Over the past several years, conversations about mental health have become more common across Oregon.
As more people speak up about struggling with mental health issues, the stigma surrounding mental health conditions like depression has shown signs of receding in Oregon.
More people are seeking help, employers are expanding mental health benefits, schools are investing in student wellness, and healthcare providers are working to improve access to behavioral health services.
These are encouraging changes. At the same time, they reflect a reality that many Oregon families already know firsthand: depression and other mental health conditions remain incredibly common, and many people continue to struggle despite receiving treatment.
For some individuals, their first round of “antidepressants plus psychotherapy” provides meaningful relief. For others, symptoms persist even after trying multiple medications and a variety of different treatment approaches. This experience, often referred to as treatment-resistant depression, has led a growing number of patients and healthcare providers to explore more specialized treatments like Transcranial Magnetic Stimulation (TMS).
At Shanti TMS, we regularly meet people who have spent years searching for answers. They are not looking for a quick fix to trivial problems, they are looking for an additional evidence-based approach to try after exhausting all of the “usual suspects” in a long-term quest for a solution to serious, chronic psychiatric symptoms.
Why More Oregonians Are Talking About Mental Health
More people feel comfortable naming, confronting, and discussing depression, anxiety, PTSD, and OCD symptoms than they did even a decade ago. Public awareness campaigns, increased media coverage, social media and online patient advocacy communities, personal stories shared by friends, family members, and public figures have helped normalize conversations about seeking support.
As awareness grows, more individuals are recognizing that their debilitating “quirks” and “shameful personal problems” are actually symptoms of a mental health condition with a name and an established path to treatment and recovery.
People are becoming more likely to seek care for persistent sadness, loss of interest, chronic fatigue, difficulty concentrating, changes in sleep, and feelings of hopelessness instead of just assuming these experiences are simply something they have to live with for the rest of their lives.
While reducing stigma is an important step forward, increased awareness has also highlighted another challenge: even after undergoing evidence-based treatment, many people continue to experience unacceptably elevated symptoms of common mental health conditions like depression and anxiety.
Understanding Treatment-Resistant Depression
A “treatment-resistant depression” diagnosis is NOT code for “you will have depression forever, sorry.”
Instead, it describes depression that has not adequately improved after trying more than one antidepressant medication at appropriate doses for an appropriate amount of time.
Experiencing multiple medication fails and receiving this diagnosis can be an incredibly frustrating experience.
Patients often describe feeling discouraged after investing months in medications, adjusting dosages, managing side effects, or participating in therapy without experiencing the level of improvement they hoped for.
No medication works for every patient. And it’s well-documented that a non-trivial percentage of people with depression do not experience significant symptom relief with any antidepressant medications, no matter how many different types of antidepressants they try.
When treatment resistant depression patients continue to experience symptoms that interfere with daily living, they are often directed to other evidence-based treatment options like TMS.
Why Demand for Advanced Depression Treatment Is Increasing
Several factors are contributing to increased interest in advanced depression treatments across Oregon.
More People Know That Antidepressants are Not the Only Option
For one, people are learning that there are more options available than they may have realized. For years, many patients believed medication and therapy were the only treatments available. While insurance restrictions can be limiting for many patients, most major insurance carriers will cover other treatments. That said, many health insurance companies will almost always require patients to begin with standard “go-to” treatments for depression, like antidepressant medications, first. However, antidepressant medications are not the ONLY – and certainly not always the BEST – option for every patient who struggles with depression. Today, there is a growing awareness of pharmaceutical-free depression interventions (like TMS) among patients and the providers who navigate their care.
More Providers are Willing to Change Course When the Status Quo Isn’t Working
Primary care physicians, psychiatrists, therapists, and other clinicians are now more adept at identifying situations when advanced treatments like TMS may be appropriate. This means that some patients who would otherwise suffer for years with ineffective treatments are now made aware of options like TMS at a much earlier point in their treatment journey.
More Informed Patients + More Informed Patient Choice Than Ever Before
With better access to evidence-based information about healthcare decisions, patients themselves are becoming more active participants in their care. Many people now have access to research about treatment options and cutting-edge scientific literature regarding their condition. This improved access translates into more patients asking more well-informed questions about alternatives when their current treatment plan is not producing meaningful results.
What Makes TMS Different?
Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment that uses targeted magnetic pulses to stimulate areas of the brain involved in mood regulation.
Unlike medications, TMS works by directly activating specific neural circuits associated with depression. You can read more about the nuts and bolts of TMS in our resource, The Science Behind TMS Therapy.
Treatment is performed in an outpatient setting, does not require anesthesia, and allows patients to return to normal daily activities after each session.
Many patients appreciate that TMS provides another option to discuss with their treatment team, particularly if medications have not provided adequate relief or have caused unwanted side effects.
Mental Health Care Is Becoming More Personalized
One of the most significant shifts occurring in behavioral healthcare is the move away from “cookie-cutter” treatment plans towards more individualized care.
When it comes to depression treatment, psychotherapy may be sufficient for some patients.
For others, medication in combination with talk therapy may be the most effective option.
For patients living with treatment-resistant depression, TMS may become an important component of a comprehensive treatment plan.
The goal is not replacing one treatment with another.
The goal is finding the combination of treatments most likely to help each individual improve their quality of life.
The Importance of Continuity of Care
Advanced treatment involves more than simply having access to technology.
Building a relationship with specialists who have the expertise and clinical conscientiousness to personally track patient progress and adjust treatments as necessary takes time.
At Shanti TMS, a physician is on-site during every treatment session, and patients work with the same care team throughout their course of care. This continuity helps create opportunities for ongoing communication, individualized adjustments, and a supportive, person-centered treatment experience. At Shanti, you’re not just a patient number and another entry in a spreadsheet. You’re a person our team is trying to actually help.
For many individuals living with depression, feeling heard and understood is just as important as receiving the treatment itself.
When Might It Be Time to Explore TMS?
Everyone’s experience with depression is different, but certain situations may signal that it’s worth having a conversation with a mental health professional about additional treatment options.
These may include:
- Persistent depression despite trying one or more antidepressant medications.
- Ongoing symptoms that interfere with work, school, relationships, or daily activities.
- Difficulty tolerating medication side effects.
- Feeling “stuck” despite actively participating in treatment.
TMS is not the right choice for everyone. Completing a TMS evaluation doesn’t necessarily mean your provider will decide that TMS is right for you. Instead, an evaluation provides us with an opportunity to review your treatment history, discuss your goals, and determine whether additional options like TMS should be considered.
Finding the Next Step
Depression makes it difficult for patients to access feelings like hope. It’s hard to imagine what it’s like to not have depression when you are experiencing depression. It’s even harder to hold onto hope for change when previous treatment attempts haven’t moved the needle.
Remember: treatment-resistant depression does not mean untreatable depression.
Exploring another treatment option is not a sign of failure—it is a continuation of your search for effective care.
At Shanti TMS, our team works closely with adults and adolescents throughout the Portland area to determine whether Transcranial Magnetic Stimulation may be an appropriate next step. Because we are part of a multidisciplinary behavioral health clinic, patients benefit from coordinated, physician-led care that considers the whole person rather than focusing only on symptoms.
If you have been living with depression despite trying medication, therapy, or other treatments, speaking with a qualified mental health provider can help you better understand the options available and identify a treatment plan that aligns with your individual needs and goals.
Reach out today to get started.