A few months ago, a patient told me something I’ll never forget:
“I’ve tried everything. Meds, therapy, lifestyle changes… but the depression just won’t let go.”
If you’ve ever felt that way—or watched a loved one wrestle with it—you know how exhausting it can be. For some, depression feels like an endless cycle of trying treatment after treatment, without finding real relief. That’s why two newer options—Transcranial Magnetic Stimulation (TMS) and Spravato® (esketamine nasal spray)—are changing the landscape of care.
At Sonder Behavioral Health & Wellness, we see how these therapies are helping people reclaim their lives, especially when traditional treatments haven’t been enough.
What Makes TMS Different?
Think of TMS as a “reset button” for parts of the brain involved in mood regulation. Using gentle magnetic pulses, TMS activates underactive brain circuits linked to depression.
Unlike medications that travel through your whole system, TMS is non-invasive, non-sedating, and non-systemic. The most common side effects? A mild tapping sensation or temporary scalp discomfort.
Treatment options include:
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Standard TMS: 36 sessions (about 7 weeks), ~20–40 minutes each.
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Accelerated TMS: Completed in just 5 days, with multiple sessions per day.
“I could go to treatment and then head back to work right after—no downtime.”
That’s a common story. Patients can drive themselves home after a session and carry on with their day.
Quick facts about TMS:
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FDA-approved since 2008 for major depression, with millions of treatments delivered nationwide.
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Particularly effective for treatment-resistant depression—those who haven’t found relief with antidepressants.
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Clinical studies show response rates around 50–60% and remission rates of about 30–40%, even in hard-to-treat cases.
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It’s also FDA-approved for other conditions like OCD, Anxious Depression, and Adolescent Major Depression (ages 15+).
How Spravato Works
Spravato takes a very different approach. It’s the only FDA-approved esketamine nasal spray for treatment-resistant depression and for people with MDD and acute suicidal ideation/behavior.
Because of its unique mechanism—targeting the brain’s NMDA (glutamate) system—Spravato can sometimes help patients feel improvement within days to weeks, instead of waiting months for antidepressants to take effect.
Here’s what a typical treatment plan looks like:
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Twice weekly for the first 4 weeks
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Once weekly for weeks 5–8
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Then once weekly or every 2 weeks as maintenance
Sessions are always supervised in-clinic, with at least 2 hours of monitoring, and patients need someone else to drive them home.
Quick facts about Spravato:
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FDA-approved in 2019, offered only through certified clinics under a REMS program.
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Used alongside an oral antidepressant—never as a stand-alone treatment.
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Common short-term side effects include dizziness, increased blood pressure, and dissociation (feeling “spaced out”), but these usually fade within a couple of hours.
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Has shown rapid symptom relief in some patients—especially valuable for those in crisis.
“Knowing I was being watched over helped me feel safe enough to try something new.”
Why These Options Matter
Both TMS and Spravato provide new hope when standard treatments fall short. They don’t replace therapy, lifestyle changes, or medication in every case, but they expand the possibilities for healing.
If you or someone you love is struggling, here are a few takeaways:
When to consider TMS:
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Medications haven’t worked or caused intolerable side effects
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You want a non-drug, outpatient option
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You can commit to daily sessions (or an accelerated protocol)
When to consider Spravato:
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At least two antidepressants haven’t worked
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Depression feels severe or urgent
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You’re open to pairing treatment with an oral antidepressant
Finding the Right Treatment at Sonder
Recovery from depression is rarely a straight line. It takes courage to keep looking for what works.
At Sonder, our team personalizes treatment, walking alongside patients through every step—whether that’s TMS, accelerated TMS, Spravato, or more traditional therapy and medication management.
Every step forward matters. And sometimes, the right step is trying something new.
Reach out to Sonder Behavioral Health & Wellness to explore if TMS or Spravato could be right for you or your loved one.