In this research study, we want to learn more about the effects that the combination of repetitive transcranial magnetic stimulation (TMS) and psychotherapy have on brain function for adults diagnosed with depression who are resistant to standard treatments.

You may qualify for a study if you meet the following criteria.

Inclusion Criteria:

• Ages 18-75

• Diagnosed with depression

• Resistant to standard treatments (treatment resistant depression)

• Willing to commute to the study site in Bethesda, M-F daily for 6 weeks, or stay as an inpatient for at least 6 weeks

• No epilepsy or seizures (self or family history)

• No loss of consciousness for more than 5 minutes

• No uncontrolled sleep apnea

• No metal implants in the body, no permanent metal retainers

• No prior TMS exposure

Participants can expect this study to consist of daily visits for 6 weeks, followed by monthly visits for 3 months.

After the initial screening, there are 3 phases:

• Phase 1: Consent and baseline assessments
• Phase 2: 6 weeks of repetitive transcranial magnetic stimulation (TMS) and psychotherapy, lasting approximately one hour Monday-Friday 
• Phase 3: Clinical ratings held over the phone once a month for 3 months

If a participant does not respond to care, we offer optional standard of care for up to 3 months at the end of phase 2.

Participants may receive up to $1,700 in compensation.

There is no cost for you to participate in our research study.