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Innovative Treatment Options in Mental Health

The Montana VA Health Care System (MTVAHCS) is pleased to offer innovative treatment options for mental health care, for Veterans diagnosed with Major Depressive Disorder (MDD) who have not improved with traditional measures including psychotherapy and medication management. This means that if you have tried at least two medications for depression that have not been effective, there are other options you can explore with your mental health provider.

What is Major Depressive Disorder (MDD)?

MDD is a disabling mental health condition characterized by feelings of sadness or despair, loss of interest in activities, changes in appetite, sleep and energy, and feelings of guilt or worthlessness. MDD can lead to trouble functioning at work or at home, and can contribute to suicidal thoughts. MDD is one of the most common conditions treated in Outpatient Mental Health, and unfortunately, some Veterans do not improve adequately with standard treatments (medications and psychotherapy). MDD that does not resolve with standard treatment is called treatment resistant MDD (trMDD).

Advanced Treatment Options for treatment resistant MDD (trMDD) Include:

  • Transcranial Magnetic Stimulation (TMS)
  • Electroconvulsive therapy (ECT)
  • Ketamine or Esketamine therapy


MTVAHCS is proud to provide innovative and evidenced-based treatment options for mental health. Within MTVAHCS, we strive to ensure all Veterans can access this life-saving treatment, similar to what would be provided in an academic center.

Our TMS Program is rapidly expanding to provide access to this highly-effective treatment for MDD, for Veterans living throughout Montana.

This will include:

  • TMS treatment locations in Billings, Kalispell
  • Potential future treatment location in Helena
  • A mobile-medical unit. This unit will house a TMS device and can be deployed to the location of the Veteran, throughout the state and to rural areas.

What is TMS?

TMS therapy is an alternative treatment option for patients living with Major Depressive disorder (MDD). TMS uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is safe, non-invasive and effective. TMS has been approved by the FDA since 2008 to treat depression.

How does TMS work?

During a TMS treatment session, an electromagnetic coil is placed against the scalp. The electromagnet delivers a magnetic pulse that stimulates nerve cells in a region of the brain that is involved in controlling mood. For depression we stimulate the “dorsolateral prefrontal cortex”, one of the major control centers in the brain. Stimulation of this region is thought to enhance the brain’s ability to control of various symptoms of depression.

Clinical outcomes

TMS has been shown in large, controlled studies to be consistently effective in treating treatment-resistant depression. This means it often works for patients who have not previously responded to antidepressant medications. The following results were obtained from treating more than 800 Veterans with treatment-resistant depression with TMS at outpatient VA clinics across the country.

Response Rate bar graph. Non-Response: 35.2 percent. Responders: 42.3 percent. Remission: 22.5 percent. Responders equal to or greater than 50 percent reduction in symptom levels.

Source: VA National Clinical rTMS Program, VA Palo Alto Precision Neuromodulation Clinic

What Veterans are saying about their treatment experience at Montana VA

“I have not felt this good in many years.”

“I felt like I was coming out of a coma and waking up again.”

“It felt like each session another layer of dirt (depression) was being lifted off of me.”

Call: Montana VA Health Care System TMS program