Depression can feel like an uphill battle, especially when standard treatments fall short. For those living with treatment-resistant depression, transcranial magnetic stimulation (TMS) offers new hope.
TMS for depression is an innovative approach that uses magnetic pulses to activate areas of the brain linked to mood and emotion. It is designed for people who haven’t found relief from traditional treatments like antidepressants or therapy.
What is TMS for Depression?
Transcranial magnetic stimulation (TMS) is a safe, non-invasive method that gently stimulates nerve cells in areas of the brain responsible for mood regulation. Cleared by the US Food and Drug Administration in 2008, TMS has become a hopeful option for many who haven’t responded to traditional treatments.
TMS works by placing an electromagnetic coil against the scalp to send targeted magnetic pulses into the brain. These pulses stimulate nerve cells in areas involved in depression — without the need for anesthesia or recovery time. Unlike electroconvulsive therapy (ECT), patients remain awake and comfortable throughout treatment.
The most common form is repetitive TMS (rTMS). Newer approaches like theta burst stimulation or Express TMS offer shorter treatment sessions while maintaining effectiveness.
TMS is FDA-cleared not only for depression but also for obsessive-compulsive disorder (OCD), migraines, and smoking cessation support.
How TMS works for depression
TMS therapy targets the dorsolateral prefrontal cortex, a part of the brain involved in mood regulation. This area often shows reduced activity in people with major depression.
During each session, a magnetic coil sends energy into the brain, producing small electrical currents that stimulate underactive neurons. The process is painless and encourages the brain to reestablish healthier patterns.
TMS promotes neuroplasticity, helping the brain form and strengthen new connections that support improved mood and cognitive function.
Before starting treatment, providers measure a patient’s motor threshold, the minimum energy needed to cause a muscle response. This ensures that treatment is personalized and safe.
Who is a candidate for TMS treatment?
TMS is typically recommended for adults with major depressive disorder (MDD) who haven’t found success with at least two different antidepressants. If medications or therapy haven’t worked — or caused unpleasant side effects — TMS for depression may be a good fit.
A psychiatrist or mental health provider can evaluate whether TMS is appropriate by reviewing medical history, past treatments, and current symptoms.
TMS is especially helpful for people seeking alternatives to medication or more invasive treatments.
Most people tolerate TMS well, but it may not be suitable for everyone. Individuals with metal implants or devices in or near the head (like aneurysm clips, cochlear implants, or shrapnel) should not undergo TMS.
People with a history of seizures or epilepsy need a careful evaluation to assess risks. TMS is generally safe, but extra precautions are taken in these cases.
The TMS treatment process
TMS for depression therapy begins with a consultation to review your history and assess whether TMS fits your needs. During this time, your provider will:
- Confirm your diagnosis
- Screen for safety
- Determine insurance eligibility
Most insurance plans cover TMS for depression when other treatments have been tried. Your care team can assist with documentation and approvals.
What to expect at the first TMS session
Your first appointment includes motor threshold mapping. Using a mapping cap, the technician finds the optimal coil placement and energy level for your treatment.
You may feel a tapping sensation on your scalp, which is normal and usually well tolerated.
Once mapped, your settings are saved for all future sessions.
Daily treatment sessions
Before each session:
- Remove any metal items (glasses, jewelry, hearing aids)
- Sit comfortably while the technician places the coil
You’ll hear a clicking noise, similar to an MRI. Ear protection may be provided.
Sessions typically last 3 to 20 minutes, and you’ll remain alert and comfortable throughout.
Afterward, you can immediately return to work, errands, or other daily tasks.
TMS for depression: effectiveness and results
Clinical research shows that about 50% to 60% of people with treatment-resistant depression respond positively to TMS. Many start noticing improvements within a few weeks of consistent treatment.
Among those who respond, over half maintain symptom relief for six months or longer. This long-lasting benefit makes TMS a promising option.
TMS is often combined with talk therapy and medication management for the best results. It’s a collaborative approach aimed at full recovery.
While TMS is highly effective, results can vary. Not everyone will experience full remission, and some may require additional care.
Side effects and safety
TMS for depression has a safety profile similar to an MRI scan, with no radiation or systemic effects.
Common side effects:
- Mild headache
- Scalp discomfort at the coil site
- Light facial twitching (temporary)
These usually fade as patients get used to treatment. Serious side effects are rare.
The risk of seizures is less than 1 in 1,000 courses. Providers screen for any risk factors ahead of time.
TMS does not cause memory loss or cognitive problems. Patients remain fully awake and clear-headed.
Managing side effects
If discomfort arises, the care team can adjust the stimulation settings. Over-the-counter pain relievers like ibuprofen can help with headaches.
Always let your provider know if you experience unusual symptoms so adjustments can be made.
Accessing TMS for depression care
To access TMS, speak with your healthcare provider. TMS is appropriate for:
- Treatment-resistant depression
- Bipolar depression (on a case-by-case basis)
- Obsessive-compulsive disorder (OCD)
Patients can schedule a free consultation to see if TMS is right for them. Most insurance plans cover TMS for depression. Your care team will help with approvals.
TMS treatment can bring significant symptom relief and improve quality of life. With a consistent routine and provider support, many people find new hope in their mental health journey.
Key takeaways
- TMS for depression treatment is often recommended when antidepressants and talk therapy haven’t brought the relief expected.
- TMS is an FDA-approved non-invasive treatment that uses magnetic fields to stimulate brain cells. No anesthesia is needed, and there is no downtime.
- TMS targets the dorsolateral prefrontal cortex, an area that often has lower activity during depression.
- Treatment typically includes 36 sessions lasting about 20 minutes each over nine weeks. Theta burst stimulation (Express TMS) reduces session times to just three to four minutes.
- TMS has very few side effects. Patients can return to regular activities right after each session.
Looking for TMS treatment near you?
Pacific Mind Health offers transcranial magnetic stimulation (TMS) for depression, OCD, and other mental health conditions at our Los Angeles locations. Our experienced clinicians provide compassionate, evidence-based care to help you feel better.
Ready to take the next step? Schedule a consultation today to see if TMS is right for you.
