TMS, medication-free options and your role: a spouse FAQ
No question is dumb here: what to do when they quit meds, what exists, sessions, driving, how you will know it is working, and self-care.
Partners of people with hard-to-treat depression ask us a lot of questions, and many of them start the same way: "This might be a dumb question, but..." None of them are. This FAQ collects the ones we hear most about drug-free treatment, answered as plainly as we can.
Some answers draw on answers our publisher's poll collected from 443 adults across ten Midwest states, and every such figure is final, after validation.
My partner says they're done with medication. Should I be alarmed?
Not by that alone. Plenty of people feel the same way, especially after several prescriptions that did not do enough. In our survey, nearly two thirds of respondents, 64 percent, said that having a drug-free option matters to them. The preference is common and reasonable.
What deserves attention is whether the preference leads somewhere. If "done with medication" becomes "done with treatment," that is the moment to gently keep the door open.
What drug-free options actually exist?
The main ones are psychotherapy, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT). Therapy is the most widely available. TMS is an outpatient treatment using a magnetic coil, with FDA clearance for adults in whom antidepressants have not adequately relieved major depression. ECT is usually reserved for severe or resistant depression and involves anesthesia. Which one, if any, fits your partner is for them and their clinician to work out.
Why has no one mentioned TMS to us?
Awareness is low. Only one in four people we surveyed, 25 percent, knew what TMS was. It often comes up only when a patient or family member asks. So one of your most useful jobs is making sure someone asks.
Isn't esketamine a drug-free option?
No. Esketamine, brand name Spravato, is a prescription drug the FDA approved for depression that standard options have not helped, sprayed into the nose at a certified clinic while staff observe. It can be a real option, but it does not meet a drug-free goal. If your partner wants to weigh it anyway, the Brain Recovery Centers site describes a typical Spravato session. At-home ketamine products are a separate category and are not FDA-approved for depression.
Can I go into the TMS session with them?
Policies vary by clinic, so ask. Many clinics are comfortable with a companion at the first visit, which tends to be the longest, since it includes finding the right position and strength for the coil. After that, many patients go on their own because the sessions are short and routine.
Will I need to drive them?
For TMS, usually not. No anesthesia or sedating medication is involved, and most people drive themselves and return to their day. That is different from esketamine, where patients must hand over the car keys until the following day, and from ECT, where someone needs to take them home.
Even so, a daily TMS course can strain a household. A typical course fills four to six weeks with weekday sessions. If you share a car or juggle childcare, plan the calendar together before the first appointment.
How will we know if it's working?
Ask the clinic how they measure progress. Most use standard depression questionnaires at the start and at intervals during treatment, so changes can be tracked against a baseline rather than guessed at. Some people notice improvement partway through a course. Some do not improve. There is no promise either way, and a good clinic will say so.
At home, you may notice small things before your partner does: getting up more easily, returning a friend's text, laughing at a show. It is fine to share those observations kindly. It is not fine to pressure them to feel better on schedule.
What should I watch for?
With TMS, the common side effects are headache and scalp discomfort, usually mild. Seizures are rare but serious, and clinics screen for risk factors. Beyond side effects, watch for any change in mood that worries you, especially new or worsening talk of hopelessness or self-harm. Tell the treating clinician, and if it feels urgent, use 988.
Does insurance cover this?
Often, with conditions. Therapy is covered by most plans. TMS is covered by many commercial plans and by Medicare in many areas, usually with prior authorization and proof that several antidepressants were tried. Medicaid coverage varies by state.
Most people care deeply about this. When our respondents chose their two top priorities for a provider, 85 percent included insurance coverage. A helpful job for a partner is gathering the medication history: each drug, the dose, how long, and what happened. That list speeds up approvals.
Should I be the one to suggest it?
You can mention it. Just keep expectations realistic about your influence. In our survey, a friend or family member's recommendation would move 18 percent of people to try a new treatment, while their own doctor's would move 74 percent. Spouses and other relatives of veterans and first responders, as a group of 156, gave the doctor 73 percent. Your best move is helping your partner carry the question to their doctor.
What if my partner says no to everything?
Then the conversation is not over, it is paused. Keep the relationship warm and the offer standing. You might say, "Okay. If you ever want to look into something that isn't medication, I'll help." People often come back to an idea once it has been named and left without pressure.
How do I take care of myself through this?
Your well-being matters too, and it affects your ability to help. Family education and support groups exist in many communities, including free programs run by mental health nonprofits. Talking with your own doctor or a counselor is also reasonable.
Is any of this medical advice?
No. This FAQ offers general information for families. Only a clinician who knows your partner's history can judge what is suitable for them.
When your partner talks of wanting to die, or you sense they could act on suicidal thoughts, contact 988 by call or text right away. The Suicide and Crisis Lifeline costs nothing, keeps things confidential, runs at every hour, and serves worried partners as well as people in crisis.
Methodology
Pollfish hosted the underlying survey on its consumer panel, gathering 443 completed responses by the June 23, 2026 close, from adults 18 to 64 in Oklahoma, Minnesota, Nebraska, Missouri, Ohio, Kansas, Illinois, Wisconsin, Iowa, and Indiana. Pollfish finished validating these figures before publication. The survey was commissioned by this site's publisher, which also paid for it.