If you’re struggling with both depression and anxiety, you know how they feed off each other—creating a cycle that’s hard to break. The racing thoughts, the physical tension, the constant worry layered on top of persistent sadness and hopelessness. Traditional treatments often address one condition while leaving the other unresolved, or they work for a while before symptoms return.
TMS therapy offers a different approach. At WHOA Wellness, we provide Brainsway Deep TMS treatment that’s specifically FDA-cleared to reduce anxiety symptoms in adults with major depressive disorder—treating both conditions simultaneously with a single, non-invasive therapy.
Anxiety and depression frequently occur together. In fact, 60-90% of people with major depressive disorder also experience moderate to severe anxiety symptoms—a condition commonly referred to as anxious depression or comorbid anxiety.
These anxiety symptoms aren’t just “feeling worried.” They manifest as:
When anxiety accompanies depression, both conditions become more severe and harder to treat. The anxiety amplifies the sense of hopelessness. The depression robs you of the energy needed to cope with anxious thoughts. Medications prescribed for one condition might worsen the other, or leave you feeling emotionally numb.
This isn’t two separate problems requiring two separate treatments. Anxious depression is a specific clinical presentation with overlapping brain circuitry—and that’s exactly what TMS is designed to address.
The brain regions involved in mood regulation overlap significantly with those involved in anxiety processing. When someone has major depressive disorder, certain areas of the prefrontal cortex become underactive, disrupting both emotional regulation and the brain’s ability to modulate anxious responses.
TMS targets these neural circuits directly. By stimulating the prefrontal cortex with focused magnetic pulses, Brainsway Deep TMS helps restore normal activity in the brain structures responsible for managing both depressive and anxious symptoms.
Here’s what happens at the neural level:
The prefrontal cortex acts as a control center for emotional responses. When it’s functioning properly, it helps regulate the amygdala—the brain’s fear and threat-detection system. In anxious depression, this regulatory connection weakens. The amygdala becomes overactive, constantly signaling danger, while the prefrontal cortex lacks the resources to calm it down.
TMS strengthens the prefrontal cortex’s ability to exert control over these threat responses. As treatment progresses, the brain becomes better at distinguishing real threats from perceived ones. The constant state of alarm begins to quiet. The racing thoughts slow down. Physical anxiety symptoms—the rapid heartbeat, the shallow breathing, the tension—start to ease.
This isn’t about suppressing anxiety or numbing yourself to it. It’s about restoring your brain’s natural capacity to regulate its own stress response systems.
The clinical evidence supports this approach. In 2021, Brainsway Deep TMS received FDA clearance specifically for reducing anxiety symptoms in patients with major depressive disorder. The clearance was based on data from 573 patients across 11 studies, which demonstrated consistent, robust, and clinically meaningful reductions in anxiety symptoms.
Importantly, the data showed that Deep TMS performed favorably when compared to both sham treatment and standard anxiety medications. The effect sizes—a statistical measure of treatment impact—ranged from 0.34 when compared to sham treatment to 0.90 when compared to medication, with an overall weighted effect size of 0.55. For context, published studies of drug-based anxiety treatments typically show effect sizes ranging from 0.2 to 0.37.
What this means in practical terms: TMS therapy can reduce anxiety symptoms more effectively than many standard medications, without the side effects that often accompany anti-anxiety drugs.
It’s crucial to understand that TMS for anxiety is not a standalone anxiety disorder treatment. The FDA clearance is specifically for reducing anxiety symptoms in adults who have major depressive disorder with comorbid anxiety.
You may be a candidate if:
You have a diagnosis of major depressive disorder (MDD)
You experience moderate to severe anxiety symptoms alongside your depression
You’ve tried at least one antidepressant medication without adequate relief
Anti-anxiety medications like benzodiazepines haven’t provided lasting relief or have caused problematic side effects
You’re looking to avoid or reduce reliance on medications that cause drowsiness, dependency, or cognitive impairment
Your anxiety symptoms are interfering with daily functioning—work, relationships, sleep, or basic self-care
You want a treatment that addresses both your depression and anxiety simultaneously
TMS may not be appropriate if:
The key eligibility factor is the presence of major depressive disorder. During your consultation at WHOA Wellness, we’ll conduct a comprehensive assessment to determine whether your anxiety symptoms occur in the context of depression and whether TMS is likely to be effective for your specific presentation.
Anxiety reduction through TMS doesn’t happen overnight, but patients often describe the changes as profound and lasting—fundamentally different from the temporary relief offered by benzodiazepines or the emotional blunting sometimes caused by SSRIs.
Early treatment (Weeks 1-2):
Physical symptoms often begin to ease before emotional ones. You might notice your resting heart rate decreasing, your breathing becoming deeper and more natural, or tension in your shoulders and jaw starting to release. Sleep may begin to improve as your nervous system becomes less hyperaroused at night.
Mid-treatment (Weeks 3-4):
The mental component of anxiety starts to shift. Rumination becomes less persistent—thoughts still arise, but they don’t loop endlessly. You may find yourself able to redirect your attention more easily. The constant sense of impending doom begins to lift. You might realize you’ve gone hours without that knot in your stomach.
Later treatment (Weeks 5-6):
Emotional resilience returns. Stressors that would have sent you spiraling now feel manageable. You can tolerate uncertainty without catastrophizing. Social situations that triggered intense anxiety become easier to navigate. The hypervigilance that kept you scanning for threats begins to fade.
After treatment completion:
Many patients report that the quality of their anxiety relief feels different from what medications provided. Instead of feeling sedated or emotionally distant, they describe feeling like themselves again—able to experience the full range of emotions without being hijacked by anxiety. They can feel appropriate concern without it escalating into panic. They can rest without needing medication to force their nervous system to calm down.
What patients often notice:
It’s important to note that TMS doesn’t eliminate all anxiety—some level of anxiety is normal and even protective. The goal is to restore your brain’s ability to regulate anxiety responses appropriately, so you experience anxiety only when there’s a genuine reason for it, and it dissipates naturally once the situation resolves.
TMS works best as part of a holistic approach to mental health.
Therapy integration: As anxiety and depression lift, therapy becomes more productive. Cognitive-behavioral therapy (CBT) for anxiety is particularly effective once your brain has the capacity to learn and implement new coping strategies. TMS creates the neurological foundation; therapy helps you build skills on that foundation.
Medication considerations: Some patients continue anti-anxiety or antidepressant medications during TMS treatment, then work with their prescriber to taper as symptoms improve. Others find they can finally discontinue medications that weren’t working or were causing intolerable side effects. These decisions should always be made collaboratively with your psychiatric provider.
Lifestyle factors: As your nervous system becomes less dysregulated, healthy lifestyle practices become easier to implement and more effective. Regular exercise, mindfulness practices, adequate sleep, and stress management techniques all support the changes TMS initiates.
Ongoing support: At WHOA Wellness, we coordinate with your existing mental health providers to ensure comprehensive care. We can also connect you with our therapy services to support your long-term wellness.
If you’re trapped in the exhausting cycle of depression and anxiety—where each condition makes the other worse—TMS offers a path forward that addresses both simultaneously.
You don’t have to keep taking medications that provide only partial relief or come with side effects you can’t tolerate. You don’t have to choose between treating your depression and treating your anxiety.
The first step is a consultation. During this appointment, we’ll:
Conditions Treated
6010 W Broad St #103, Richmond, VA 23230