Sources

Madore MR, Kozel FA, Williams LM, et al. Prefrontal Transcranial Magnetic Stimulation for Depression in US Military Veterans - A Naturalistic Cohort Study in the Veterans Health Administration. Journal of Affective Disorders. 2022;297:671-678.
Reger MA, Smyth MJ. Mental Health Research in the Department of Veterans Affairs. JAMA Psychiatry. 2025. doi:10.1001/jamapsychiatry.2025.1808.
Brockington R, Buelt A, Capaldi V, et al. Management of Major Depressive Disorder (MDD) (2022). VA/DoD Clinical Practice Guideline. Published February 1, 2022.
Coleman SJ, Stevelink SAM, Hatch SL, Denny JA, Greenberg N. Stigma-Related Barriers and Facilitators to Help Seeking for Mental Health Issues in the Armed Forces: A Systematic Review and Thematic Synthesis of Qualitative Literature. Psychological Medicine. 2017;47(11):1880-1892.
Bahraini N, Bodie C, Brenner LA, et al. Assessment and Management of Patients at Risk for Suicide (2024). VA/DoD Clinical Practice Guideline. Published April 1, 2024.
MacDermid JC, Lomotan M, Hu MA. Canadian Career Firefighters' Mental Health Impacts and Priorities. International Journal of Environmental Research and Public Health. 2021;18(23):12666.
Nichter B, Stein MB, Norman SB, et al. Prevalence, Correlates, and Treatment of Suicidal Behavior in US Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study. Journal of Clinical Psychiatry. 2021;82(5):20m13714.
Ravindran C, Morley SW, Stephens BM, Stanley IH, Reger MA. Association of Suicide Risk With Transition to Civilian Life Among US Military Service Members. JAMA Network Open. 2020;3(9):e2016261.
Hauck H, Li L, Gregg E, Dragonetti J. Resource Document on Psychiatry and Military Service. American Psychiatric Association. Published February 1, 2024.
Rogers P, Hileman C, Salazar G, et al. Pilots Using Selective Serotonin Reuptake Inhibitors Compared to Other Fatally Injured Pilots. Accident Analysis & Prevention. 2017;107:86-91.
Hoffman WR, Aden J, Barbera RD, et al. Healthcare Avoidance in Aircraft Pilots Due to Concern for Aeromedical Certificate Loss: A Survey of 3765 Pilots. Journal of Occupational and Environmental Medicine. 2022;64(4):e245-e248.
Lisha I, Godbole Kroger NB, Tsalatsanis A, et al. The Durability of Response to Transcranial Magnetic Stimulation in Veterans With Major Depressive Disorder. Journal of Affective Disorders. 2025.

Active Duty Military & EMS

Prenatal TMS

Research supports TMS as a promising treatment option for depression during pregnancy, particularly for patients seeking to avoid or minimize medication exposure. Clinical trials, including a randomized controlled trial and open-label studies in pregnant women with major depressive disorder, have demonstrated meaningful reductions in depressive symptoms with goodtolerability [1] [2].

Systematic reviews and meta-analyses similarly report significant symptom improvement and reassuring maternal and fetal safety data, with no serious adverse obstetric or neonatal outcomes identified in the availableliterature [3] [4].

While larger studies are ongoing, current evidence suggests that TMS is a viable and well-tolerated non-pharmacologic treatment during pregnancy.

Postpartum TMS

TMS has also shown effectiveness for depression in the postpartum period, where untreated symptoms can significantly affect maternal functioning and infant bonding. Reviews of peripartum populations, including postpartum patients, demonstrate significant reductions in depressive symptoms and favorable tolerabilityprofiles [3] [5].

Importantly, because TMS is not a systemic medication, it does not transfer into breast milk, making it an appealing option for breastfeeding mothers. Emerging literature continues to support TMS as a safe and effective treatment for postpartum depression, expanding access to non-medication-based care during this criticalperiod [4] [5].

TMS for Military, First Responders & Their Families

TMS Treatment Without Career Consequences

You’ve spent your career showing up for others. But lately, something feels off.

Maybe you're not sleeping well. You're more irritable with your family. You can’t focus the way you used to. You push through—but it’s getting harder.

If this sounds familiar, you're not alone.

Depression affects about 1 in 6 veterans [1][2] and 12% of deployed active duty service members [3]. Yet more than half of service members and first responders with mental health problems do not seek care [4].

You shouldn’t have to choose between your health and your career.

Why Many Don’t Seek Treatment

In your line of work, getting help can feel risky.

Concern about losing security clearance
Worry about being placed on duty limitations
Fear of being seen differently by your team
For pilots, risk of losing flight status

More than half of service members and first responders with mental health conditions avoid care due to stigma and career concerns [4]. A majority of pilots—56%—report avoiding healthcare due to fear of losing certification [11].

The Real Impact of Untreated Depression

Depression often shows up as:

Irritability or anger
Sleep issues or fatigue
Difficulty concentrating
Feeling disconnected
Increased substance use
Loss of interest in hobbies, exercise, or time with family

Suicide risk is significantly elevated in these populations [5][6][7][8], yet many are not engaged in treatment [7]. Transition out of service is a particularly high-risk time [8].

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TMS: A Different Approach

TMS is a non-medication treatment that stimulates brain regions involved in mood regulation.

Because it does not involve medication, it typically does not trigger:

Duty-limiting profiles [9]
Deployment restrictions [9]
FAA medication complications [10][11]
Concerns about carrying a firearm [9]

Covered by TRICARE

TMS is now covered by TRICARE for eligible patients.

We can help verify your benefits.

Proven Results

TMS is recommended in the 2022 VA/DoD Clinical Practice Guideline for patients who have not responded adequately to two or more medication trials [3].

In a large study of veterans receiving TMS:

41% experienced meaningful improvement in depression [1]
85% of responders remained stable for at least 2 years without significant relapse [12]
Treatment was safe and well-tolerated [1]

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What About PTSD?

Among veterans with both depression and PTSD, 65% showed clinically meaningful reduction in PTSD symptoms after TMS [1].

What to Expect

Sessions under 20 minutes
Typically 5 days per week for about 6 weeks
Accelerated options may shorten treatment to 1 week or less
You remain awake and alert
No downtime

A Path Forward Without Compromise

Mental health care is not a sign of weakness—it’s part of staying ready.
You don’t have to choose between getting help and doing the job you care about.
TMS offers a path forward without compromising your role, your responsibilities, or your future.
Schedule a confidential consultation.

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