The MEND Trial is a research study testing whether combining FDA-approved Transcranial Magnetic Stimulation (TMS) with mindfulness exercises can help people with Treatment-Resistant Depression (TRD). In this phase of the study, participants will be randomly assigned to one of two active treatment groups. Participation involves both online and in-person visits over several weeks.

You may be eligible for this study if you meet the following criteria.

Inclusion Criteria:

• Ages 18–65
• Currently experiencing moderate to severe depression
• Have tried antidepressant medications in the past without success or were unable to tolerate them
• If currently taking antidepressant medication, have been on a stable dose for at least 4 weeks
• Able to participate in up to 24 study visits, including 20 TMS treatment sessions at UC San Diego

Exclusion Criteria:

• History of bipolar disorder or psychosis
• History of a neurological or seizure disorder
• Currently pregnant
• Active suicidal behaviors
• Unable to undergo an MRI (for example, due to non-removable metal in the body or severe claustrophobia)

Overall Duration

This study lasts about 8–12 weeks, including a 4–7 week treatment period and a follow-up visit about 4 weeks after treatment ends.

In-Lab and Virtual Activities

Participants may complete up to 25 study visits, including 20 TMS treatment sessions at UC San Diego.

• Virtual Screening (about 2 hours): Review the study, complete questionnaires, and meet with the research team to determine eligibility.
• Pre-Treatment Visits: Complete an MRI, questionnaires, cognitive tests, an EEG, and a TMS setup procedure.
• Treatment (20 visits over 4–7 weeks): Receive a 3–4 minute TMS treatment followed by up to 20 minutes of digital mindfulness training. Participants will also complete brief weekly symptom questionnaires.
• Post-Treatment & Follow-Up: Complete a final in-person assessment and one virtual follow-up visit about 4 weeks later.

Data Collection

Researchers will collect information from interviews, questionnaires, MRI scans, EEG recordings, cognitive tests, and TMS treatment sessions. All study information will be kept private and securely stored.

Participants who complete the study will receive a $300 Amazon gift card for their time. While transportation is not provided, mileage reimbursement may be available for some participants with longer commutes.

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

• “I consider this experience to have been beneficially life-changing and am looking forward to pursuing getting my right dorsal prefrontal cortex done as well.”
• “I’m glad I got to participate in the study, and during it I did notice a difference in my mood.”
• “I greatly see a big difference in my mood. I went from crying daily to being hopeful. I wish I could do it again.”
• “My experience with the MEND Study was mixed. I experienced some short-term improvement in my depression, but it did not become a lasting or functionally meaningful recovery… Even though the results did not last, the experience gave me hope that I am not beyond repair.”