Do I Qualify for TMS or Spravato? How to Know if You’re Eligible for Advanced Depression Treatment

If you’ve been struggling with depression and traditional treatments haven’t helped, you’re not alone—and you’re not out of options. Today, many people are finding relief through advanced depression treatment options like Transcranial Magnetic Stimulation (TMS) and Spravato (esketamine nasal spray). But how do you know if you're a candidate for these therapies?

At Goodwin Health Café, we believe in making mental health care accessible, understandable, and stigma-free. In this guide, we’ll walk you through common eligibility criteria for both TMS and Spravato, what each treatment involves, and how to start a conversation with your provider about next steps.

What Is Advanced Depression Treatment?

“Advanced depression treatment” refers to nontraditional, evidence-based therapies for individuals who haven’t responded to first-line treatments like SSRIs, talk therapy, or lifestyle changes.

These include options like:

• TMS (Transcranial Magnetic Stimulation): A non-invasive, FDA-cleared treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation.

• Spravato (Esketamine): A nasal spray derived from ketamine that is administered under supervision in a clinic setting to help treat treatment-resistant depression.

Both treatments offer real hope for people who’ve tried multiple antidepressants without success.

You Might Be a Candidate If...

While only a medical professional can formally assess your eligibility, here are some common indicators that you may qualify for either TMS or Spravato:

1. You’ve Been Diagnosed with Major Depressive Disorder (MDD)

Both TMS and Spravato are FDA-cleared for adults with treatment-resistant MDD. If you’ve been living with MDD for some time and your symptoms are interfering with daily life, this is the first sign that advanced care might be appropriate.

2. You Haven’t Responded to Antidepressants

Most insurance providers require documentation that you’ve tried at least two different antidepressant medications—at an adequate dose and duration—without significant improvement. This is often referred to as “treatment resistance.”

3. You’ve Tried Talk Therapy Without Long-Term Relief

While therapy is an essential part of mental health care, many people still experience severe or persistent symptoms even with consistent therapeutic support. If this sounds familiar, it may be time to explore other options.

4. You’re Not Currently Pregnant or Nursing

Spravato is not currently recommended for individuals who are pregnant or breastfeeding. TMS, however, may be considered during pregnancy depending on the provider's judgment and the patient’s medical history.

5. You’re Willing and Able to Commit to a Structured Treatment Schedule

TMS typically requires daily sessions (Monday through Friday) for 6–8 weeks. Spravato requires twice-weekly treatments initially, tapering down over time. While both options require a time investment, they offer structured and supervised paths to healing.

Who Shouldn’t Receive TMS or Spravato?

While these treatments are generally safe, they’re not right for everyone. You may not be a candidate if:

• You have a history of seizures or certain neurological conditions (TMS).

• You have uncontrolled high blood pressure or certain cardiovascular risks (Spravato).

• You have active substance use disorders not currently being treated.

• You have a metal implant in your head or neck area (TMS contraindication).

• You have untreated psychosis or bipolar mania.

Your provider will complete a full medical history and screening to assess these and other risk factors.

What About Insurance Coverage?

Here’s the good news: most commercial insurance plans and Medicare now cover both TMS and Spravato, provided eligibility criteria are met.

This usually includes:

• A documented history of MDD

• Evidence of failed trials with two or more antidepressants

• A psychiatric evaluation and treatment plan

We help walk you through the approval and preauthorization process, making it as seamless as possible.

Next Steps: How to Get Evaluated

If you’re wondering whether you’re a fit for advanced depression treatment, we encourage you to reach out for a no-pressure consultation.

At Goodwin Health Café, our team will:

• Conduct a thorough evaluation of your symptoms and medical history

• Explain the pros and cons of each treatment option

• Help coordinate insurance paperwork

• Work with you to build a personalized care plan that fits your lifestyle

Mental health care isn’t one-size-fits-all—and your journey doesn’t stop just because the first treatment didn’t work. You deserve care that evolves with you.

You’re Not Broken. You Just Need a New Approach.

If you’ve been carrying the weight of depression with no end in sight, TMS or Spravato might be the next right step. These therapies aren’t experimental—they’re proven, FDA-cleared, and already changing lives.

Let’s find out if they’re right for you.

Interested in learning more about advanced depression treatment? Contact Goodwin Health Café to schedule a consultation or call us at (509) 415-3507. Relief may be closer than you think.