treatment.
Combining them. Many patients do well on a combination—continuing medication during and after TMS. Some patients eventually taper medication after TMS produces a strong response. These decisions are individualized.
Some patients ask whether TMS is similar to electroconvulsive therapy (ECT). They’re related in concept—both use forms of brain stimulation for treatment-resistant depression—but the experience is very different:
ECT involves general anesthesia, induces a brief therapeutic seizure, typically requires inpatient or outpatient hospital-based delivery with significant recovery time after each session, can produce temporary memory effects, and is reserved for the most severe or treatment-resistant cases. ECT is highly effective for severe depression and remains a valuable treatment in the right circumstances.
TMS is fully outpatient, involves no sedation or seizure induction, has no memory effects, lets you drive yourself home, and is appropriate for many patients who wouldn’t be candidates for ECT or who want to try a less invasive option first. Most patients trying brain stimulation for the first time appropriately start with TMS.
TMS is appropriate for most adults with depression, OCD, anxiety, or PTSD who haven’t fully responded to standard treatments, who want to avoid medication, or who can’t tolerate medication side effects. Specific considerations:
Established diagnosis. A clear diagnosis of one of the conditions TMS treats. We confirm this through our standard evaluation process before recommending TMS.
Prior treatment history. Insurance typically requires documentation of one or more (often two or more) antidepressant medication trials that haven’t worked adequately. Some patients qualify on a first-line basis based on intolerance to medication; others qualify after a treatment history.
No contraindications. The primary contraindications to TMS are metal implants in or near the head (cochlear implants, deep brain stimulators, aneurysm clips, certain dental implants—we assess this carefully) and a history of seizure disorder or significantly elevated seizure risk. Many patients with metal elsewhere in the body, including hip and knee replacements, are fine candidates.
Treatment commitment. The 4-6 week daily session course is the main practical commitment, and we want patients who are ready to engage with it. We work with patients on scheduling, but the time investment is real.
TMS is one of the better-tolerated treatments in psychiatry. Most patients have minimal side effects, and the side effects that do occur are typically mild and temporary:
Common (most patients). Mild headache during or after the session, mild scalp discomfort at the treatment site, brief facial twitching during pulses (the pulses can stimulate nearby facial muscles). These typically resolve within minutes to hours and become less noticeable over the course of treatment.
Less common. Lightheadedness during sessions, mild jaw discomfort if the pulses affect the masseter muscle. These typically resolve with minor coil position adjustments.
Rare. Seizure during treatment is the most serious potential side effect, occurring in well under 1 in 10,000 sessions in patients without seizure risk factors. We screen carefully for seizure risk before treatment and monitor during sessions.
What TMS doesn’t cause. Weight gain. Sexual side effects. Sedation or fatigue. Cognitive blunting. Sleep disturbance. GI issues. Memory problems. Dependency. None of the side effects that drive patients to stop antidepressants are TMS side effects, because TMS isn’t a drug.
Most major insurance plans cover TMS for treatment-resistant depression, and coverage has expanded substantially over the past decade. Plans we work with that typically cover TMS include Aetna, Blue Cross Blue Shield, Cigna, Optum, United Healthcare, Oscar, Tricare, Champ VA, Denver Health Medical, UMR, Meritain, First Health, and many others. Coverage details vary—some plans cover TMS only for depression, others cover OCD and additional indications—and we verify your specific coverage during the consultation process.
Prior authorization. Insurance plans typically require prior authorization for TMS, which involves documentation of your prior treatment history, current diagnosis, and medical necessity. We handle the prior authorization paperwork on your behalf as part of getting started. This typically takes 1-3 weeks, depending on the insurance company.
What patients usually pay. With insurance coverage in place, patients are typically responsible for their plan’s standard cost-sharing—deductibles, copays, or coinsurance—rather than the full cost of treatment. We walk through the financial picture during consultation so there are no surprises.
Patients sometimes ask whether Denver’s elevation (5,280 feet) affects TMS treatment. The short answer: not in any clinically significant way. The magnetic pulses TMS delivers are unaffected by altitude. What altitude does affect is sleep architecture (some patients have less restful sleep at altitude until acclimated), oxygenation, and the broader physiology that interacts with depression and anxiety. For new transplants to Denver, the adjustment period can sometimes amplify mood symptoms, and we factor this into evaluation. For longtime residents, the altitude is just part of the baseline.
Starting TMS isn’t a same-day decision. Here’s how the process typically unfolds:
Initial consultation. A thorough evaluation that includes review of your diagnosis, current symptoms, prior treatment history, and goals. We assess whether TMS is likely to help your specific situation and answer your questions about what treatment involves.
Screening for contraindications. Review of medical history for metal implants, seizure risk factors, and other considerations that affect TMS candidacy. Most patients clear this screening without issue.
Insurance authorization. Our team submits the prior authorization paperwork to your insurance company. This typically takes 1-3 weeks. We handle this; you don’t.
Treatment planning and scheduling. Once authorization is in place, we schedule your first session and the rest of the course. Sessions are scheduled to fit your actual schedule—morning, midday, or after work.
First session and mapping. The first session takes longer (typically 60-90 minutes) because it includes initial mapping to determine optimal coil placement and intensity for you specifically. After that, sessions are at the standard 19-to-37-minute duration.
Treatment course and follow-up. Daily sessions Monday through Friday for 4-6 weeks. Periodic check-ins to track progress and adjust as needed. End-of-course evaluation and planning for what comes next—whether maintenance sessions, continued medication or therapy, or simply ongoing monitoring.
TMS is most effective when delivered as part of comprehensive psychiatric care, not as a standalone procedure. Our approach integrates TMS with medication management, therapy referrals, and ongoing clinical follow-up. We assess whether co-occurring conditions—anxiety, ADHD, sleep disorders, substance use, medical conditions—are affecting outcomes, and we adjust the broader plan as needed.
Many patients arrive at TMS after years of feeling stuck on medication or after multiple unsuccessful trials. Our goal isn’t just to deliver TMS sessions; it’s to help patients build a sustainable approach to their mental health that works after the initial course ends.
Our Cherry Creek clinic is led by a board-certified psychiatrist and three psychiatric nurse practitioners, all with training in mood, anxiety, and related conditions:
Dr. Jennifer French, DO — Psychiatrist. View profile.
Austin Alderton, PMHNP — Psychiatric Nurse Practitioner. View profile.
Nico Bohm, PMHNP — Psychiatric Nurse Practitioner. View profile.
Emily Brookshire, PMHNP — Psychiatric Nurse Practitioner. View profile.
Our Cherry Creek team takes a patient-first, evidence-based approach: careful evaluation, transparent conversations about what TMS can and can’t do, and a steady pace that respects how you’re actually doing. With same-week consultations, extended hours, Champ VA and Tricare accepted, and TMS delivered on-site in Cherry Creek, we’re committed to making this signature treatment genuinely accessible for Denver-area patients.
TMS is fundamentally an in-person treatment—it can’t be delivered remotely. That makes location matter. Our Cherry Creek clinic is at 425 South Cherry Street, Penthouse Suite, easily accessible from the I-25 / Colorado Boulevard / Leetsdale corridor and convenient to downtown Denver, Glendale, the Anschutz medical corridor, the Denver Tech Center, and the southern suburbs. Patients coming from across the Denver metro can typically reach us in 15-25 minutes (longer in heavy weather)—and that proximity matters when you’re coming five days a week for several weeks. We schedule sessions to minimize the disruption to your work, family, and outdoor life.
Our clinic is located at 425 South Cherry Street, Penthouse Suite in Denver, CO 80246, on the east side of Cherry Creek near the Glendale border—convenient to the Cherry Creek Shopping District, downtown Denver, and the I-25/Colorado Boulevard corridors. TMS therapy is delivered on-site, and we serve patients from across the Denver metro, including Glendale, Aurora, Lakewood, Englewood, Centennial, Greenwood Village, and Cherry Hills Village.
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