From our survey

Most adults want a drug-free option, and few know TMS exists

Near the end of our survey sat a question we almost cut for length. It checked two things at once: had people heard of TMS, and would a depression treatment free of medication matter to them? The answers turned out to be among the most telling in the whole study.

Most people said a drug-free option would matter. Most people had no idea one already exists.

The numbers behind the gap

Our sample was 443 Midwest adults answering on their phones through a consumer panel, not a patient list, and the results are final. Respondents sorted themselves into four groups:

• Never heard of TMS, and a drug-free option matters: 51 percent
• Never heard of TMS, and drug-free is not a big deal: 25 percent
• Familiar with TMS, and drug-free matters a lot: 13 percent
• Familiar with TMS, but it would not change much: 12 percent

Add up those rows and two headline figures appear in what respondents told us. Sixty-four percent place real value on a treatment that involves no drug, while just 25 percent can say what TMS is. The biggest single group was half the sample: people who want what TMS offers and have never once heard its name.

What TMS actually is

The letters stand for transcranial magnetic stimulation. A clinician rests a magnetic coil on the scalp, and brief pulses travel into a region that governs mood. Nobody is sedated and nothing is swallowed or injected, and most patients drive themselves home and carry on with the day.

The FDA has cleared these devices to treat major depression when antidepressants have failed an adult patient. "Cleared" names the route devices take, separate from how medicines win approval, though it is still a regulatory review. TMS is mainstream care, not an experiment.

The real cost is time. A usual course asks for nearly daily weekday visits over several weeks. Scalp soreness and headache are the side effects people mention most. Seizures are rare, so clinics ask about seizure history and metal near the head before starting. Whether it fits any one person is a clinical call.

Why so few people have heard of it

Our survey was not built to explain this gap, but it offers clues.

First, people search by need, not by name. Our open-ended search question drew 319 written answers from respondents, with phrases such as "ptsd treatments" and "best ways to handle depression." Nobody typed the name of a technology. Someone searching "depression medicine alternatives" is, in effect, hunting for TMS without the vocabulary, and whether they find it depends on what the results page shows.

Second, people expect to hear about options from a doctor. Asked whose advice would most likely get them to try a new depression treatment, 74 percent of respondents picked their own physician. If TMS rarely surfaces in a primary care visit, most people never learn of it.

Third, awareness of newer treatments is low across the board. Spravato, an esketamine nasal spray with FDA approval for treatment-resistant depression, drew a blank from 73 percent of respondents when we asked about it. The two treatments work nothing alike, yet they share a problem: they exist, and most people do not know it.

This is not a small audience

A related finding explains the appetite. In our survey, 72 percent of respondents reported that ordinary medication had failed them or someone close with depression, anxiety, or PTSD, and half said that person was themselves. After a pill has failed, wondering about something other than another pill is a natural response.

What drug-free does and does not mean

Wanting to avoid medication is a preference, not a treatment plan. TMS is one drug-free route; psychotherapy is another, and it often works best combined with other care. ECT is sometimes grouped with brain stimulation, but because it requires general anesthesia it is not drug-free in the everyday sense.

Some people do best on medication, and a drug-free preference is never a reason to quit a prescription without talking to whoever wrote it. Stopping antidepressants abruptly can cause real harm.

Most of our survey concerned ketamine and esketamine, and both are medicines. Esketamine is a medicine, administered in a certified office while staff observe, so it is not drug-free. For a sense of how that supervised treatment works, you can read Brain Recovery Centers' walkthrough of a Spravato session.

If you are the one struggling

If a drug-free option matters to you, say so plainly at your next visit. Try: "Are there treatments that skip another medication? Could TMS be one of them?" You do not need to understand the device to ask.

Then get practical. Where is the closest clinic that offers it? Will your insurance pay, and what does the plan want first? Many plans ask for proof of earlier medication trials, so keep your records handy.

Coverage will likely shape the choice. Our respondents made coverage a top two concern at a rate of 85 percent and closeness to home at 43 percent, and a treatment with that many visits raises both concerns.

The larger lesson

When a clear majority wants something and only about a quarter know it exists, the problem is communication, not demand. People are not turning options down. Nobody is telling them.

If you are in a dark place right now, please do not hold out for the perfect treatment before reaching out. Dial or text 988 from anywhere in the United States, whatever the hour, and a real person responds.

Methodology

We commissioned this study and paid for it. Fieldwork by Pollfish wrapped up on June 23, 2026, after 443 people completed the questionnaire. Each participant consented at a screener, was 18 to 64 years old, and resided in a ten-state Midwest area that includes Minnesota and Missouri. Figures are final, after validation.