What is your primary dx? I believe both have counterindications for bipolar but a good track record in major depression.

I have a friend who swears by TMS for his MDD and he is very high functioning. But he is also on the max dose of Prozac and in regular therapy.

I do not personally know anyone who has tried ketamine injections. I have read that they can be effective swiftly but not for a long time. You have to continue treatments to maintain the effect which can be expensive.