Can TMS Make Depression Worse? TMS Treatment and the TMS Dip

When a new medication or treatment is developed, it’s normal for both excitement and caution to arise among healthcare professionals and patients alike. In the realm of mental health treatments, each individual’s experience is unique and nuanced, so the introduction of innovative therapies demands thorough scrutiny.

One treatment that has garnered considerable attention in recent years is repetitive transcranial magnetic stimulation (TMS). TMS treatment is a non-invasive, non-medication method of combatting depression and other psychiatric disorders. While many studies have demonstrated its effectiveness and safety, some are rightfully curious about the complete lack of any notable side effects. It might seem too good to be true!

This article aims to recap the side effects of TMS treatment and answer the question: “Can TMS make depression worse?”

Understanding TMS Treatment

Transcranial magnetic stimulation (TMS) therapy is a cutting-edge brain stimulation treatment that offers new hope for individuals struggling with certain psychiatric conditions, mainly major depressive disorder. During TMS sessions, an electromagnetic coil is placed near the forehead. This electromagnet painlessly delivers a magnetic pulse which stimulates nerve cells in the specific regions of the brain involved with mood. TMS is FDA-approved for treating depression, obsessive-compulsive disorder (OCD), and cigarette cessation, but is used “off-label” by psychiatrists to treat a number of other conditions such as generalized anxiety disorder (GAD) or bipolar disorder (BD).


TMS is non-invasive, which means that patients can undergo this outpatient procedure with no downtime, and without general anesthesia.


TMS is also not a medication. TMS treatment uses magnetic pulses that stimulate nerve cells in the brain and can be performed alongside psychiatric medications like SSRIs.


TMS therapy is also considered a non-systemic treatment, which means it does not affect the entire body. TMS treatment is targeted at a very specific part of the brain, unlike many medications.

Side Effects of TMS

TMS is an extremely well-tolerated treatment, with very few short-term or long-term side effects being reported. Commonly reported side effects include:

  • Tapping Sensations: Some patients report feeling tapping sensations around the head area during treatment.
  • Mild Headache: Sometimes, mild headaches are reported, but typically subside shortly after the treatment session and can be treated with over-the-counter medication like Advil.
  • Mild Sleep Disruption: Sleep patterns may be temporarily affected but usually return to normal soon after treatments end.

Many patients report absolutely zero side effects. Overall, TMS therapy provides a safe and convenient option for individuals looking to improve their depression symptoms and mental well-being.

The “TMS Dip” Phenomenon

Despite the incredible efficacy and safety of TMS therapy, as with any therapeutic intervention, TMS comes with its own set of unique experiences and potential challenges. One such phenomenon that some patients encounter during TMS treatment is colloquially known as the “TMS dip.” The TMS dip refers to a temporary spike in depression or anxiety symptoms that can occur around halfway through your therapy.

It can be alarming for patients who find their depressive symptoms intensifying or lingering for a brief period. Luckily, the TMS dip is only a temporary worsening of symptoms, and while not everyone undergoing TMS will encounter this phenomenon, it is essential to be aware of its possibility so that you can manage expectations and your TMS provider can provide appropriate support.

What Causes the “TMS Dip”?

The exact mechanism behind this phenomenon remains unclear. One theory suggests that as TMS stimulates specific brain regions, it may initially disrupt existing neural pathways, causing a temporary exacerbation of depressive symptoms before positive changes take hold. Another possibility is that individual differences in brain chemistry and responsiveness to TMS could play a role in the occurrence of the TMS dip. The TMS dip does not mean your condition is getting worse, nor does it predict whether TMS treatment will ultimately be effective for you. However, remember to always communicate openly and honestly with your provider throughout the entire process so that they can make adjustments as necessary.

Managing Symptoms During the “TMS Dip”

If you’re currently experiencing a ‘dip’, don’t lose hope. While a temporary worsening of depression symptoms can be disheartening, it is crucial for patients to remember that the TMS dip is a researched part of the treatment process. It’s usually just part of the journey and can be seen as a signpost indicating progress rather than regression. Here are some strategies for managing symptoms during this phase:

  • Maintain open communication: Always keep your healthcare provider informed about any changes experienced during TMS treatments, including heightened anxiety, depression, or other similar conditions at certain stages.
  • Sustain self-care practices: Regular exercise, balanced nutrition, and adequate sleep all contribute significantly towards effective management while undergoing transcranial magnetic stimulation therapy sessions.
  • Patient support groups: Connecting with others who have been down similar paths provides reassurance along with practical advice for coping with temporary side effects encountered during ‘the dip’.

Navigating ‘the TMS dip’ can be frustrating and disheartening, but understanding that it’s a normal part of the process, alongside having effective coping mechanisms makes handling this stage much easier.

Other Than the TMS Dip, When Can TMS Potentially Worsen Symptoms?

Overall, TMS therapy is not known to worsen symptoms, and many individuals experience significant improvements in their mental health conditions following treatment. However, there are certain mental health disorders where the application of TMS is underresearched. Although these cases have not been shown to make symptoms worse, they have also not been proven to effectively relieve symptoms.

Effects of TMS on Schizophrenia Patients

TMS has an uncertain effect on those with schizophrenia, making it a challenging case to study. Clinical studies have produced mixed results.

This inconsistency suggests more research needs to be conducted before we can fully understand how TMS affects individuals with schizophrenia.

Learn More About TMS Therapy

Transcranial magnetic stimulation has shown significant promise as a non-invasive and effective treatment for depression. While it is generally well-tolerated and safe, as with any novel treatment or medication, there is a need for careful monitoring during and after treatment to minimize risk. Ongoing research and advancements in this field will continue to shed light on the underlying mechanisms of TMS, helping to refine the treatment protocols.

Patients considering TMS should feel encouraged to reach out to Neuro Wellness Spa with any questions they have. The psychiatrists and other mental health professionals at Neuro Wellness Spa can help you determine if TMS treatment is right for you.

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