Transcranial magnetic stimulation (TMS) is a non-invasive type of brain stimulation therapy that is primarily used to treat depression However, it is also effective in the management of certain mental illness symptoms. TMS is also sometimes used as repetitive transcranial magnetic stimulation (rTMS) and the terms can be used interchangeably. 

Transcranial Magnetic Stimulation For Depression & Other Mental Illnesses

TMS is a treatment method that has been around since 1985 when it was first developed. It was evaluated to treat depression, anxiety, and psychosis, among others, and is currently FDA approved for depression. This has shown immense success in lowering depressive symptoms (for a longer period than other non-invasive brain stimulation therapies) which are present in a variety of mood or psychiatric disorders. 

Like the other types of brain stimulation therapy—vagus nerve stimulation (VNS), deep brain stimulation (DBS), magnetic seizure therapy (MST), and the better known electroconvulsive therapy (ECT)—transcranial magnetic stimulation has been shown to be highly effective in treating mental illnesses that are generally either difficult to treat or cases where the individual did not respond to drug treatments.

It has yet to be determined whether TMS is effective as maintenance for keeping depressive symptoms at bay (undergoing sessions when symptom-free). However, this therapy continues to be effective for use when symptoms surface again (known as re-induction). 

How Does Transcranial Magnetic Stimulation Work?

TMS sends electrical impulses directly on the brain that are the same type and strength as the ones generated by an MRI machine. These pulses are fired in rapid succession in concentrated areas of the brain. These electromagnetic pulses stimulate neural activity, particularly in underactive areas. Whereas electroconvulsive therapy (ECT) sends electric impulses to a generalized area, TMS specifically targets parts of the brain that deal with mood regulation. 

As far as the particulars of transcranial magnetic stimulation effectiveness, this treatment is relatively new and science has yet to determine the biology behind the success. There is also no clear consensus in the medical communities about the ideal number of sessions or if TMS is more effective when combined with other treatment methods such as psychotherapy or medication. 

Deep Transcranial Magnetic Stimulation

There is a subset of TMS known as deep transcranial magnetic stimulation or Deep TMS. The primary difference between the two is the type of coil used which allows Deep TMS to reach a wider and deeper range of the brain, whereas traditional TMS is more contained. Those who do not experience notable improvement in depression or other mental illness symptoms might find success with deep TMS. One study found that more severely depressed individuals have higher response rates than traditional TMS. 

What Getting TMS is Like

A TMS procedure typically lasts between half an hour to a full hour—here’s how it works. Patients are seated in a reclining chair and the transcranial magnetic stimulation device, an electromagnetic coil, is placed on the forehead. Before beginning the treatment, patients will be given earplugs to protect their hearing. 

Short pulses are generated in quick succession which is reported to feel like a light tapping which will be accompanied by repeated clicking sounds. Do not be alarmed if your fingers start twitching—this is what the doctor is looking for. Twitching hands or fingers indicate the motor threshold and is used to determine how much stimulation you can handle and ultimately, the proper electromagnetic dose. Your threshold for these pulses may change depending on whether your tolerance increases or decreases and how your symptoms respond.

Although painless, patients will feel these sensations as there is no anesthesia used and they will be awake during the entire procedure. Patients will have much less downtime and should be able to drive themselves home after their session (which usually takes less than an hour in total) and immediately resume normal activities. 

Transcranial Magnetic Stimulation Side Effects

Anesthesia is not used in transcranial magnetic stimulation. This reduces the amount of downtime a patient will feel along with a lower risk of experiencing after-effects like memory loss or confusion. 

The side effects that are most commonly reported are minor, resolving within a short time and becoming more gradual with continued sessions. These include:

  • Headaches
  • Lightheadedness
  • Tingling or discomfort at the stimulation site
  • Twitching facial muscles

Serious side effects such as seizures, hearing loss, and mania can occur, but they are quite rare. Hearing loss can be a result of improper ear protection, and primarily those with bipolar disorder face the risk of triggering manic behavior. Talk with a mental health professional today to learn your risks and which form of brain stimulation therapy might be best for you.