Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS)

If you've tried everything and you're still not better, you may need something different.

Treatment-resistant depression is one of the most exhausting places a person can be. You've shown up to appointments, tried the medications, done the work — and something still isn't shifting.

TMS can be that shift, and it's one of the most compelling tools we have. Hartselle & Associates offers the newest, accelerated Transcranial Magnetic Stimulation that can be completed in one day.

WHAT IS TMS?

TMS uses similar technology to an MRI machine but on a smaller scale. It delivers targeted magnetic pulses positioned over areas of the brain involved in depressive or anxious thought patterns.

Depression and severe anxiety disorders create and reinforce negative thinking and behavioral loops that can feel impossible to overcome. Traditional treatment helps patients re-pattern emotion processing and automatic negative thought loops, but the time it takes can be extensive. TMS can help accelerate the brain’s ability to generate more positive thoughts by stimulating those circuits. The magnetic pulses provided in one day of TMS treatments reinforce the positive neural pathways thousands of times, accelerating the work done in regular outpatient treatment and shortening recovery time.

WHAT DOES THE RESEARCH ACTUALLY SHOW?

This isn't new or experimental. TMS has been FDA-approved for depression since 2008, and the emerging data on accelerated protocols is striking.

In published clinical studies, accelerated TMS can achieve up to an 80% response rate and 51% remission rate, with results holding in 93% of patients at six months.

For context: less than 30% of patients respond meaningfully to a first antidepressant. Each additional medication trial frequently lowers the odds further. TMS doesn't follow that pattern. For most, the results don't diminish and this is precisely why TMS belongs in the conversation earlier, not as a last resort. Most of the research has been done in settings where sessions are once a day, five days a week for about six weeks. Recently, studies have shown that condensing the treatments into one week or even one day, are just as effective.

WHO IS THIS FOR?

People in the middle of a severe depressive episode, whether it's your first or your fifteenth
Treatment-resistant depression that hasn't responded to medication trials
OCD and anxiety, particularly when they've been woven into the depression
Suicidal thoughts : We are comfortable treating high-complexity cases for which other practices aren't equipped.

WHAT DOES TREATMENT ACTUALLY LOOK LIKE?

Traditionally, TMS is delivered over six weeks of daily appointments. We offer an intensive, one-day protocol augmented by two enhancing medications most practices don’t offer.

We have access to d-cycloserine and lisdexamfetamine, a precision medication combination shown to accelerate recovery and expand the window of neuroplasticity.

Ten hours total. You're under the magnet for 3.5 minutes, then you rest for 30. That cycle repeats throughout the day with your downtime being available for reading, listening to music or just resting. There are no needles, no procedures and requires no sedation or anesthesia.

Though the treatments are delivered in one day, you won’t immediately feel the benefits. Instead, patients often experience recovery over the next six weeks, providing an opportunity to practice coping skills and new thinking patterns in the healing brain.

your EXPERIENCE HERE IS different than anywhere else

Your team is dedicated to you and works with you from start to finish, including a board certified psychiatrist and a health and wellness coach -dually trained in TMS technician work. Our teams are comprised of people who care about your time with us and your recovery journey after the treatment. After your treatment day, we are here to help build skills around what actually matters to you — your creative life, your relationships, what you want to get back to. The neuroplasticity window TMS opens is an opportunity. We help you use it.

This isn't in-and-out. It's not rotating staff who don't know your name. It's a practice that built its reputation entirely on what happens when patients walk through the door.

WHAT DOES IT COST?

We believe in being transparent about this. Traditional TMS involving daily visits for six weeks can be covered by insurance and there are facilities in Rhode Island that offer this route.

Accelerated TMS is typically not covered by insurance. Providers in Rhode Island charge $6,000–$7,000 for one day TMS. Our program is priced differently — because it is different.

The TMS treatment day is $15,000. That includes an extensive intake by your board certified psychiatrist, access to d-cycloserine (unavailable at most facilities) and lisdexamfetamine, wellness coaching with our dually trained technicians, and a private, non-clinical setting.

For comparison: the most advanced accelerated TMS protocol currently available (Stanford's SAINT) runs $30,000–$36,000. We sit well below that ceiling while offering a level of integration, personalization, and clinical depth that most programs at any price don't match.

This is a real investment. We know that. And we also know that you've likely already spent years and significant resources on approaches that haven't moved the needle. What we're offering is not more of the same.

WHAT IF IT DOESN'T WORK?

It's a fair question, and you deserve a straight answer.

TMS doesn't work for everyone. No treatment does. What we can tell you is that the response rates are high, the safety profile is remarkably impressive and its durability is proven. You’ll also leave with the skills, relationships, and insight you’ll develop through the programming we provide. The fear around these treatments makes sense, but weigh it against the cost of years of treatment and an inability to live well.

READY TO FIND OUT IF TMS IS RIGHT FOR YOU?

The first step is an intake — 90 minutes to understand your history, what you've tried, and what we think is possible. You'll leave knowing more about your brain and your options than you came in with, regardless of what you decide.

Schedule an intake consultation →

And if you want to go further: a ketamine session the day before your TMS can prime the brain for even greater change. That combination is something most practices haven't figured out how to do. We have. We believe it is critical to update and coordinate with your established team.

One Day TMS Total $15,000

Intake with board certified psychiatrist $2000

One D TMS Day: Administrative and technician fees $1500

Physician mapping, clinical monitoring, treatment delivery: $11,500

One-Day Transcranial Magnetic Stimulation (TMS) with Ketamine add on

Ketamine Prior to TMS $4500

Ketamine Intake and Preparation session with Dr. Sarah Wichman $500

Ketamine journey with your team $3000

Two integration sessions with Dr. Sarah Wichman $500 ea