TMS Therapy: What it Is and How It Can Help

Key Takeaways

• TMS (transcranial magnetic stimulation) is a noninvasive treatment that uses focused magnetic pulses to modify brain activity.

• A coil placed on the scalp induces brief electrical currents that safely stimulate targeted cortical regions without surgery.

• For depression, TMS commonly targets the left dorsolateral prefrontal cortex and is used for treatment‑resistant cases.

• Typical treatment courses involve outpatient sessions five days a week for about six weeks.

• Most side effects are mild (headache, scalp discomfort); seizure risk is very low with proper screening (<0.01% per session in patients without epilepsy).

What Is TMS and How It Works

TMS — short for transcranial magnetic stimulation — is a noninvasive brain‑stimulation method that delivers focused magnetic pulses through a coil on the scalp to change cortical activity. When used for depression, clinicians usually aim at the left dorsolateral prefrontal cortex to help improve mood regulation and reduce ruminative thinking. The magnetic pulses induce electric currents in the underlying tissue via Faraday induction, which can depolarize neurons without surgery or anesthesia. Treatment starts with motor‑threshold mapping to personalize intensity. Sessions are brief and performed while the patient is awake; ear protection helps reduce the clicking sounds. Care is provided under the supervision of a qualified clinician, and a prescribed course generally involves repeated sessions over several weeks.

Who Can Benefit From TMS Therapy

Who might be a good fit for TMS? Adults age 18 and older with treatment‑resistant depression or with obsessive‑compulsive disorder are commonly evaluated for TMS after medications and psychotherapy have not provided adequate relief. Selection is clinical and safety‑focused, overseen by a board‑certified psychiatrist and including screening for implants, seizure history, and other neurological conditions.

Common candidate considerations:

• Persistent major depressive symptoms despite multiple medication trials and psychotherapy, suggesting treatment‑resistant depression.

• Adults with OCD or other mood disorders for which TMS is an approved or appropriate option.

• Individuals without contraindicated implanted devices or uncontrolled seizure disorders; adolescents may be evaluated on a case‑by‑case basis with family involvement.

TMS can often be continued alongside medications and is delivered in supervised clinical settings.

What to Expect During a TMS Treatment Course

A typical TMS course usually consists of daily sessions, five days per week, for about six weeks (roughly 30 sessions). The first appointment includes motor‑threshold mapping to find the minimal energy level that produces a thumb twitch; that measurement sets the stimulation intensity. During each session you’ll sit awake in a comfortable chair while a magnetic coil is positioned on the scalp, typically over the left dorsolateral prefrontal cortex for depression. Sessions can last from a few minutes up to around 30 minutes; ear protection is provided for the device’s clicking noise. A TMS‑trained psychiatrist supervises the treatment plan while trained technicians deliver sessions and adjust parameters based on response. Most patients are able to return to normal activities immediately after treatment.

Risks, Side Effects, and Safety Considerations

The level of risk with TMS depends on individual health and device settings, but serious complications are rare. Most side effects are mild and short‑lived — common complaints include headaches, scalp or neck soreness, dizziness, or facial tingling that resolve quickly. Seizure risk in people without epilepsy is very low (<0.01% per session), though it is higher in those with a seizure history or other risk factors. Temporary hearing changes such as tinnitus or sensitivity to sound can occur without proper ear protection. Contraindications include metal near the head or certain implanted devices (for example, deep brain stimulators, cochlear implants, pacemakers) because of possible heating or movement. Sessions do not require anesthesia, and patients usually resume activities right away.

• Mild, transient side effects are most common.

• Seizure risk is exceedingly low for eligible patients.

• Device and implant safety screening is essential before treatment.

Accessing TMS: Referrals, Insurance, and Treatment Centers

Thinking about TMS for depression? The typical path begins with a clinician referral — often from a psychiatrist or other mental‑health prescriber — who can determine suitability. Board‑certified psychiatrists oversee mapping, motor‑threshold testing, and treatment selection (standard or deep TMS). Many insurance plans cover initial evaluations and a large number of treatment courses; where gaps exist, clinics frequently offer payment plans or financing options. Treatment centers operate in accredited settings, including university hospitals and private clinics, and commonly provide sessions up to five days a week for several weeks — sometimes extending to around 36 sessions if clinically indicated.