Transcranial Magnetic Stimulation, or TMS treatment, has brought new hope to people struggling with major depression and other mental health conditions that haven’t improved with traditional therapies. However, some patients notice that their depression feels worse before it gets better. This temporary worsening is often called a TMS dip.
Can TMS make depression worse? If you’ve started TMS and are worried about this reaction, you’re not alone. Understanding why it happens and how to manage it can help you stay the course toward recovery.
Questions Answered in This Article:
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What is TMS Therapy and How Does It Work?
TMS treatment is a noninvasive therapy that uses magnetic pulses to stimulate specific areas of the brain involved in mood regulation. These areas, especially the prefrontal cortex, tend to be underactive in people with major depressive disorder.
By sending gentle brain-stimulating magnetic energy through the skull, TMS helps “wake up” these regions, improving how the brain communicates and processes emotions. It’s an FDA-approved therapy used for treating depression, especially when antidepressant medications or talk therapy haven’t been effective.
TMS is also approved for obsessive-compulsive disorder (OCD) and is being studied for other mental health conditions like anxiety and PTSD.
Patients usually complete a series of treatment sessions, often five days a week for four to six weeks. Each session lasts about 20 to 40 minutes. During the session, you remain awake and alert as the magnetic device delivers pulses to the scalp.
Can TMS Make Depression Worse?
Many patients ask, “Can TMS make my depression worse?” The short answer is that TMS rarely causes a long-term worsening of depression symptoms. However, it’s common for some people to feel emotionally unsettled or even more depressed for a short period during treatment.
This temporary mood decline is what many call the TMS dip — a normal and expected phase of the healing process. According to studies, about 60% of people with treatment-resistant depression improve significantly after TMS, and around 30% achieve full remission. This means that while TMS is highly effective, the path to improvement may not always feel linear.
Why Depression Symptoms Worsen During TMS Therapy
So, why do some patients experience a TMS dip?
TMS works by stimulating neurons and changing activity patterns in the brain. As your brain adjusts to this new level of activity, you might temporarily feel worse before feeling better. These early changes can influence mood, energy, and sleep.
Here are some possible reasons for this temporary worsening of depression symptoms:
- Brain adaptation: The brain needs time to respond to new magnetic pulses and reorganize neural circuits.
- Neurochemical shifts: TMS affects neurotransmitters such as dopamine and serotonin. Early in treatment, these changes may cause fluctuations in mood.
- Physical adjustment: Some people experience mild fatigue, headaches, or scalp discomfort as side effects of TMS, which can indirectly impact mood.
- Psychological expectations: Feeling discouraged during the early stages is natural if progress seems slow.
Typically, this dip happens around the second or third week of TMS sessions. Most patients notice gradual improvement after pushing through this period.
Recognizing the Signs of a TMS Dip
If you’re going through TMS and feel worse, it’s important to recognize that you might be experiencing a normal dip, not a relapse.
Common signs include:
- Increased sadness or irritability
- Fatigue or restlessness
- Worsened anxiety or emotional sensitivity
- Disrupted sleep patterns
- Hopelessness about treatment progress
These symptoms can feel discouraging, but they usually fade as your brain adapts to the ongoing treatment sessions.
How to Manage a TMS Dip
Managing a TMS dip is all about consistency, communication, and support. Here’s what can help:
1. Stay Consistent with Your TMS Sessions
Stopping treatment early may interrupt progress. The brain needs repeated stimulation to rewire neural pathways related to mood regulation. Stay committed to your schedule, even if you don’t see immediate results.
2. Talk to Your Treatment Provider
If your mood significantly worsens, speak up. Your doctor can adjust the stimulation intensity, frequency, or coil position to reduce discomfort. Open communication ensures the treatment remains safe and effective.
3. Combine TMS with Therapy or Medication
TMS works even better when paired with psychotherapy or antidepressant medications. These combinations help reinforce positive mood changes and prevent a long-term decline in motivation.
4. Track Your Mood and Symptoms
Keep a daily journal of your emotional state, sleep, and energy. Seeing small improvements over time can boost your confidence and remind you that recovery is happening, even if it feels slow.
5. Practice Self-Care
During TMS, prioritize healthy habits such as getting enough rest and sleep, eating nourishing and healthy meals, and staying physically active. Avoiding alcohol and drugs is also important in supporting treatment and promoting a more stable recovery.
When to Seek Professional Help
While most depression treatments like TMS are safe, any worsening of depression symptoms that feels severe or persistent should not be ignored.
Seek immediate help if you experience:
- Thoughts of self-harm or suicide
- Intense hopelessness or panic attacks
- Severe insomnia or agitation
- No improvement after several weeks
Your TMS provider or psychiatrist can evaluate whether the changes are temporary or if a treatment adjustment is needed. In emergencies, contact local crisis hotlines or go to the nearest emergency room.
Long-Term Outlook After TMS Treatment
Most patients notice steady progress once the TMS dip passes. Improvements in energy, motivation, and emotional balance become more noticeable toward the end of the treatment sessions.
Many experience lasting relief from major depressive disorder symptoms, especially when continuing therapy or medication maintenance afterward. Studies show that TMS can provide long-term benefits for people who previously struggled with treating depression through other methods.
Because TMS is FDA-approved and noninvasive, it remains one of the safest modern depression treatments available. The most common side effects of TMS include mild scalp discomfort or headache, both of which usually fade quickly.
Healing Takes Time
It can be discouraging when TMS treatment seems to make you feel worse at first. But for most patients, this early TMS dip is a temporary stage in the brain’s healing process, not a setback.
If you continue your treatment for depression, communicate openly with your care team, and take care of your overall health, you’re far more likely to see long-term relief.
Healing isn’t always a straight line, but every pulse of energy brings you one step closer to a balanced, healthier mind.
Schedule a consultation with a local TMS provider to learn whether this innovative treatment is right for you. Many individuals have discovered renewed hope and healing through TMS, and you can too.