What Is TMS Therapy?

By Sarah Fader |Updated July 15, 2022
CheckedMedically Reviewed By Wendy Boring-Bray, DBH, LPC

Are You Struggling To Find The Right Mental Health Treatment?

There have been many ways to combat mental disorders. From counseling to pills, you think you've seen them all. But one way to combat therapy that you may not have heard of is TMS, and it can help revolutionize the way many disorders are treated, including depression.

TMS stands for transcranial magnetic stimulation. Sometimes it’s called repetitive transcranial magnetic stimulation. TMS is not the same as electroconvulsive therapy (ECT) or deep brain stimulation (DBS)/therapies that use deep brain stimulators.

How It Works

As you may have inferred from the name, transcranial magnetic stimulation (TMS) involves magnetism, and the magnets help to stimulate certain parts of the brain, including the prefrontal cortex that helps with mood regulation. TMS can activate the human motor cortex. A powerful magnetic field generator is put near your head, and the generator lets out currents to help stimulate your brain. This brain stimulation can help ease symptoms of depression and can play other roles in the diagnosis and treatment of health concerns. TMS is an outpatient procedure. You do not have to stay in the hospital, and no recovery time is needed. You can go about your day after your treatment.

What It Can Do

Besides treating disorders, which we'll get into later, TMS can help diagnose disorders in the brain, as well as help see damage to the brain. If you've had a stroke, multiple sclerosis, or any other disorder or injury, transcranial magnetic stimulation (TMS) can help see the extent of the damage, and this, in turn, can help treat it better. TMS can also help investigate motor dysfunction by taking measurements of brain activity in the motor cortex.TMS can also treat disorders. If you experience neuropathic pain, TMS can help to alleviate it.

Perhaps the best treatment repetitive transcranial magnetic stimulation is known for, however, is depression. Depression is typically treated with medication and talk therapy (psychotherapy), but there are cases where the depression is so severe that those treatments have little to no effect. TMS can help those who experience major depression finally be able to treat it after nothing else has worked.

Does It Work?

With magnetic therapy, you may wonder if it's effective, or if it's bunk. Luckily, transcranial magnetic stimulation is the former. While there are still unknowns about TMS, such as what kinds of mental disorders it can treat, this noninvasive form of brain stimulation therapy TMS was found effective by the FDA back in 2008 as an effective way to treat depression.

While it's still being recognized by health insurance providers as an effective treatment, it's progressing, and perhaps someday TMS will improve even further to be a safe way to treat depression and other disorders.

Why Does It Work?

For depression, the exact reasons why TMS works are not entirely understood. The brain is a complex organ, with many different parts, and by stimulating certain parts of your brain (such as the prefrontal cortex, in many cases of TMS) with magnetism, it can help reduce the symptoms of depression.

Are There Any Side Effects?

Perhaps the most important question to ask yourself when doing a treatment like transcranial magnetic stimulation is "Is it safe?" Well, the good news is that TMS is safe to use, but with all treatments, there are some slight chances of side effects.

Some side effects may include:

Discomfort/pain: You may feel achy after the procedure, but it should go away.

Hypomania: You may feel some euphoria after the procedure.

Hearing loss: Your hearing may lessen temporarily.

Memory loss: You may lose your memories briefly.

Fainting: You may feel faint or faint altogether.

Seizures: There may be an induced seizure, but the risk is rare.

Although some of these sound scary, the good thing is that they're extremely rare. No procedure is 100 percent safe, so talk to your doctor if you have any concerns. Also, be certain to discuss any implants, such as aneurysm clips or any other object implanted, with your doctors, as well as your complete medical history.

What Is The Cost? What About Health Insurance?

When doing TMS, or any procedure for that matter (brain stimulation therapies or other health care treatments), the question that comes up is the cost. Is transcranial magnetic stimulation anaffordable procedure, or something that would cost me tens of thousands of dollars?

With any of these procedures, there is no straight answer. It'll depend on you, your doctor, and a few other factors. Luckily, TMS is cheaper than ECT, or electroconvulsive therapy. You may pay $500 a session for TMS. That doesn't sound too bad, but you need to realize that you may need multiple sessions for TMS to work. For ten sessions, you may pay around $15k.

Are You Struggling To Find The Right Mental Health Treatment?

Of course, while this is less expensive than some other therapies, that's still a lot of money for the average person. So, what about health insurance? Can your health insurance company help cover the bill?

The good news is that many insurance providers are starting to see the importance of TMSand have decided to cover it. A few providers that cover it include Anthem, Health Net, Blue Cross Blue Shield in a few states, and a few others. Their coverage has been relatively new, with coverage starting less than five years ago so you should talk to your healthcare provider to make sure you're covered. As it's always changing, talking to them directly instead of trusting a single article is the best route. There are still some healthcare providers that are not on board with the idea of TMS being an effective treatment, so see which healthcare providers do.

If Medicare covers you, it's a bit spotty. Medicare in some places honors TMS, while others still don't believe it's effective. Talk to your Medicare provider before doing TMS to make sure you're covered.

So, as you can see, TMS is a more affordable option, and as more insurance providers accept it, it'll be even better.

What To Expect

You may have to have a physical and psychiatric evaluation to be sure that transcranial magnetic stimulation (TMS) is right for you. When you begin your first appointment, it'll mostly be about the doctor figuring out what TMS treatment is right for you. You'll sit down in a comfy chair, wear earplugs, and then the electromagnetic generator will be over your head. The doctor will figure out which position works best for you, and then the doctor will figure out how much magnetic energy is needed. A TMS technician may assist the doctor.

During transcranial magnetic stimulation (TMS), the amount of energy needed varies from person to person, so the doctor will increase the dosage until they figure it out. They’ll measure your motor threshold to personalize your treatment. Just sit back and be comfortable, and the doctor will take care of the rest.

The entire evaluation may take an hour. Other sessions will involve the same procedure but may take less. It'll be around 40 minutes, and you'll be awake. The procedure does not feel bad minus some discomfort, and you'll be out the door and ready for the rest of your day afterward.

Who Can't Have TMS?

With any of these treatments or brain stimulation therapies, there are certain groups of people who are more at risk for side effects. While these won't totally bar you from being able to do transcranial magnetic stimulation (TMS), you should still talk to your doctor ifany of the following apply to you:

You’re pregnant/Thinking of being pregnant: TMS is typically safe for women who are pregnant, and there don't appear to be any adverse effects on the baby. However, it's still worth talking to your doctor about if you're not sure.

You have implants or metal devices: Since transcranial magnetic stimulation (TMS) uses magnetism, you should worry a bit if you have any metal devices in your body, especially if they're used for medical reasons. This is another case-by-case basis; some people who have metal implants may be able to have TMS without any risk. Others who have an object implanted may not be able to safely do TMS.If you have cochlear implants, brain electrodes, facial tattoos with metallic ink, pacemakers, stimulators, stents, medication pumps, deep brain stimulators, aneurysm clips, or any other device like this in you, you may not be able to do TMS. Again, though, talk to your doctor and see if you can.

You have a history of seizures: As TMS can (rarely) induce seizures, it's worth mentioning too that if you or your family has had seizures or epilepsy.

Talking To Your Doctor:

You should tell your doctor about your complete medical history and medical conditions (both mental and physical). You should also feel comfortable asking your doctor any questions you might have. Topics to discuss can include:

Medications: Always tell your doctor what kind of medications you're taking, even if they're over the counter, to see if they'll clash with TMS. Also, talk to your doctor about side effects of medications. (For instance, some antidepressants are linked to sexual dysfunction. Your doctor may be able to offer different options.)

Other Brain Disorders: If you have bipolar disorder, psychosis, or any other disorder that can affect your mind, talk to your doctor. The depression could be caused by that, and you may not even need TMS.

Frequent headaches: If you suffer from severe headaches, they may worsen through TMS. Talk to your doctor and see what the best route is.

Brain injury: Tell your TMS physician if you have any form of brain damage, no matter how minor it may be.

Treatment time: Your doctor can give you information about how long your treatment sessions might be and how many treatment sessions you might need. A course of TMS might be about thirty to forty minutes a day, five days a week for four to six weeks. The outpatient treatment often takes place in a doctor’s office or clinic.

Any other questions: If you have any other question at all or any other medical concern, please bring it up while you're discussing TMS with a TMS physician. It will help the doctor to make sure you're taking the safest path possible.

Is It Right For Me?

After reading about this, you may wonder if TMS is the right way to go. We don't know how to answer that without knowing you, and it depends on a case by case basis. If you're depressed, and nothing seems to work, you may qualify for TMS. There may be other mental disorders and injuries that could benefit from TMS treatment as well.

The answer, ultimately, is to speak to a professional. A TMS physician (a physician experienced and trained in TMS) should be able to tell you if TMS is right for you, give you a frame for how much it will be, and be able to go through the process along with you. Your doctor can help you find an individualized treatment that will work for you. If it includes TMS, your doctor will further individualize your treatment by measuring your motor threshold to determine the right amount of energy for you.

Transcranial magnetic stimulation (rTMS) is a treatment that may be the future of how we battle depression. Maybe one day, we won't need medication and years of therapy to end the depression, but just a little bit of magnetism for brain stimulation. If you want to be a part of that fight, talk to your doctor today and see if TMS is right for you.

Commonly Asked Questions On This Topic Found Below:

What does TMS therapy do?

Transcranial magnetic stimulation (TMS therapy) is a treatment for major depressive disorder (unipolar depression). Typically, transcranial magnetic stimulation may usedfor treatment resistant depression (when other depression treatments, such as antidepressant medications and psychotherapy, have not improved depression symptoms). This is a noninvasive treatment. It uses magnetic fields to stimulate nerve cells (sometimes called brain cells) in the prefrontal cortex of the patient’s brain in the area responsible for mood regulation.

The brain stimulation from transcranial magnetic stimulation (rTMS) can improve symptoms of depression. TMS therapy involves delivering repetitive transcranial magnetic stimulation (magnetic pulses), so it is often called repetitive TMS or rTMS. Repetitive transcranial magnetic stimulation is thought to play a role in brain stimulation. Nerve cells (brain cells)  in the region of the brain involved in mood control and depression are stimulated by each magnetic pulse during rTMS treatment. This brain region is the left dorsolateral prefrontal cortex.

What are the dangers of TMS therapy?

Generally, repetitive TMS is considered safe and well-tolerated. Patients treated with TMS may experience some side effects like headache, scalp discomfort where the magnetic coil was placed, tingling or twitching of facial muscles, or lightheadedness. Your doctor will measure your motor threshold to personalize your treatment. They may try to adjust it to minimize side effects.

What is the success rate of TMS therapy?

In the majority of cases, TMS is a successful treatment for depression symptoms. Between 50 percent to 60 percent of people with depression who receive rTMS therapy experience improvement.

There are also some clinical trials (a clinical trial studies an interventions effects on patients) and research that show that TMS may be part of an effective treatment plan for other mental health disorders and psychiatric disorders, such as post traumatic stress disorder or obsessive compulsive disorder (OCD).In 2018, the FDA approved TMS for the treatment of OCD. This form of TMS is called deep transcranial magnetic stimulation (dTMS).

Is TMS therapy painful?

TMS can offer symptom relief without pain. During TMS, an electromagnetic coil is placed on a person’s head. It is not painful. It is noninvasive (unlike, for example, deep brain stimulation that uses deep brain stimulators and requires brain surgery). TMS does not require anesthesia nor does it require surgery. TMS uses a series of repetitive magnetic pulses that are not painful. Your doctor will measure your motor threshold to personalize your treatment and determine the right amount of energy for you. A TMS technician or other wellness professionals who work with your doctor may assist.

Can TMS change your personality?

Personality change is not considered an effect of TMS.

Can TMS cause brain damage?

TMS, a noninvasive form of treatment. It is generally considered safe and well tolerated. The National Institute of Mental Health says, “Transcranial magnetic stimulation (TMS) is a highly precise and noninvasive brain stimulation tool approved by the U.S. Food and Drug Administration for the treatment of major depression and other conditions. 

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