Some people respond well to traditional depression treatments, finding relief with medication quite quickly. However, others still have debilitating symptoms after trying multiple medications, a condition that we call difficult-to-treat depression. Thankfully, transcranial magnetic stimulation (TMS) therapy has shown promising results in treating depression when other treatments haven’t worked.
Alongside counseling and other forms of therapy, TMS can be a powerful tool in your journey toward better mental health.
How Does TMS Work?
TMS therapy is a non-invasive treatment method that uses magnetic fields to stimulate nerve cells in the brain. A magnetic field generator, or coil, is placed near the head of the individual receiving treatment, creating a targeted magnetic field that stimulates areas of the brain associated with mood and depression.
The first TMS device was approved by the U.S. Food and Drug Administration in 2008 for the treatment of major depressive disorder. Since then, TMS therapy has been continuously refined and used in conjunction with therapy for depression to offer a comprehensive treatment approach for those with hard-to-treat depression.
The Benefits of TMS for Depression
Depression is a complex mental health condition is characterized by persistent feelings of sadness, hopelessness, and loss of interest in daily activities. TMS directly targets the regions of the brain associated with depression, stimulating areas that are underactive to restore balance and improve mood regulation.
About 60% of people who didn’t respond to other depression treatments responded well to TMS, and more than half of them were still in remission after six months.1
TMS is incredibly safe and has very few side effects compared to many medications. Some people experience mild headaches or discomfort at the treatment sight, but these feelings are typically gone the next day. Plus, TMS clients are able to drive themselves home after treatments, adding to the convenience of the procedure.
Who Is Ineligible for TMS?
People will likely not be good candidates for TMS if they have anything metal implanted in their head or scalp, such as a cochlear implant, deep brain stimulator, or implanted pacemakers. Additionally, those with a history of brain injury or seizure disorder will need careful review before starting TMS. Our skilled care team will review your medical history to determine whether TMS is right for you.
For the small number of people who may not be a good candidate for TMS, Spravato® offers another option for difficult-to-treat depression.
What to Expect During TMS Sessions
A typical TMS session takes less than an hour, in which you’ll be seated comfortably in a chair with a coil placed on your head by a trained clinician, who will monitor your response during the entire session.
Here’s a typical breakdown of what happens in a TMS therapy session:
- Preparation: The client is seated comfortably in a treatment chair, removing any glasses or jewelry. The specialist positions the TMS coil on the client’s head, aligning it with the pre-determined treatment area. TMS doesn’t require any form of anesthesia, so you’ll stay alert during treatment.
- Treatment: The TMS coil generates rapid magnetic pulses that pass through the skull and stimulate the targeted brain cells. These pulses feel like a slight tapping sensation on the scalp. The interventional specialist is present throughout the session to ensure the comfort and safety of the client.
- Duration: Each session typically lasts around 20 to 40 minutes, and the client can resume their normal activities immediately afterward. A course of TMS therapy generally consists of five sessions each week for four to six weeks, but this can vary based on individual needs.
- Follow-up: A psychiatric provider will regularly review the client’s progress, working with the client, therapist, and intervention technician to adjust the treatment plan if necessary. Therapy for depression is often recommended to complement TMS therapy, providing a holistic approach to managing and overcoming depression.
What Does TMS Feel Like?
TMS stimulation feels like a burst of light tapping on your head followed by a pause while the magnetic pulses are delivered. You’ll hear machine clicking sounds, so you may choose to wear earplugs during treatment. Some people might get a twitch or tingle in the muscles around the scalp, face, or jaw.
Potential Risks & Side Effects of TMS
It’s important to note that while TMS therapy is generally considered safe and well-tolerated, there are some risks involved, such as discomfort at the treatment site or headache. These side effects typically only last a few hours, but could persist for about a day or so. Others may experience temporary hearing loss or tinnitus, which can be mitigated by wearing earplugs. These adverse effects are typically mild and often improve after the first session or two.
There is an incredibly low risk of seizures, about 0.1% of all clients. These are most likely for people who have an unaddressed or undisclosed history of seizure or are on certain medications.1
These listed potential side effects of TMS are not exhaustive, and your mental health care provider will review potential risks and side effects with you when considering TMS treatment.
TMS for Depression Treatment Timeline
TMS typically involves five sessions per week for four to six weeks. This adds up to 30-36 sessions, though this can vary depending on individual needs discussed with your provider. Many people start to notice improvements within the first week or so, while others won’t experience relief until later in treatment.
Some people also benefit from “maintenance” or additional sessions later if depression symptoms return. It’s important to complete the full course of treatment to get the most out of TMS.
TMS as Part of a Larger Depression Treatment Plan
TMS can be incredibly effective for difficult-to-treat depression, but it should still be part of a comprehensive depression treatment plan. Pairing TMS with therapy for depression can help you process your feelings and learn new coping skills while also targeting symptoms with brain stimulation. TMS improves the brain’s plasticity and activity, often leading to new therapeutic insights. Many people who start TMS are pleased by how it also improves their therapy experience due to these changes to the brain.
Call Northeast Health Services for TMS Therapy in Massachusetts
Depression can feel overwhelming, but you don’t have to face it alone. Call 508.794.8711 or contact Northeast Health Services online to schedule a consultation and learn more about your depression treatment options in Massachusetts.
Footnote:
- MacMillan, C. (2025). Transcranial Magnetic Stimulation (TMS) for Depression, OCD: What to Know. Yale Medicine. https://www.yalemedicine.org/news/transcranial-magnetic-stimulation-tms-what-you-need-to-know
