Start here — the one picture that holds it all together
Daily pills work on the whole body and the whole brain, all day, every day. TMS works on one targeted spot in the brain, in a clinic, with no drug running through the rest of the body. Spravato works on a completely different brain system than standard antidepressants, works fast, and must be given in a clinic with two hours of watching afterwards. None of them erases trauma, and none replaces trauma therapy for PTSD. They do different jobs, carry different burdens, and for many people the strongest plan uses more than one of them together, on purpose, with a clear reason for each piece.
The pages in this library
TMS
How magnetic pulses exercise an underactive depression circuit. Session by session, machine by machine, with side effects and safety screening in full.
Read about TMSSpravato
Esketamine nasal spray for treatment-resistant depression: the treatment day, the 2-hour watch, the ride home rule, and what the FDA approvals actually say.
Read about SpravatoMeds & Weaning
Can you use TMS or Spravato with no other medicines? If you are on medicines now, do you stop them? The direct answer, and how a safe taper works later.
Read Meds & WeaningCompare Treatments
TMS vs. Spravato vs. daily oral medicines vs. therapy vs. ECT — side by side — plus every main family of psychiatric medicine, with pros and cons.
Compare treatmentsConditions
Depression and treatment-resistant depression in depth, plus PTSD, anxiety, and cigarette smoking — what truly treats each one, and where TMS and Spravato do and do not fit.
Read about conditionsCandidate & Cost
Am I a candidate? What counts as a “failed” medicine trial, what a consult involves, insurance rules, questions to ask, and a worksheet to bring.
Check candidacy & costHistory & Evidence
Who invented these treatments, the research papers behind them, and the FDA timelines — told plainly, including the trial that missed its endpoint.
Read the historyBrain & Trauma
Your brain, neuroscience, neuropsychoanalysis, and trauma — CAMHP's model of care. Why trauma lives in circuits, in the body, and in a human story, all at once.
Read Brain & TraumaVideos & FAQ
Six trusted videos to watch, the research dossiers to download, and answers to the questions patients ask most often.
Watch & read FAQWhat is happening in the brain, in brief
Depression — the dimmer switch turned down
In major depression, the front of the brain that handles planning, motivation, and holding mood steady — the prefrontal cortex, especially the dorsolateral prefrontal cortex (DLPFC) — runs underactive. The starter motor for getting up, caring, concentrating, and feeling pleasure is underpowered. Antidepressants try to raise the volume by changing chemical messengers everywhere at once. TMS tries to raise it by exercising that one spot, directly, over and over. Read the fuller brain picture on Brain & Trauma.
PTSD — the alarm that never got the all-clear
The threat system learned, during overwhelming danger, to react at full force — and never learned the danger ended. The smoke detector (amygdala) fires too fast, the brakes (prefrontal cortex) arrive late, and the filing system (hippocampus) stored the memory as if it is still happening now. That is why a sound or smell can flood the body in under a second.
Anxiety and smoking
In anxiety, the same alarm is pointed at the future. In smoking, nicotine trains the reward loop so cues — coffee, driving, a meal, stress — fire craving on their own. Each condition page names which treatments carry real evidence for that condition.
Honest limits, stated up front
- TMS devices are FDA-cleared, not FDA-approved — the wording matters, and this library uses it correctly.
- Standard TMS machines are not cleared for PTSD, generalized anxiety on its own, or smoking. Two narrow exceptions exist and are named on the TMS page: BrainsWay H4 for smoking, and Wave MeRT — that system only — as an adjunct for PTSD.
- Spravato is not approved for PTSD, anxiety on its own, or smoking, has not been shown to prevent suicide, and does not replace hospital care when hospital care is needed.
- No treatment here is a cure, a guarantee, or a promise of coverage. Every page says what is known, what is hoped, and what is not known.