Transcranial Magnetic Stimulation (TMS): An Alternate Path to Well-Being

What is TMS?

TMS uses magnetic fields to affect brain activity. During a TMS session, a special electromagnetic coil rests against your scalp, targeting areas of the brain linked to depression. The coil sends magnetic pulses to stimulate the nerve cells responsible for regulating mood.

The full TMS schedule is a bit of a commitment. Patients go for many sessions, often spanning several weeks. The standard regimen is five days a week for up to six weeks. Although, the number of TMS treatments needed for major depression varies and is being studied.

What does TMS treat?

TMS has mostly been researched for depression, including major depressive disorder and treatment-resistant depression. But it can also help with:

• Obsessive-compulsive disorder (also known as OCD)

• Migraines

• Smoking cessation

Plus, TMS shows promise for treating other conditions. There are studies investigating its use in:

• Bipolar disorder

• Post-traumatic stress disorder (PTSD)

• Borderline personality disorder

• Schizophrenia

• Eating disorders

• Addictions

• Alzheimer’s disease

• Parkinson’s disease

• Tinnitus

• Traumatic brain injuries (TBI)

Is TMS right for me?

Your health care provider can help decide whether TMS is right for you. They’ll probably start with asking whether you:

• Are pregnant or thinking of becoming pregnant

• Suffer from frequent or severe headaches

• Have brain damage from illness or injury

• Struggle with drug or alcohol use

• Have metal in your body, such as:

  • Implanted electrical devices, like pacemakers or medicine pumps

  • Implanted stimulators

  • Aneurysm clips or coils

  • Stents

  • Implanted vagus nerve or deep brain stimulators

  • Cochlear implants for hearing

  • Magnetic implants

  • Electrodes for monitoring brain activity

  • Metal fragments from bullets or other objects

To make sure the treatment is safe and effective, your provider will also:

• Conduct a physical exam, which might include blood tests

• Do a thorough mental health evaluation

What will the treatment be like?

Before TMS treatments, you’ll take off any metal. This includes jewelry, hearing aids, or glasses with metal frames.

At the first appointment, your health care provider will find your “magnetic sweet spot”—the best place on your head for the magnetic coil. They’ll also fine tune the level of stimulating pulse, which is different for everyone. Here’s what that process looks like:

• You’ll sit in a comfortable chair and wear earplugs.

• The provider will place the coil against your head.

• By switching stimulating pulses on and off, they’ll find the right type of pulse for you. This may feel like tapping on your head. You may also hear a clicking sound.

• Next, they’ll move the coil to different parts of your head while adjusting the magnetic energy. Your fingers or hands may twitch in response to the pulses.

The first appointment usually lasts about an hour. Your next visits should be shorter, since the provider can use the coil location and measurements from your initial session. Here’s what to expect from the rest of your treatments:

• You’ll sit in a comfortable chair and wear earplugs.

• The provider will place the coil against your head.

• The pulses will go on for a few seconds and pause for a few seconds. You’ll feel tapping on your scalp and hear clicking during the pulses.

  • The tapping may feel uncomfortable or even hurt. But the discomfort goes away during the pauses.

• The session will last between 3 to 20 minutes

What are the side effects?

Generally, people feel fine during and after TMS. The most common side effect? A minor headache that goes away quickly. About half of patients get headaches, but they become less frequent as your body gets used to the treatment.

Other side effects can include:

• Twitching or tingling in the face or scalp

• Pain or redness in the scalp or neck

• Dizziness or lightheadedness

• Temporary ringing in your ears

• Temporary sensitivity to sound

• Worsened anxiety or panic attacks

These side effects tend to be mild and only last for a few minutes. But if any of them really bother you, let your provider know. They can adjust the coil location and pulses to reduce symptoms. They might also suggest taking a pain medicine before treatment sessions. One very rare but serious side effect to be aware of: seizures. Though if you don’t have epilepsy, it is very rare to have a seizure from TMS.

Overall, know that TMS has been diligently studied for safety and effectiveness. It’s a valuable and safe alternative when standard treatments aren’t the answer for you.