Overview
This NIH-funded single-arm pilot tests the feasibility, acceptability, and preliminary effects of embedding brief guided mindfulness practice (via the Waking Up smartphone app) into the inter-session intervals of clinically administered accelerated intermittent theta-burst stimulation (aiTBS) for major depressive disorder (MDD). Participants receive aiTBS as standard clinical care at MUSC; the research intervention is daily guided mindfulness practice during the aiTBS course. Outcomes include feasibility/acceptability, changes in state mindfulness and hedonic tone (Day 0 to Day 5), perceived ease of meditation, trait mindfulness at 4 and 12 weeks, and durability of antidepressant response (PHQ-9) at 4 and 12 weeks.
Eligibility
Inclusion Criteria:
- Clinical diagnosis of MDD and eligible for aiTBS at MUSC
- Already enrolled in aiTBS course at MUSC
- English proficiency
- Smartphone or willingness to use study-provided device
Exclusion Criteria:
- TMS contraindications (e.g., seizure history, implants, pregnancy)
- Concurrent neuromodulation (ECT, VNS)
- Psychotic disorder, bipolar disorder, active substance use disorder, high suicide risk
- Unable/unwilling to engage in mindfulness or complete questionnaires
