What TMS Therapy Is, In Plain English
Transcranial magnetic stimulation is a form of neuromodulation. A magnetic coil sits on your scalp, quickly turning a magnetic field on and off. That changing field induces a gentle electrical current in the left dorsolateral prefrontal cortex, an area tied to mood regulation. In depression, this region tends to be underactive. After successful treatment, activity looks closer to people without clinical depression. TMS also influences deeper circuits that connect to the limbic system, improves regional blood flow, and is linked with healthier levels of neurotransmitters, including BDNF.
What a Session Feels Like
- The coil or helmet is pressed firmly against the scalp, closer is better.
- Sessions usually run 3 to 20 minutes, depending on device and protocol.
- Stimulation comes in short bursts called trains, for example 2 seconds on, 2 seconds off.
- Expect a rhythmic tapping sound and a woodpecker-like sensation on the scalp. It is noticeable, usually not painful, and may briefly twitch facial or jaw muscles.
Right After Treatment
- You can drive yourself. Many patients schedule sessions during a lunch break.
- Early in week one or two, some people notice scalp tenderness, a mild headache, or a lingering odd sensation that fades by the end of the day.
- Acetaminophen or ibuprofen is fine as needed, check with your own clinician. I suggest limiting to two or three days per week to avoid rebound headaches.
How I Measure Whether TMS is Working
- I use standardized scales such as PHQ-9 and BDI. Sometimes I add a clinician scale like HAM-D.
- We score before treatment, then weekly or every other week, at least by session 20 and at the end.
- I look for fewer depressed days, more energy, better follow through, and fewer thoughts of death.
What Are The Signs That TMS is Working?
- Most patients notice early gains between sessions 10 and 20.
If there is no measurable change by session 20, the odds of responding later are lower, although a minority of late responders exists.