Transcranial Magnetic Stimulation (TMS) is a noninvasive mental health treatment that targets and stimulates regions of the brain that regulate mood, emotions, and impulse control.
TMS was FDA-approved in 2008 for depression and is considered an advanced, effective therapy for treatment-resistant cases of depression, as well as used off-label for mental health conditions such as bipolar disorder, anxiety, and substance use.
Do you struggle with chronic depression despite having tried multiple antidepressants or standard talk therapy? TMS could offer hope, read on to learn more.
How Does TMS Work?
TMS uses small magnetic pulses and vibrations to increase and balance excitability in areas such as the prefrontal cortex (PFC), anterior cingulate cortex (ACC), and other networks involved in depression and anxiety. An electromagnetic coil is placed against the scalp of your head, and the magnetic pulses stimulate these regions through nerve cells [1].
There is also “deep transcranial magnetic stimulation” or “deep TMS.” This uses different coils to stimulate deeper and wider areas of the brain. Deep TMS is FDA-approved for OCD and smoking cessation, and is typically not used for depression [1].
What Are The Side Effects of TMS
TMS typically has few side effects reported as it is a non-invasive, non-anesthetic, outpatient procedure. The most common complaint by participants is a headache, although this often resolves shortly after finishing treatment.
Those with epilepsy, traumatic brain injuries, or other neurological problems are considered high risk and are typically not eligible for TMS due to a risk of seizures.
Is TMS A First-Line Treatment for Depression?
TMS is not a first line of treatment for depression and is often used when other methods, such as antidepressant medications or cognitive behavioral therapy (CBT), have not been effective.
Rather, it is a promising therapy for Treatment-resistant depression (TRD), a type of major depressive disorder (MDD) that occurs when at least 2+ antidepressant medications have failed [2].
Medications must have been the correct dose, and the course of treatment should have been for at least 6 to 8 weeks to be considered TRD.
What Causes Treatment-Resistant Depression?
Nearly 30% of those suffering from depression in the US are affected by treatment resistance. This is thought to be caused by a combination of factors, including incorrect medication, misdiagnosis, and lack of context, such as awareness of trauma, addiction, or co-occurring conditions [2][3].
- Medication: Incorrect dosing, poor adherence, or prescribing antidepressants that don’t match the patient’s neurochemistry (e.g., SSRIs failing due to quick metabolism and enzyme variations).
- Unaddressed Co-Occurring Disorders: Ignoring substance use disorders like alcohol or opioid dependence, where addiction increases depressive symptoms and blocks medication.
- Lack of Trauma-Informed Care: Overlooking PTSD or adverse childhood experiences (ACEs), where standard treatments fail without trauma-focused approaches such as EMDR to process deep emotional wounds.
Is TMS Effective for Depression?
TMS is highly effective for treating chronic cases of depression. Research from 2022 found that 63% of patients with treatment-resistant depression were responsive to TMS with a 42% rate of improvement [4].
Patients with severe treatment-resistant depression (failed 4+ antidepressants) had around a 35% response rate and 19% remission rate. As of 2025, research continues to emerge showing its effectiveness, with some clinical trials finding it to be an effective alternative to lithium medication for mood disorders [5].
Does TMS Treat Other Mental Health Conditions Besides Depression?
Transcranial Magnetic Stimulation (TMS) is FDA-approved for Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), and smoking cessation/nicotine addiction.
Research shows that TMS can modulate neural circuits in these disorders, offering a non-invasive alternative to medications with fewer side effects.
TMS for OCD shows particular promise, with trials reporting a disruption in “cortico-striato-thalamo-cortical loops” that drive obsessions and compulsions. Many TMS clinicians also use the therapy off-label for conditions such as chronic anxiety or bipolar disorder, when standard treatments fall short.
What Can I Expect in My TMS Session?
During your TMS session, a technician places a magnetic coil over your scalp that delivers gentle magnetic pulses in brain regions that impact mood, emotions, and impulse control. The session can be noisy, like an MRI machine, but you can listen to music, talk with your technician, or close your eyes and relax (if you’re able).
Sessions typically last 20 to 40 minutes, during which you will hear clicking noises and feel tapping or vibrations on your head. A typical TMS course includes daily sessions 4 to 5 times a week over 4 to 6 weeks. Your provider monitors progress and can adjust treatment protocols as needed, tailored to your individual mental health needs.
Your First TMS Session: Brain Mapping
Your first TMS session often includes “mapping” where the TMS clinician measures your motor threshold (the minimal level of stimulation needed to cause muscle movement or twitching). This ensures the coil is placed correctly and tailored to the level that best suits your needs.
FDA-Approved TMS Therapy at Maple Mountain
If you’ve already tried conventional methods of mental health treatment with no relief, you may be eligible and covered by insurance for TMS therapy. At Maple Mountain Mental Health and Wellness, we use this innovative approach to target treatment-resistant depression, OCD, chronic anxiety, and other mental health challenges.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Contact our admissions team to learn if you are a good candidate for TMS today.
Sources
[1] Mayo Clinic. Transcranial Magnetic Stimulation.
[2] Maj, M. et al. (2023). Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions. World psychiatry: official journal of the World Psychiatric Association (WPA),
[3] Pillinger, T. (2022). Treatment resistance in psychiatry: state of the art and new directions. Molecular psychiatry, 27(1), 58–72.
[4] Uğurlu, T. et al. (2022). Efficacy of transcranial magnetic stimulation in treatment-resistant depression. Turkish journal of medical sciences, 52(4), 1344–1354.
[5] Nakajima, S. et al. (2025). Repetitive Transcranial Magnetic Stimulation as Maintenance Treatment of Depression: The MAINT-R Randomized Clinical Trial. JAMA network open, 8(6), e2515881.
