Transcranial magnetic stimulation (TMS) has become a groundbreaking option for people with depression who do not respond well to antidepressant medications. This non-invasive therapy uses magnetic pulses to stimulate areas of the brain involved in mood regulation. Many patients experience significant improvements, but some notice a temporary setback early in treatment. This is known as the TMS dip.
The dip occurs when patients experience a short-term worsening of depression symptoms before improvements begin. While this stage can feel discouraging, understanding what it means and how long it lasts can help patients stay committed to their treatment plan.
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The TMS dip is a temporary exacerbation of depression symptoms that may appear during the first phase of TMS treatment. Instead of immediate relief, some patients experience heightened anxiety, fatigue, or a stronger sense of hopelessness.
This does not mean that TMS is failing. Instead, the dip occurs because the brain is adjusting to repeated magnetic stimulation in specific brain regions. Just as the body can feel sore after starting a new workout, the brain may need time to adapt before changes in mood regulation are noticeable.
According to the National Institute of Mental Health, about 30% of people with major depression do not respond to antidepressant medications. TMS provides a new path for these individuals, but understanding the TMS dip helps set realistic expectations for recovery.
When patients experience a TMS dip, they may notice:
These symptoms are usually mild to moderate, but they can feel significant if someone expected immediate improvement. Importantly, the TMS dip differs from standard depression symptoms because of its timing. It typically emerges within the first one to two weeks of treatment.
For most patients, the dip occurs within the first 1–2 weeks of treatment. Symptoms often ease by week 3 or 4, as the brain adapts to stimulation. In some cases, patients never experience a dip at all.
The short-term nature of the dip means it should not discourage patients from continuing their treatment plan. If symptoms feel overwhelming, patients should contact their healthcare provider to discuss options for support.
A study found that around 60% of patients who completed a full TMS course experienced significant improvement in depression symptoms, showing that persistence pays off.
The exact cause of the TMS dip is still being studied. However, researchers believe it is connected to how TMS works on different parts of the brain.
In short, the dip occurs because the brain is re-learning healthier signaling patterns. This process can briefly make symptoms worse before they improve.
Going through the dip can be discouraging, but there are practical steps that help patients stay grounded:
Not every dip is mild. Some patients may experience a more severe temporary exacerbation of symptoms. It is important to talk to a doctor if:
Providers may adjust medications, add therapy sessions, or recommend additional coping strategies to help patients manage this phase. The key is to remember that the dip does not mean failure.
Although the dip occurs in the short term, the long-term outcomes of TMS treatment are promising. Studies show that many patients experience relief from depression symptoms after completing the full course of TMS sessions.
TMS works by targeting specific brain regions tied to emotion and thought. As these areas of the brain adjust, patients experience improved mood regulation. For many, this translates to better daily functioning, improved relationships, and reduced reliance on antidepressant medications.
Patients often describe the TMS dip as a small hurdle compared to the long-term relief they feel later.
The TMS dip can be an unsettling experience, but it is temporary and manageable. Patients experience a dip because their brain is adjusting to new patterns created by magnetic pulses. While it may bring a short term worsening of depression symptoms or heightened anxiety, most people move past it within a few weeks.
Sticking with the treatment plan, relying on a support system, and communicating openly with healthcare providers are the best ways to handle this phase. In the long run, TMS works to relieve symptoms and improve mood regulation by stimulating critical brain regions.
If you are starting TMS treatment, remember that the dip occurs only for some patients and usually does not last long. With persistence and support, many people find lasting relief and new hope for managing depression and other mental health conditions.
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