TMS uses focused magnetic pulses — similar in strength to those used in an MRI — to gently stimulate the part of the brain involved in regulating mood. The pulses pass through the scalp and skull to reach the cortex, --a region that tends to be underactive in depression, particularly depression that hasn't responded to medication. Repeated stimulation over several weeks helps those circuits become more active again. For many people, that translates into a real lift in mood and a meaningful reduction in symptoms.
Because TMS works through the brain's circuitry rather than through the bloodstream, it avoids the side effects patients most often dislike about antidepressants — weight gain, sexual side effects, emotional numbness, and fatigue.
What a treatment session is like
TMS is done in our office. You'll sit in a comfortable chair, fully awake, while a small magnetic coil is positioned against your head. You'll hear a clicking sound and feel a tapping sensation on your scalp. There’s no sedation and no anesthesia, so you can read, listen to music, or simply rest during the session.
At your first visit, we'll take a bit of extra time to map the right location and determine the right stimulation strength for you. After that, sessions are quick and routine.
- Session length: typically about 30 minutes
- Schedule: usually five days a week
- Full course: most commonly 20 to 36 sessions over about four to six weeks
- Afterward: you drive yourself home and go back to your day — work, school, childcare, all of it
What to expect from the results
Improvement is usually gradual rather than sudden. Some people notice changes within the first two to three weeks, but most improvement appears over the course of four to six weeks, or even after treatment completion, and it's common for family members or friends to notice a difference before you do. Because of this, we measure your symptoms with brief standardized questionnaires throughout treatment, so progress is tracked rather than guessed at.
TMS doesn’t work for everyone — no depression treatment does. If it isn't helping, we will tell you honestly and move on to another option in our program rather than continuing indefinitely.
Depression can return after a successful course of TMS, as it can after any treatment. If that happens, repeat courses often work again, and ongoing maintenance sessions are an option for some patients. We'll build a plan for staying well, not just for getting well.
Side effects and safety
TMS is generally well tolerated.
- Most common: headache and discomfort, tingling, or tapping sensation at the treatment site. These affect a minority of patients, are usually mild, tend to fade after the first week as you adjust, and typically respond to over-the-counter pain relievers.
- Less common: lightheadedness, brief facial or eye twitching during stimulation, temporary changes in sleep, or fatigue.
- Rare: seizure. This is the most serious risk associated with TMS, and it is uncommon — on the order of a handful of events per 100,000 sessions. We screen carefully for seizure risk before starting, and treatment takes place with staff present throughout.
Is TMS right for me?
TMS is FDA-cleared for depression that hasn't improved with antidepressant medication. It may be a particularly good fit if you want to avoid medication side effects, need to keep working during treatment, cannot take certain medications because of other medical conditions, or want an option that doesn't require anesthesia.
There are a few situations that require extra evaluation or make TMS unsafe. Most importantly, metal implants or devices in or near the head (such as aneurysm clips, cochlear implants, or certain stimulators). Two others are: a history of seizures or a condition that raises seizure risk, and certain medications. Dental fillings, braces, and most implants below the neck are not a problem. We'll review all of this with you in detail at your consultation.