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TMS THERAPY SUPPORTS MENTAL WELLNESS
- Depression
- Lack of Joy
- Sadness and Despair
- Low Mood
- Lethargy
- Insomnia
- Oversleeping
- Social Isolation
- Self-Harm
- Substance Abuse
- Suicidal Ideation
- Alcoholism
Sleep and Mental Health: Why Sleep Care Is Foundational Sleep is essential for emotional regulation, cognitive function, and neuroplasticity. Disrupted sleep, especially insomnia, is not just a symptom but a risk factor and potential driver for mood and anxiety disorders, including depression. Insomnia can impair brain plasticity, over-activate the stress system (including cortisol dysregulation), and promote neuroinflammation, all of which contribute to psychiatric symptoms and vulnerability to mental illness. 1 2 3 4 Chronic insomnia is associated with increased risk of new-onset depression and can worsen the course of existing psychiatric conditions. 5 6 7 4 Treating Insomnia Improves Mental Health Improving sleep quality leads to measurable improvements in mental health. Meta-analyses and randomized controlled trials show that interventions targeting sleep — especially cognitive behavioral therapy for insomnia (CBT-I) — not only improve sleep but also reduce symptoms of depression, anxiety, and stress, and enhance overall psychological well-being. 8 9 10 11 There is a dose-response relationship: greater improvements in sleep yield greater improvements in mental health. 9 Treating insomnia can also prevent the onset of depression and improve outcomes in those with comorbid mood disorders. 6 11 Sleep, Hormones, and Mood Sleep physiology is tightly linked to hormone regulation. Sleep loss and insomnia can disrupt the hypothalamic-pituitary-adrenal (HPA) axis, leading to abnormal cortisol rhythms, and may affect reproductive hormones such as progesterone, which in turn can influence mood and sleep quality. 12 Evaluating and addressing hormonal imbalances can be an important part of a comprehensive sleep and mental health assessment. What a Thorough Sleep Consultation Covers A thorough sleep consultation — including review of sleep habits, medication effects, and hormone status — can identify modifiable contributors to insomnia and psychiatric symptoms. Medication review is crucial, as many drugs can worsen sleep or interact with mood. Addressing sleep hygiene, optimizing medications, and evaluating hormone levels (such as cortisol and progesterone) can all support better sleep and, by extension, better mental health. 12 7 Bottom Line Prioritizing sleep health is a powerful, evidence-based strategy for healing the mind and preventing psychiatric illness. Comprehensive sleep consultations, hormone evaluation, and medication review are key services that can help patients achieve restorative sleep and improved mood. 1 5 2 12 6 9 7 10 3 11 4 At Unchained Wellness, we take an integrative approach to restoring balance — addressing the underlying hormonal, nutritional, and psychological factors that influence sleep and emotional well-being. Schedule a consultation today to begin your personalized path toward deeper rest, improved focus, and renewed vitality.  References Sleep, Insomnia and Mental Health — Palagini L, Hertenstein E, Riemann D, Nissen C. Journal of Sleep Research. 2022;31(4):e13628. https://doi.org/10.1111/jsr.13628 The Key Role of Insomnia and Sleep Loss in the Dysregulation of Multiple Systems Involved in Mood Disorders — Palagini L, Bastien CH, Marazziti D, Ellis JG, Riemann D. Journal of Sleep Research. 2019;28(6):e12841. https://doi.org/10.1111/jsr.12841 Sleep Markers in Psychiatry: Do Insomnia and Disturbed Sleep Play as Markers of Disrupted Neuroplasticity in Mood Disorders? — Palagini L, Geoffroy PA, Riemann D. Current Medicinal Chemistry. 2022;29(35):5595-5605. https://doi.org/10.2174/0929867328666211214164907 Sleep, Insomnia, and Depression — Riemann D, Krone LB, Wulff K, Nissen C. Neuropsychopharmacology. 2020;45(1):74-89. https://doi.org/10.1038/s41386-019-0411-y Insomnia Disorder: State of the Science and Challenges for the Future — Riemann D, Benz F, Dressle RJ, et al. Journal of Sleep Research. 2022;31(4):e13604. https://doi.org/10.1111/jsr.13604 Recent Advances in Sleep and Depression — Mirchandaney R, Asarnow LD, Kaplan KA. Current Opinion in Psychiatry. 2023;36(1):34-40. https://doi.org/10.1097/YCO.0000000000000837 Insomnia Disorder — Winkelman JW. New England Journal of Medicine. 2015;373(15):1437-1444. https://doi.org/10.1056/NEJMcp1412740 Emotional Processing Following Digital CBT-I in People With Depressive Symptoms: RCT — Tamm S, Tse KYK, Hellier J, et al. JAMA Network Open. 2025;8(2):e2461502. https://doi.org/10.1001/jamanetworkopen.2024.61502 Improving Sleep Quality Leads to Better Mental Health: Meta-analysis of RCTs — Scott AJ, Webb TL, Martyn-St James M, Rowse G, Weich S. Sleep Medicine Reviews. 2021;60:101556. https://doi.org/10.1016/j.smrv.2021.101556 Effect of Digital CBT-I on Health and Well-being: RCT — Espie CA, Emsley R, Kyle SD, et al. JAMA Psychiatry. 2019;76(1):21-30. https://doi.org/10.1001/jamapsychiatry.2018.2745 Sleep Disturbance and Psychiatric Disorders — Freeman D, Sheaves B, Waite F, Harvey AG, Harrison PJ. The Lancet Psychiatry. 2020;7(7):628-637. https://doi.org/10.1016/S2215-0366(20)30136-X Sleep Physiology, Pathophysiology, and Sleep Hygiene — Baranwal N, Yu PK, Siegel NS. Progress in Cardiovascular Diseases. 2023;77:59-69. https://doi.org/10.1016/j.pcad.2023.02.005
Why Antidepressants Aren’t Always Enough — The Rise of Integrative Psychiatry Many patients with major depressive disorder and fatigue do not achieve remission with standard antidepressant therapy alone. Integrative psychiatry combines medication, hormone therapy, nutrition, intravenous therapies, IV supplementation, red light therapy, Spravato (esketamine), and transcranial magnetic stimulation (TMS) to address these unmet needs. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Medication and Hormone Therapy Conventional antidepressants remain foundational, but many patients require additional strategies. Hormonal interventions targeting the HPA, HPT, and HPG axes—including estrogen, progesterone derivatives, and testosterone—may benefit select individuals, especially when endocrine dysfunction is present. 1 6 10 11 Nutrition and IV Supplementation Nutritional optimization and IV therapies, such as ketamine, can be considered for documented deficiencies or as adjuncts in treatment-resistant cases. IV ketamine has demonstrated rapid antidepressant effects, while micronutrient supplementation remains investigational. 7 8 12 Red Light Therapy (Photobiomodulation) Transcranial and systemic photobiomodulation using red or near-infrared light is a non-invasive neuromodulation technique with emerging evidence for efficacy in moderate-grade depression. Optimal protocols are still being defined, but the therapy is well tolerated. 2 3 4 5 9 13 Spravato (Esketamine) Spravato is an FDA-approved intranasal formulation of esketamine indicated for adults with treatment-resistant depression and for depressive symptoms with acute suicidal ideation or behavior, always in conjunction with an oral antidepressant. 14 19 21 27 Clinical trials show rapid symptom improvement, often within hours, and a favorable sexual side effect profile compared to SSRIs/SNRIs. 19 21 Dosing for TRD typically starts at 56 mg or 84 mg twice weekly for 4 weeks, then transitions to weekly or biweekly maintenance. 21 Administration requires in-clinic monitoring due to transient dissociative symptoms and blood pressure changes. Transcranial Magnetic Stimulation (TMS) TMS is a non-invasive brain stimulation technique approved for treatment-resistant depression. High-frequency repetitive TMS to the dorsolateral prefrontal cortex yields response rates of 25–37% and remission rates of 17–30% in TRD, with a number needed to treat of 6–8. 24 25 28 29 TMS is well tolerated, with minimal adverse effects, and can be considered early in the course of treatment-resistant depression. 15 22 23 24 25 26 28 29 Recent consensus guidelines endorse TMS as a safe and effective option, with newer protocols offering faster and potentially more robust results. 25 Summary Integrative psychiatry leverages a multidisciplinary toolkit—including medication, hormone therapy, nutrition, IV therapies, red light therapy, Spravato, and TMS—to optimize outcomes for patients with treatment-resistant depression and fatigue. This approach is supported by clinical guidelines and recent evidence, and offers a personalized, holistic framework for care. 15 24 25 27 28 29 If you’ve struggled to find full relief from antidepressants or feel persistently fatigued despite treatment, schedule a consultation with Unchained Wellness to explore a personalized, integrative care plan. Together, we can identify underlying contributors and design a treatment approach that restores balance—mind, body, and spirit.  References Hormonal Treatments for Major Depressive Disorder: State of the Art — Dwyer JB, Aftab A, Radhakrishnan R, et al. American Journal of Psychiatry. 2020;177(8):686-705. Photobiomodulation: Shining a Light on Depression — Wang L et al. Theranostics. 2025;15(2):362-383. Transcranial and Systemic Photobiomodulation for Major Depressive Disorder: A Systematic Review — Caldieraro MA, Cassano P. Journal of Affective Disorders. 2019;243:262-273. Photobiomodulation for Major Depressive Disorder — Vieira WF et al. Harvard Review of Psychiatry. 2023;31(3):124-141. Photobiomodulation Therapy in Mood Disorders — Montazeri K et al. Lasers in Medical Science. 2022;37(9):3343-3351. Translational Interdisciplinary Research on hCG’s Enhancement of Neuroendocrine Crosstalk — Gaspary JFP et al. Frontiers in Psychiatry. 2025;16:1537442. Comparative Efficacy of Ketamine, Esketamine, Aripiprazole, and Lithium in TRD — Terao I et al. Journal of Affective Disorders. 2024;346:49-56. Double-Blind, Placebo-Controlled, Dose-Ranging Trial of IV Ketamine — Fava M et al. Molecular Psychiatry. 2020;25(7):1592-1603. Photobiomodulation Improves Depression Symptoms — Ji Q et al. Frontiers in Psychiatry. 2023;14:1267415. Low-Dose Testosterone Augmentation for Antidepressant-Resistant Depression in Women — Dichtel LE et al. American Journal of Psychiatry. 2020;177(10):965-973. Promoting Good Mental Health Over the Menopause Transition — Brown L et al. The Lancet. 2024;403(10430):969-983. Effectiveness of Repeated IV Ketamine — McIntyre RS et al. Journal of Affective Disorders. 2020;274:903-910. Photobiomodulation: An Emerging Treatment Modality for Depression — Vieira WF et al. Psychiatric Clinics of North America. 2023;46(2):331-348. FDA Orange Book — U.S. Food and Drug Administration. Management of Major Depression: Guidelines From the VA/DoD — AAFP 2023. TMS and Ketamine: Implications for Combined Treatment — DÄ™bowska W et al. Frontiers in Neuroscience. 2023;17:1267647. Treatment-Resistant Depression in Older Adults — Steffens DC. New England Journal of Medicine. 2024;390(7):630-639. Comparing Efficacy of Ketamine and TMS for TRD — Mikellides G et al. Frontiers in Psychiatry. 2021;12:784830. Spravato for Treatment-Resistant Depression: Efficacy and Sexual Side Effect Profile — Raza AA et al. Neuropsychiatric Disease and Treatment. 2025;21:2125-2140. Therapeutic Strategies for TRD — Goh KK et al. Current Pharmaceutical Design. 2020;26(2):244-252. Spravato Label Information — FDA. Updated Aug 2025. Comparative Effectiveness Research Trial (ASCERTAIN-TRD) — Papakostas GI et al. Molecular Psychiatry. 2024;29(8):2287-2295. Recent Innovations in Non-Invasive Brain Stimulation — Piccoli E et al. International Review of Psychiatry. 2022;34(7-8):715-726. Treating Depression With rTMS: A Clinician’s Guide — Chen L et al. American Journal of Psychiatry. 2025;182(6):525-541. Consensus Review and Considerations on TMS to Treat Depression — Trapp NT et al. Clinical Neurophysiology. 2025;170:206-233. Management of Major Depressive Disorder (VA 2022) — Department of Veterans Affairs. Synthesizing the Evidence for Ketamine and Esketamine in TRD — McIntyre RS et al. *American Journal
Discover Medication-Free Depression Treatment | TMS Therapy Welcome to Unchained Wellness Clinic in Gilbert, Arizona , where we specialize in non-medication services to improve lifestyles and mental health. Our holistic approach empowers individuals through innovative treatments, including Transcranial Magnetic Stimulation (TMS) therapy. TMS therapy is a non-invasive outpatient procedure that effectively treats depression without medication. At Unchained, we believe in combining TMS therapy with lifestyle changes such as exercise, balanced nutrition, stress management, quality sleep, and social support to enhance treatment outcomes. With our state-of-the-art MagVenture TMS device, we offer the highest standard of care. Break free from depression and discover a life of vitality and well-being at Unchained Wellness Clinic. Together with our dedicated team of experts, we empower individuals to rise above the limitations of depression, embrace a life filled with purpose and joy, and discover the incredible strength they possess within themselves. Understanding TMS Therapy TMS Therapy, short for Transcranial Magnetic Stimulation, is a revolutionary non-invasive treatment that holds the power to transform lives affected by depression. At Unchained Wellness Clinic, we are proud to offer this cutting-edge therapy that goes beyond traditional approaches. By harnessing the strength of magnetic fields, TMS therapy stimulates specific regions of the brain associated with mood regulation, igniting a path to healing without the need for medication. This safe and gentle procedure opens new doors of hope and possibility for individuals seeking a fresh perspective on their mental health journey. How Does TMS Therapy Work? During a TMS session, a specialized device, such as the MagVenture TMS device we utilize, delivers precisely targeted magnetic pulses to the brain. These pulses generate tiny electrical currents that activate underactive regions and restore balance to the intricate neural pathways involved in mood regulation. By stimulating and reinvigorating the brain's natural processes, TMS therapy breathes new life into those battling depression, offering a beacon of light in the darkest times. Benefits of TMS Therapy TMS therapy offers many advantages that set it apart from traditional treatment approaches. Unlike pharmaceutical interventions that may introduce unwanted side effects, TMS therapy embraces a medication-free path to healing. This benefit alleviates concerns about potential adverse reactions and provides an empowering alternative for those seeking a more holistic and natural approach to their well-being. Additionally, individuals can receive the care they need without disrupting their daily lives or enduring the constraints of a hospital stay. Flexibility and convenience intertwine to redefine the treatment landscape, empowering individuals to take control of their mental health journey on their terms. Beyond these benefits, TMS therapy is: Non-Invasive: It does not require sedation, ensuring a comfortable experience. Well-Tolerated: The treatment has minimal side effects compared to traditional psychiatric medications. FDA-Approved: TMS Therapy has FDA approval for treating depression, supported by extensive clinical research. Drug-Free: As an alternative to traditional treatments, TMS reduces the risk of medication-related side effects. Many patients experience significant and sustained relief from symptoms after completing a course of TMS Therapy. It is more than a treatment—it's a revolution in mental health care. Lifestyle Changes and TMS Therapy: Enhance Treatment Outcomes At Unchained Wellness Clinic, we firmly believe that the path to healing extends far beyond the confines of any single treatment (despite the incredible benefits TMS offers on its own). To unlock the full potential of TMS therapy and enhance its outcomes, we encourage and embrace the power of lifestyle changes. By incorporating positive shifts in various aspects of life, individuals undergoing TMS therapy can unlock their inner strength and achieve profound transformation in their battle against depression. #1 - Exercise and Physical Activity Engaging in regular exercise and physical activity not only benefits the body but also nurtures the mind. Research continuously shows the profound impact of exercise on mental health , with its ability to boost mood, reduce symptoms of depression, and increase overall well-being. When combined with TMS therapy, exercise acts as a catalyst, amplifying the therapeutic effects and helping individuals break free from the grip of depression. #2 - Balanced Nutrition Nourishing the body with a balanced and nutrient-rich diet is essential for physical and mental well-being . A diet rich in whole foods, including fruits, vegetables, lean proteins, and healthy fats, provides the foundation for optimal brain function and mood regulation. By fueling the body with the nutrients it needs, individuals can support the healing process of TMS therapy and experience enhanced overall well-being. #3 - Stress Management Techniques Stress has a profound impact on mental health, exacerbating symptoms of depression and hindering the healing process. Implementing effective stress management techniques is a vital component of supporting TMS therapy. Practices such as mindfulness, meditation, deep breathing exercises, and relaxation techniques can help individuals cultivate inner calm, reduce stress levels, and create a healing environment for the benefits of TMS therapy to flourish. #4 - Sleep Hygiene Quality sleep is the cornerstone of mental and physical well-being. Establishing good sleep hygiene practices ensures that individuals undergoing TMS therapy optimize their restorative sleep cycles. By creating a sleep-friendly environment, adhering to a regular sleep schedule, and practicing relaxation techniques before bed, individuals can enhance the regenerative effects of TMS therapy and promote overall mental wellness. #5 - Social Support and Connection We should always appreciate the power of human connection. Maintaining a strong support network and fostering meaningful social interactions can significantly impact an individual's mental health journey. Engaging in activities that promote social support, such as joining support groups or participating in community events, can provide a sense of belonging, understanding, and encouragement. These connections offer a valuable source of strength, resilience, and motivation throughout the TMS therapy journey. By embracing these lifestyle changes in tandem with TMS therapy, individuals open the door to a transformative experience. At Unchained, we empower our clients to embrace these shifts, providing the tools, guidance, and unwavering support needed to redefine their lives. Together, we unleash the true potential within, unlocking a path to lasting well-being and freeing individuals from the chains of depression. Transform Your Life with TMS Therapy & a Healthy Lifestyle Unchained Wellness Clinic in Gilbert, Arizona, offers a non-prescriptive approach to mental health and well-being through innovative treatments like non-invasive, medication-free TMS therapy. By incorporating lifestyle changes, we can amplify the healing potential of TMS and empower individuals to embark on a transformative journey toward lasting well-being. If you or a loved one is seeking an alternative path to treating depression and improving your overall lifestyle, we invite you to consider TMS therapy at Unchained. Our compassionate team of experts provides the support and guidance you need to break free from the chains of depression and embrace life. Take the first step toward reclaiming the life you deserve today. Life's got problems. We got answers. Your new chapter begins at Unchained Wellness Clinic. Contact us today.
Normal Stress vs. Burnout
When “Normal Stress” Isn’t Normal Anymore
Everyone feels stressed sometimes. But when stress sticks around or starts to affect your daily life, it may be a sign of anxiety or burnout. Knowing the difference can help you get the support you need.
What’s Normal?
It’s normal to feel worried before a big event, nervous in new situations, or tired after a busy week. These feelings usually go away on their own and don’t stop you from living your life.
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When Stress Isn’t Normal
If you notice these symptoms often, or they make it hard to do your job, enjoy time with family, or take care of yourself, it may be more than just stress:
- Feeling anxious, nervous, or worried most days
- Trouble sleeping or relaxing
- Fast heartbeat, shortness of breath, or muscle tension
- Feeling overwhelmed or unable to cope
- Avoiding people or places because of fear or worry
- Feeling emotionally drained, “empty,” or detached from work or loved ones
- Losing interest in things you used to enjoy
- Trouble concentrating or making decisions 1 2 3 4
Burnout vs. Anxiety
Burnout is often caused by ongoing stress at work or home and can make you feel exhausted, cynical, or less effective. Anxiety is more about constant worry or fear, sometimes with physical symptoms like panic attacks. Both can overlap, and sometimes depression can be part of the picture too.
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Why Get Help?
Anxiety and burnout can get better with support. Treatments like counseling, cognitive behavioral therapy (CBT), mindfulness, and sometimes medication can help you feel more like yourself again.
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Quick Self-Check Quiz
Check all that apply:
- I feel anxious or worried most days
- I have trouble sleeping because of stress or worry
- I avoid people, places, or activities due to fear or anxiety
- I feel emotionally exhausted or “burned out”
- I have physical symptoms like a racing heart, shortness of breath, or muscle tension
- I find it hard to concentrate or make decisions
- I’ve lost interest in things I used to enjoy
- My stress or anxiety is affecting my work, school, or relationships
Schedule a consult if you checked three or more.
Getting help early can make a big difference. If you’re struggling, reach out to a healthcare provider for an anxiety evaluation or to talk about treatment options. You’re not alone, and support is available. 1 2 3 4 5 6 7 8 9
References
- Anxiety Disorders: A Review — Szuhany KL, Simon NM. JAMA. 2022;328(24):2431–2445.
- Anxiety Disorders — Penninx BW, Pine DS, Holmes EA, Reif A. The Lancet. 2021;397(10277):914–927.
- Physician Health and Wellness — McClafferty HH, Hubbard DK, Foradori D, et al. Pediatrics. 2022;150(5):e2022059665.
- Current Issues in Relation to Burnout’s Definition, Measurement, Prevalence and Management: A Narrative Review — Parker G, Russo N. Psychiatry Research. 2025;352:116709.
- Quality and Safety in Healthcare, Part LIII: Counseling, Depression, and Burnout — Harolds JA. Clinical Nuclear Medicine. 2019;44(11):870–872.
- Judged Effectiveness of Help-Seeking Strategies Employed by Those Experiencing Differing Burnout Phases and the Suggested Benefits of Antidepressant Medication — Russo N, Parker G. Journal of Affective Disorders. 2025;385:119395.
- Anxiety Screening: Evidence Report and Systematic Review for the US Preventive Services Task Force — O’Connor EA, Henninger ML, Perdue LA, et al. JAMA. 2023;329(24):2171–2184.
- Alternative Treatments to Selected Medications in the 2023 American Geriatrics Society Beers Criteria® — Steinman MA. Journal of the American Geriatrics Society. 2025;73(9):2657–2677.
- Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers: A Randomized Clinical Trial — Joshi SP, Wong AI, Brucker A, et al. JAMA Network Open. 2022;5(9):e2231917.