Anxiety disorders are the most prevalent mental health conditions in the United States, affecting around 40 million adults annually 1. Despite the availability of various treatment options for anxiety such as medication and therapy, many people fail to find relief. However, transcranial magnetic stimulation (TMS) therapy is a care approach that offers promising results at treating anxiety, especially for those who have not found success with first-line interventions.
Initially approved by the FDA for the treatment of major depressive disorder (MDD), TMS therapy has been indicated as an off-label treatment for various anxiety disorders. Understanding TMS therapy and its beyond-label application for alleviating symptoms of anxiety can help you prepare for treatment and assess if this approach is right for you.
What Is TMS Therapy?
TMS therapy is a non-invasive, medication-free treatment that works by using magnetic pulses to gently stimulate nerve cells in the brain that may be underactive in those struggling with anxiety. It does not require surgery, IVs, or any other intrusive medical modality. Additionally, it does not come with any systematic side effects such as weight gain or sexual dysfunction, which are commonly associated with many types of anxiety medications like selective serotonin reuptake inhibitors (SSRIs) or anxiolytics. TMS is administered on an outpatient basis, with each patient typically undergoing 20 to 30 sessions, each lasting about 20 minutes.
What Is Anxiety? Understanding the Anxiety Spectrum
At its core, anxiety is a survival mechanism — it’s the body’s way of alerting us to potential danger. When we feel anxious, our bodies release stress hormones like cortisol and adrenaline, which can be helpful when we’re facing a physical threat.
However, when anxiety becomes chronic or excessive, it can lead to a range of negative psychological and physical symptoms, such as irritability, difficulty concentrating, restlessness, and trouble sleeping. In severe cases, anxiety can also lead to panic attacks, which are characterized by intense feelings of fear and physical symptoms like chest pain, shortness of breath, and dizziness.
Situational anxiety vs. anxiety disorders
Anxiety can be triggered by a variety of factors, including stress, trauma, genetics, and environmental factors. For some people, anxiety may persist for years as a chronic condition, while for others, it may be more episodic, occurring in response to specific stressors or life events. While anxiety is a normal stress response, persistent and disproportionate fear, worry, or dread that impairs daily functioning may indicate a clinical anxiety disorder.
Common types of anxiety disorders
Several types of anxiety disorders can be effectively treated with TMS therapy, including:
- Generalized anxiety disorder (GAD): Characterized by persistent, excessive worry about various life situations that’s difficult to control. This ongoing anxiety interferes with daily functioning and typically must persist for at least six months for a GAD diagnosis.
- Panic disorder: Features sudden, intense episodes of fear accompanied by physical symptoms like shortness of breath, shaking, and sweating. Though panic attacks are typically brief, their unpredictability can significantly disrupt daily life.
- Phobias: Common types include agoraphobia (fear of situations where escape might not be readily available) social anxiety disorder (SAD; fear of judgment in social situations) and specific phobias (intense fears of particular objects or situations). These disorders involve overwhelming fears that lead to avoidance behaviors.
- Comorbid anxiety and depression: Occurs when anxiety and depressive disorders present simultaneously — approximately 60% of people with anxiety also experience symptoms of depression 2. TMS is FDA-approved for depression treatment and has shown to be approximately 75% effective at achieving remission in two-month follow-up studies of patients who completed a full TMS treatment course 3.
Regardless of your anxiety disorder diagnosis, seeking prompt treatment is essential for developing emotional resilience and comfortably navigating day-to-day life. Effectively managing anxiety symptoms can be life-changing.
Treatment-resistant anxiety disorder
Not all anxiety disorders respond adequately to treatment. Some people will go to anxiety therapy or take prescribed anxiety medication but show little symptom improvement. When anxiety continues to be unmanaged and interferes with daily functioning despite at least one first-line treatment, it is known as treatment-resistant anxiety.
This is where TMS therapy can be particularly effective. Just as TMS therapy shows promise at treating treatment-resistant depression (TRD), it can also provide hope for those who struggle with anxiety that have found unsatisfactory results with medication or therapy 4.
How TMS Therapy Can Treat Anxiety Disorders
Our brain is like an electrical organ that operates via electric signals with the help of chemicals called neurotransmitters. Any imbalance in the level of neurotransmitters can cause mental illnesses, like an anxiety disorder. TMS therapy uses magnets that produce magnetic pulses to stimulate areas with underactive neurotransmitters and rebalance the brain, which can improve mood, sleep, and energy levels.
Early clinical research on TMS focused solely on MDD, and as such, the 2008 FDA indication was limited to this one application. However, in the years since, hundreds of studies have demonstrated TMS therapy’s efficacy in treating a broad range of psychiatric disorders, including GAD and anxious depression.
Can TMS make anxiety worse?
Starting a new treatment can naturally stir up anxiety — especially when you’re unsure how your body or mind will respond. This is even more true for those who have already tried multiple anxiety treatments without success and are turning to TMS as a last resort for relief.
That’s why the environment where you receive TMS matters so much. A calm, welcoming space with caring, well-trained technicians can make all the difference. TMS providers often ease nerves by explaining each step of the process, helping you recognize rare side effects, and playing soothing music or TV during sessions. They’re there to help you feel at ease, remind you that any anxiety about treatment is temporary, and support you on a path that can lead to lasting, meaningful recovery.
The TMS dip
The TMS dip is recognized as a temporary worsening of anxiety following the first few days or weeks after the start of treatment. When you notice anxiety worsening, it can cause negative thought patterns and a hyperfocus on symptom severity, which can fuel a self-perpetuating cycle of worry and skepticism.
However, this dip is considered a natural but fairly uncommon reaction to starting TMS sessions, and is almost always short-lived. Furthermore, the side effects of TMS are mild, safe, and temporary, typically subsiding as people progress through the course.
Considerations for TMS for anxiety disorders
When you’re considering TMS treatment, it’s always important to assess your treatment history, symptom severity, comorbidities with other mental disorders, and medical history like seizures, metal implants, traumatic brain injury, or pregnancy. Although TMS can be used while pregnant, it’s always important to discuss trying out a new procedure with your doctor and mental health professionals.
You’ll typically undergo 20 to 30 sessions over the course of four to six weeks, and some insurance providers may only cover TMS treatment if you provide documentation of multiple failed medication trials. However, at Neuro Wellness Spa, we work with most major insurance providers to help cover the cost of TMS therapy.
Integrating TMS therapy into comprehensive anxiety treatment plans
Therapy for anxiety, medications, and TMS may work well independently, but the most effective treatment plans will integrate several forms of care for the best results. TMS therapy combined with medication can be a safe and effective approach, and therapy offers an extended period of time to discuss potential side effects and efficacy.
Additionally, certain therapies such as cognitive behavioral therapy (CBT) can teach valuable coping skills to manage day-to-day anxiety and improve emotional regulation, which may be useful if you’re stressed during TMS sessions. When psychiatrists, therapists, and TMS technicians are all collaborating to help you achieve a common mental health goal, you give yourself the best chance at finding relief.
How Effective Is TMS for Anxiety Disorders?
While TMS is FDA-approved for depression treatment, it remains an excellent intervention for anxiety disorders with growing research supporting its effectiveness. One preliminary study showed that 80% of respondents struggling with GAD and occupational stress responded positively to treatment, and 33% achieved full remission after completing a TMS course 4. However, much like studies done on those with TRD, maintenance sessions of TMS may be required for sustained results.
Can TMS help with situational anxiety without a diagnosis?
You don’t have to be diagnosed with an anxiety disorder to benefit from the mood-enhancing effects of TMS therapy. Additionally, symptoms that you may self-diagnose as situational anxiety could potentially meet the criteria for a clinical anxiety disorder requiring professional treatment. With few side effects and minimal risks, TMS therapy can be a safe and effective approach for anyone looking for a life with increased emotional resilience and reduced reactivity to stress triggers. However, consulting with a trusted TMS provider is essential to understand costs and if brain stimulation is right for you.
How Neuro Wellness Spa Can Treat Anxiety With TMS Therapy
At Neuro Wellness Spa, our care team of qualified mental health professionals and TMS technicians can assess whether TMS therapy is an appropriate treatment option, as well as offering complimentary approaches like talk therapy and medication management. They’ll work with you to create a personalized anxiety care plan that provides the best chance at effective results, which may include several treatments used in tandem.
You don’t have to let anxiety continue to rule your life — we offer several evidence-based treatments that can help you manage your symptoms and put you on the path to healing. Reach out to Neuro Wellness Spa today to better manage your anxiety symptoms and take back control of your life.
References
- National Alliance on Mental Illness. (2025, January 3). Anxiety Disorders | NAMI. NAMI. https://www.nami.org/about-mental-illness/mental-health-conditions/anxiety-disorders/
- Nami, & Nami. (2025, April 8). The comorbidity of anxiety and depression. NAMI. https://www.nami.org/education/the-comorbidity-of-anxiety-and-depression/
- Mantovani, A., Pavlicova, M., Avery, D., Nahas, Z., McDonald, W. M., Wajdik, C. D., Holtzheimer, P. E., George, M. S., Sackeim, H. A., & Lisanby, S. H. (2012). LONG-TERM EFFICACY OF REPEATED DAILY PREFRONTAL TRANSCRANIAL MAGNETIC STIMULATION (TMS) IN TREATMNT-RESISTANT DEPRESSION. Depression and Anxiety, 29(10), 883–890. https://doi.org/10.1002/da.21967
- Diefenbach, G. J., Bragdon, L. B., Zertuche, L., Hyatt, C. J., Hallion, L. S., Tolin, D. F., Goethe, J. W., & Assaf, M. (2016). Repetitive transcranial magnetic stimulation for generalised anxiety disorder: A pilot randomised, double-blind, sham-controlled trial. The British Journal of Psychiatry, 209(3), 222–228. https://doi.org/10.1192/bjp.bp.115.168203