Can TMS Make Depression Worse? TMS and its Effects on Depression

If you are considering treatment for depression, then chances are that you have heard about TMS or transcranial magnetic stimulation. It is a non-invasive procedure that uses electromagnetic pulses to stimulate the nerve cells in the brain’s prefrontal cortex, which is responsible for mood regulation. However, there has been some concern about whether TMS can actually make depression worse.
In this blog, we will explore the effects of TMS on depression and address this common concern. Before we dive into that, let’s first understand what exactly TMS is and how it works.

What is TMS?

TMS was first approved by the FDA in 2008 for the treatment of depression. It involves placing a magnetic coil on the scalp and delivering electromagnetic pulses to certain areas of the brain. These pulses are similar to those used in an MRI machine but at a much lower intensity. The goal is to stimulate nerve cells in the prefrontal cortex, which can improve mood and alleviate symptoms of depression.
According to the Brain & Behavior Research Foundation, TMS has been shown to be effective in treating depression, with remission rates ranging from 30-40%. It is often used as a last resort for individuals who have not responded well to other forms of treatment, such as medication or therapy.

Non-Invasive and Safe

One of the major advantages of TMS is that it is non-invasive and does not require anesthesia or sedation. This means that it can be performed in an outpatient setting, with no need for hospitalization. It also has minimal side effects, which typically include mild headaches or scalp discomfort during treatment. These side effects usually subside after the first few sessions.
Now, let’s address the main concern – can TMS make depression worse? The short answer is no.

Can TMS Make Depression Worse?

There is no evidence to suggest that TMS can make depression worse in individuals who are receiving treatment for it. In fact, several studies have shown that TMS has a positive effect on reducing symptoms of depression and improving overall mood.

However, it is important to note that TMS may not be suitable for everyone. Individuals who have a history of seizures or certain medical conditions, such as metal implants in the head or neck area, may not be candidates for TMS. It is crucial to consult with a qualified healthcare provider before undergoing TMS treatment to determine if it is the right choice for you.

Following are some common concerns that may have prompted the question – can TMS make depression worse:

Temporary Increase in Symptoms: Some individuals may experience a temporary increase in symptoms during the initial stages of treatment. This is known as “treatment-emergent worsening” and typically resolves within the first week or two of treatment. It is important to communicate any changes or concerns with your healthcare provider, who can adjust the treatment accordingly.

Inadequate Treatment: If TMS is not administered correctly or at an appropriate dose, it may not be effective in improving depression symptoms. This could lead to a perception that TMS has made the condition worse. It is crucial to receive TMS from a qualified and experienced healthcare provider who can monitor progress and make adjustments as needed.

Underlying Conditions: Depression is often accompanied by other mental health conditions, such as anxiety or substance abuse. TMS may not be effective in treating these co-occurring conditions, leading to a perception that the treatment has made depression worse. It is important for individuals to undergo a thorough evaluation and have a comprehensive treatment plan that addresses all underlying conditions.

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What Causes TMS to be Ineffective?

As mentioned earlier, TMS may not be effective in treating depression if it is not administered correctly or at an appropriate dose. This can happen due to various reasons, such as inexperienced providers, incorrect targeting of brain areas, or inadequate number of treatment sessions. It is important for individuals to do their research and choose a reputable healthcare provider who has experience and expertise in administering TMS.
According to a study published in the Journal of Affective Disorders, TMS was found to be more effective when a higher number of treatment sessions were administered. This highlights the importance of following the recommended treatment protocol and not giving up too soon if results are not seen immediately.

TMS Dip and Recovery

Another factor that may lead to the perception of TMS making depression worse is the “dip and recovery” phenomenon. This refers to a temporary worsening of symptoms during treatment, followed by improvement in mood and overall well-being. While this dip can be worrying for some individuals, it is actually a sign that the treatment is working and should not cause concern.
With TMS, it is important to have realistic expectations and understand that improvement takes time. It is not a quick fix but rather a gradual process that requires patience and persistence.


TMS has been shown to be an effective treatment for depression with minimal side effects. There is no evidence to suggest that TMS can make depression worse in individuals who are receiving proper treatment. It is important to consult with a qualified healthcare provider and have realistic expectations before undergoing TMS treatment. With the right approach and proper monitoring, TMS can significantly improve symptoms of depression and lead to a better quality of life.


For more information and guidance related to Mental and Behavioral Health, get in touch with our specialized Adult Mental Health Expert!
Dr. Lubna Siddiki MD
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Dr. Lubna Siddiki MD
Dr. Lubna Siddiki is a board-certified Adult Psychiatrist. She specializes in treating adults struggling with various mental health disorders, including depression, anxiety, bipolar disorder, and more. Dr. Siddiki believes in a holistic approach to mental health treatment and works closely with her patients to develop personalized treatment plans that focus on their overall well-being. She is dedicated to helping individuals improve their behavioral health and lead fulfilling lives.