Depression is one of the most common mental health conditions worldwide. For many people, medications and therapy bring relief. But for others, symptoms linger despite trying different treatment options. This is known as treatment resistant depression.
In recent years, TMS therapy has gained attention as a science-backed approach to treating depression and other disorders. Short for transcranial magnetic stimulation, TMS uses magnetic pulses to influence brain circuits that regulate mood.
The neuroscience behind TMS is fascinating. By using a TMS coil or electromagnetic coil, doctors can target underactive areas of the brain linked to depression. This article explores how TMS works, its effects on the brain, and why it is becoming an effective treatment for a range of conditions.
Questions Answered in This Article:
Our Alcohol Addiction Treatment Programs
Scottsdale Rehab
Luxury Personalized Rehab
Hart Rehab
Holistic Luxury Personalized Rehab
Scottsdale Detox
Luxury Medical Detox
What is TMS Therapy?
TMS, or transcranial magnetic stimulation, is a non-invasive brain stimulation method. Unlike surgery or implanted devices, it does not require cutting or anesthesia. Instead, doctors place a magnetic coil against the scalp. This coil delivers magnetic pulses that stimulate nerve cells in specific brain regions.
The process is safe and painless. During a treatment session, the patient sits in a chair while the machine delivers repeated pulses. The sensation feels like gentle tapping on the head. Each session lasts about 20 to 40 minutes.
Since 2008, the U.S. Food and Drug Administration (FDA) has approved TMS treatments for depression, especially for people who do not respond to medication. It is now considered a reliable option in modern psychiatry.
Types of TMS Therapy
Several types of TMS therapy are now used as treatment options:
Repetitive TMS (rTMS)
The most established type of TMS, rTMS uses repeated magnetic pulses at high or low frequencies to stimulate the prefrontal cortex. High frequencies (above 10 Hz) tend to excite neurons, while lower frequencies (1 Hz or less) can calm overactive regions.
Deep TMS (dTMS)
Deep TMS utilizes H-coils specifically designed to target deeper brain structures than standard TMS coils. It is especially promising for treatment-resistant depression and obsessive-compulsive disorder OCD, boasting response rates higher than some traditional protocols. For instance, recent studies show deep TMS can achieve a 58.8% response rate and a 52.9% remission rate after 30 sessions in older adults.
Theta Burst Stimulation (TBS)
This newer protocol delivers brief, patterned bursts of magnetic pulses to optimize results while reducing session duration. TBS can offer similar benefits as rTMS in less time.
Each type of TMS shares the goal of using a magnetic coil to target disrupted brain circuits and restore healthier function.
Side Effects and Safety
TMS treatments are generally well tolerated. Common side effects include:
- Mild scalp discomfort or headache at the stimulation site
- Tingling or muscle contraction under the coil
- Rare instances of seizure, mostly in patients with pre-existing neurological risk factors
Adverse effects with magnetic pulses are minimal compared to many psychiatric medications, and there is no risk of addiction or withdrawal syndrome.
TMS Neuroscience and Brain Response
To understand how TMS works, we must first look at the brain. Depression is not just a matter of emotions; it involves disrupted brain activity.
Research shows that in depression, the prefrontal cortex becomes less active. This part of the brain regulates mood, decision-making, and problem-solving. When activity decreases, symptoms like sadness, hopelessness, and lack of motivation appear.
How TMS Therapy Works for Depression
During a typical treatment session, an electromagnetic coil is placed against the patient’s scalp, sending brief bursts of magnetic energy through the skull into underlying nerve cells. These pulses induce small electric currents that depolarize neurons and “reset” dysfunctional patterns of brain activity often found in people with depression.
TMS therapy works by stimulating this region with magnetic pulses. The electromagnetic coil generates currents that activate neurons. This process increases synaptic plasticity, making the brain more adaptable, responsive, and capable of changing its own signaling patterns. Over time, this stimulation improves brain activity and strengthens neural pathways.
Scientists call this process neuroplasticity, the brain’s ability to rewire and form new connections. By promoting neuroplasticity, TMS helps restore balance in mood regulation circuits.
The effects of TMS are both immediate and long-term. Many patients notice mood improvements within 2 to 4 weeks. After a full course of treatment, typically 20 to 36 sessions, the benefits can last for months or even years.
In fact, one study found that 50–60% of patients with treatment-resistant depression improved with TMS, and about one-third achieved full remission. This highlights how powerful the brain’s response can be when targeted correctly.
How Depression Affects the Brain
Depression changes the brain in measurable ways. Imaging studies show reduced blood flow and lower brain activity in the prefrontal cortex. There are also disruptions in communication between different brain regions.
Neurotransmitters, such as serotonin and dopamine, may become imbalanced. These chemicals are critical for regulating emotions and motivation.
For people with treatment-resistant depression, these changes can be more severe. Medications often target neurotransmitters, but they may not fully correct disrupted brain circuits. This is where TMS provides a unique advantage.
Brain imaging reveals decreased activity and blood flow in the prefrontal cortex of people with depression, which correlates with the severity of mood symptoms. These findings guide where and how TMS targets the brain—the goal is to “reset” neural circuits using magnetic pulses that improve connectivity and restore healthy activity.
TMS Neuroscience vs. Antidepressant Medications
Antidepressants work by adjusting neurotransmitter levels. While helpful, they act on the brain indirectly and often take weeks to show results. They can also cause side effects such as weight gain, insomnia, or sexual dysfunction.
TMS treatments, on the other hand, directly influence brain activity through targeted stimulation. Instead of circulating throughout the body, the electromagnetic coil acts only on the brain region linked to mood.
Another alternative is electroconvulsive therapy (ECT). While highly effective, ECT involves seizures induced by electricity under anesthesia. This can cause memory loss and requires hospital care.
Compared to ECT, TMS is gentler, more convenient, and has fewer risks. For many patients, it strikes a balance between safety and effectiveness.
Comparing TMS to Electroconvulsive Therapy (ECT)
Some patients with severe, persistent depression may be offered electroconvulsive therapy ECT. This approach uses controlled electrical currents to induce brain seizures, which can produce powerful antidepressant effects but may carry risks such as memory loss and require anesthesia.
In contrast, TMS is a non-invasive and safer treatment option. It does not induce seizures or require sedation, and side effects are usually mild, such as headaches or mild scalp discomfort. Both therapies can benefit treatment-resistant cases, but the choice often depends on medical history, preference, and risk tolerance.
TMS and Brain Disorders Beyond Depression
While TMS is most widely recognized for its role in treating treatment-resistant depression, its reach extends far beyond mood disorders. Neuroscientists and clinicians are now investigating how various types of TMS therapy, including repetitive TMS (rTMS) and deep TMS (dTMS), can impact brain activity in other conditions.
1. Obsessive Compulsive Disorder (OCD)
In 2018, the FDA cleared deep TMS as an effective treatment for obsessive-compulsive disorder (OCD). OCD is linked to overactive brain circuits, especially between the prefrontal cortex and deeper structures like the striatum. By using a TMS coil that delivers magnetic pulses to these regions, doctors can calm the excessive firing of neurons.
Clinical trials show promising results. In one study, nearly 40% of patients with OCD experienced significant symptom reduction after a course of deep TMS treatments. This makes TMS a valuable alternative when medications and behavioral therapy alone are not enough.
2. Post-Traumatic Stress Disorder (PTSD)
PTSD alters fear, memory, and emotional regulation circuits in the brain. Research indicates that repetitive TMS (rTMS) applied to the dorsolateral prefrontal cortex can help restore balance in these circuits. Patients report fewer flashbacks, reduced hypervigilance, and improved sleep after courses of treatment.
While more studies are needed, early findings suggest that TMS could become a safe, non-invasive treatment option for veterans and others living with PTSD.
3. Anxiety Disorders
Anxiety often involves high frequencies of abnormal firing in brain regions tied to worry and stress responses. TMS can regulate this brain activity, providing relief without the side effects of long-term medication use. Trials with rTMS show decreases in generalized anxiety and panic symptoms, making it a valuable tool for patients seeking non-drug treatment options.
4. Neurological Disorders
Beyond psychiatry, TMS is being tested for conditions that directly affect the nervous system:
- Stroke Recovery: By stimulating motor areas of the brain with magnetic pulses, TMS may help re-establish lost connections and improve motor control.
- Parkinson’s Disease: TMS has shown potential in improving motor symptoms such as tremors and stiffness by targeting motor circuits.
- Alzheimer’s Disease and Cognitive Decline: Early trials suggest that combining TMS treatments with cognitive training could boost memory and slow decline.
5. Chronic Pain and Migraines
The FDA has also approved a specialized handheld electromagnetic coil for treating migraines. Patients can apply the device at the onset of symptoms to reduce pain intensity. Studies are ongoing to see whether similar methods can ease fibromyalgia and other chronic pain syndromes.
Finding Help and Treatment
Depression affects millions, and many struggle with treatment-resistant depression. TMS therapy offers hope by targeting the brain directly with magnetic pulses.
The effects of TMS go beyond depression, offering new treatment options for OCD, PTSD, and other disorders. As neuroscience research advances, TMS will likely become an even more powerful tool in modern psychiatry.
For those who have struggled to find relief, TMS represents not just science—but hope.
Consider connecting with a local TMS provider and discover whether this innovative therapy could be right for you.