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Mindful Health Solutions – San Rafael

You Deserve to Feel Better

361 E. Third St., Suite A, San Rafael, California 94901

TMS Center

We’re a team of clinicians and staff who have dedicated our lives to research, education, and treating those with mental health conditions. We’re especially passionate about helping those with Treatment-Resistant Depression and providing the most advanced therapies available, including Transcranial Magnetic Stimulation (TMS) and esketamine nasal spray, both FDA-approved for advanced depression.

Mental health conditions can be profoundly painful and isolating, making it difficult to seek help. Our team provides a unique, patient-centered experience to help you find the appropriate treatment and relief from your symptoms. We’re grateful to be practicing psychiatry during this era in which there are so many new treatment possibilities and new hope for those with mental health conditions.

Antidepressants are invaluable aids in the treatment of clinical depression and other mood disorders, but they’re not for everyone. According to the World Journal of Psychiatry, antidepressants don’t improve symptoms in 10–15 percent of people with depression and only partially improve symptoms in 30–40 percent. Also, many people experience side effects from antidepressants that can impact their overall well-being. On the other hand, TMS therapy has shown significantly better results than antidepressants with a small risk of experiencing mild, short-term side effects. One in two patients treated with TMS had a 50% reduction in their symptoms and about 30% of patients experience full remission, which means that their symptoms go away completely. While most patients begin to show improvement after two to three weeks of TMS treatments, it can take up to six weeks to achieve the maximum benefits. It is important to understand that mental health treatment plans are not a one-size-fits-all situation. Treatment plans may take longer or require different treatment option combinations to work best for certain patients. It is important for patients to communicate clearly with their provider about how their treatment plan is working. Collaboration between patient and provider can greatly impact the results of a patient’s wellness journey.
TMS is a safe treatment. While it is a relatively new mental health treatment, it was FDA-approved for the treatment of depression in 2008. Since then, there have been millions of individual treatment sessions performed in the United States. Our clinicians who administer TMS treatments are professionally trained and put each patient’s comfort first. TMS treatments do not hurt during or after each session. There are very few side effects of TMS therapy. Most side effects are mild and short-lasting, and can include: headaches, sleepiness, lightheadedness, scalp discomfort, twitching or tingling of the facial muscles. Many patients find the headpiece to be uncomfortable on their scalp and mild headaches are common during the first few treatments, but these generally go away within the first two weeks as people get used to the sensation. Patients rarely drop out of TMS because of side effects. More serious side effects happen very rarely, but can consist of: seizures, hearing problems from the loud clicking noise that occurs. during treatment, mania, which is more likely to occur if an adolescent has bipolar disorder However, our expert providers will use their professional knowledge to help avoid serious side effects like the ones listed above. Generally, patients will feel just like their normal selves. They will be able to drive and go back to their regular activities. Some people report feeling a little tired or having a mild headache, but that usually goes away after the first week or two. Other people report more energy and better focus, as well as the ability to ignore obsessive, anxious thoughts after treatment.
TMS delivers localized electromagnetic pulses to the prefrontal cortex, which is the area of your brain that regulates mood. These electromagnetic pulses stimulate neurons, which release neurotransmitters and hormones such as serotonin and dopamine. Depression and other mental health conditions are linked to an imbalance of these neurotransmitters. TMS for depression works to restore that balance and can provide a more lasting impact on relieving depression symptoms than other treatments, such as antidepressants. During a TMS treatment, the patient sits in a comfortable chair while the TMS coil is properly set in place on their head. (While this may sound intimidating, it really isn’t!) After the headpiece is in place, electromagnetic pulses are sent to the prefrontal cortex, which is the area of the brain responsible for mood. While the pulses are being sent to the brain, patients can watch TV, listen to music, or talk with our staff. If they want and are comfortable, they can also have a friend or family member in the room with them during their TMS treatment session. Each treatment lasts about 20-30 minutes. The full course of treatment of TMS for depression will generally be five days a week for four to six weeks. We know that coming in five days a week for weeks on end is a commitment, but the results could impact your mental well-being for a lifetime.
Anxiety is sometimes treated with TMS, along with migraines and OCD. There is evidence that TMS may help for schizophrenia, bipolar disorder, certain types of chronic pain, smoking cessation, PTSD, and autism in adults. There is also evidence TMS may help in recovery from stroke. There is evidence that it may help in mild dementia and certain other neurological disorders such as Parkinson’s disease and multiple sclerosis may benefit as well.
Yes! Most major insurances cover TMS, and we’ll work directly with your insurance provider on your behalf to help you get covered.
OPENING HOURS
monday   9AM-6PM
tuesday   9AM-6PM
wednesday   9AM-6PM
thursday   9AM-6PM
friday   9AM-6PM
Treatments
Medication Management
Talk Therapy
Transcranial Magnetic Stimulation (TMS)
Spravato (Esketamine)
Ketamine Infusion
Psychiatric Services
Conditions Treated
Major Depressive Disorder
Anxiety
OCD
Bipolar Disorder
PTSD
Depression
Accepted Insurances
TriCare
VA-TriWest
Kaiser
Anthem
BlueCrossBlueShield
Cigna
Magellan Health
Aetna
MHN
Optum
United
Blue Cross
Other
Manufacturers Used
BrainsWay

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Providers

Nikhil Majumdar

Dr. Majumdar works with patients who may be experiencing clinical depression or other psychiatric disorders. He loves hearing people’s life stories and helping them untangle their past and present. He appreciates patients that embrace a shared responsibility with him to improve their lives. With his experience in diagnosis and treatment, he can help them learn more about themselves and how to assist in their own recovery.

He realized the importance of mental health at a very early age. As a child, his father required a heart bypass and due to complications, there was a concern his father might not wake with his brain fully functioning. In that moment, it was clear to him that as important as overall health is, the health and sharpness of your mind really defines your life. He found this to be even more evident in medical school, where he witnessed people with grave physical struggles continue to do well by finding and maintaining overall contentment with their lives.

He considers Transcranial Magnetic Stimulation to be at the forefront of neurological and psychiatric treatment, which he uses to stimulate the brain in a specific area to improve symptoms of depression. He looks forward to watching TMS grow in its ability to treat other conditions as other areas of the brain are carefully mapped.

David Roth

Dr. David Roth is a Psychiatrist with a focus in patients with a wide range of behavioral, neurological, medical, and mental health disorders and issues. He loves working with youth, and the young at heart. He has many areas of professional interest including obsessive-compulsive disorder, depression, anxiety, insomnia, bipolar disorder, tics, irritability, impulsivity, ADHD, ADD, high functioning autism spectrum disorder (and other developmental disabilities), and many more.  

As a Psychiatrist, he has a very motivational approach with patients and often finds the paths to meaning and purpose through the forest of pain and suffering. He tries to include a patient’s key support people and passions as part of the treatment process. When managing a chronic condition, he tries to educate patients about how their condition cycles, how to identify changes in acuity, and how to use booster medications and other interventions to avert negative consequences such as problems with school, coworkers, law enforcement and hospitalization. 

Dr. David Roth is also an advocate for alternative treatment plans such as Transcranial Magnetic Stimulation (TMS) and esketamine in addition to traditional medication management. In his words, These treatments can positively impact patients in ways that other medications and even great therapy cannot. Having immediate access to these impactful procedures ensures patients don’t get stuck suffering while their depression resists more commonly available treatments.  

Jennifer Guo

Jennifer Guo is passionate about connecting with her patients first and foremost. She works with them to design a comprehensive treatment plan to target their symptoms and improve their overall sense of well-being. Her style with patients is highly collaborative, and she meets patients where they are at each stage of their journey to wellness. Jennifer appreciates patients with an openness to self-discovery and exploration, and works to ensure they feel heard and are engaged in their treatment.

She is particularly interested in using interventional psychiatric approaches including Transcranial Magnetic Stimulation (TMS) and esketamine for treatment-resistant depression. She sees TMS as a non-invasive, durable, and modern treatment for psychiatric disorders with minimal side effects, allowing providers to modulate specific brain circuitry involved in these disorders in a targeted way.

Jennifer Guo joined Mindful Health Solutions in the Fall of 2019.

Kim Schurman

Dr. Kim Schurman is a Psychiatrist with a focused interest in working with patients who struggle with Post-Traumatic Stress Disorder, Depression, Bipolar Disorder, and Anxiety. Her style of psychiatry is a warm, curious, and empathic approach to working with her patients. She prefers to work collaboratively in order to help patients understand themselves and their treatment process.

She became interested in psychiatry while in medical school. She was drawn to understand and connect with people on a deeper level than is possible in primary care. In her opinion, the human mind and brain are fascinating and an endless source of curiosity.

Dr. Kim Schurman took interest in Mindful Health Solutions because of forward thinking and exploring modern methods. Working with treatments such as Transcranial Magnetic Stimulation (TMS) and esketamine allows patients to find a treatment plan that works best for them. Being able to offer patients options for more treatment-resistant conditions is something that Dr. Schurman believes is not only important but can be life-changing for those patients.