TMS 101: What to Expect from Brain Stimulation Therapy
A complete guide to TMS therapy: how it works, who it helps, what sessions feel like, and what outcomes to expect.
Clinically Reviewed: Board-Certified Psychiatrist |Next Review: December 2025
Key Takeaways
- TMS uses magnetic pulses to stimulate specific brain areas involved in mood regulation
- Most people complete 20-36 sessions over 4-6 weeks; benefits often build over time
- Common side effects are mild (scalp discomfort, headache) and usually fade
- We track progress with brief check-ins (like the PHQ-9) to measure improvement
- You can continue work, driving, and normal activities—no downtime required
What TMS Is (Plain Language)
TMS stands for Transcranial Magnetic Stimulation. It's a noninvasive treatment that uses magnetic pulses—similar to an MRI—to gently stimulate specific areas of your brain involved in mood regulation.
Think of it like a "reset button" for underactive brain regions. When you have depression, certain areas of your brain show less activity than usual. TMS helps wake up those areas, which can improve mood, energy, focus, and overall quality of life.
At Tasel Health, we use BrainsWay Deep TMS™, which is FDA-cleared for treating major depressive disorder, OCD, and anxious depression. Deep TMS uses a specialized H-Coil that reaches deeper brain structures (up to 6cm) than traditional TMS, potentially offering more comprehensive treatment.
How TMS Works
During a TMS session, you sit in a comfortable chair while a specialized coil is positioned over your head. The coil delivers brief magnetic pulses—you'll feel a tapping sensation and hear clicking sounds.
These magnetic pulses pass through your skull and stimulate nerve cells in the targeted brain region. This stimulation triggers a cascade of biological changes:
- Increases activity in underactive brain areas
- Helps balance neurotransmitters like serotonin and dopamine
- Strengthens neural connections (brain plasticity)
- May promote growth of new brain cells
The effects are cumulative—each session builds on the last. That's why TMS requires multiple sessions over several weeks rather than a single treatment.
Targets brain chemistry
Stimulates underactive areas involved in mood
Non-invasive
No surgery, anesthesia, or sedation needed
Quick sessions
20-30 minutes per session
No downtime
Return to normal activities immediately
Who TMS May Help
TMS is FDA-cleared for adults with:
- Major Depressive Disorder (MDD) - especially if you haven't responded well to at least one antidepressant
- Obsessive-Compulsive Disorder (OCD) - when symptoms interfere with daily life
- Anxious Depression - depression with significant anxiety symptoms
TMS may be a good option if:
- You've tried multiple medications without adequate relief
- Medication side effects are intolerable or concerning
- You prefer a non-medication approach
- You want to enhance the effects of current treatments
Important Safety Information
TMS may not be safe if you have:
- Metal implants in or near your head (cochlear implants, aneurysm clips, deep brain stimulators)
- Metallic ink tattoos on your scalp (not on face or neck)
- A history of seizures or epilepsy
- Certain medical devices (some heart pacemakers, medication pumps)
Tell your doctor about any metal in your body, medical devices, or health conditions. We'll conduct a thorough safety screening before starting treatment.
What to Expect: Before, During & After
Before Your First Session
- Complete a safety screening and medical history review
- Remove earrings, hairpins, or other metal objects near your head
- Bring a list of current medications and supplements
- Wear comfortable clothing (you'll be sitting for 20-30 minutes)
- You can eat, drive, and follow your normal routine beforehand
During Treatment
- Sit in a comfortable reclining chair
- The TMS coil is positioned carefully over your head
- You'll wear earplugs to muffle the clicking sound
- Feel a tapping sensation on your scalp (not painful)
- Stay awake and alert—you can listen to music or watch TV
- Sessions last 20-30 minutes for most protocols
After Treatment
- Resume normal activities immediately—drive, work, exercise
- Some people have mild scalp tenderness or a light headache
- Over-the-counter pain relievers can help if needed
- Side effects typically lessen after the first week
Treatment Schedule & Timeline
A typical TMS course includes:
- Acute Phase: 20-36 sessions over 4-6 weeks, usually 5 days per week
- Each Session: 20-30 minutes (Deep TMS for depression is typically 20 minutes)
- Maintenance (if needed): Some people benefit from occasional booster sessions
When to expect results:
- Weeks 1-2: Getting adjusted; side effects may occur but typically lessen
- Weeks 2-3: Some people begin noticing subtle improvements
- Weeks 3-4: More people report mood improvements and increased energy
- Weeks 4-6: Benefits continue building; full response often seen by end of treatment
Outcomes & Success Rates
Clinical research on BrainsWay Deep TMS™ for depression shows:
Significant symptom improvement
Minimal or no symptoms
Typical treatment course
Response means a significant reduction in symptoms (typically 50% or more improvement on depression rating scales). Remission means symptoms have largely resolved.
Individual results vary. Success rates are based on clinical trial data and real-world outcomes. Your response depends on factors like symptom severity, treatment adherence, and individual brain chemistry.
How We Track Your Progress
We use measurement-based care to objectively track your improvement:
- PHQ-9: Brief depression screening (9 questions, takes 2 minutes)
- GAD-7: Anxiety assessment if you have significant anxiety
- Weekly check-ins: You'll complete brief questionnaires so we can monitor trends
- Collaborative review: We'll discuss your scores together and adjust the plan if needed
These tools help us see what's working and make data-driven decisions about your care.
Safety & Side Effects
TMS has an excellent safety profile. It's been used for millions of treatments worldwide.
Common Side Effects (generally mild)
- Scalp discomfort or tingling during or after treatment (most common; usually fades after first week)
- Mild headache after sessions (can take over-the-counter pain relief)
- Facial twitching during pulses (temporary; adjusting coil position can help)
- Lightheadedness (rare; usually related to sitting for extended periods)
Rare but Serious Risks
- Seizure: Extremely rare (less than 0.1% risk). We screen for seizure risk factors beforehand.
- Hearing changes: Very rare if you wear earplugs as instructed.
- Mania: Rare; we monitor for mood elevation, especially in bipolar disorder.
Call your doctor if you experience:
- Severe or worsening headaches
- Unusual mood changes or agitation
- Twitching that doesn't stop after treatment
- Hearing changes or ringing in ears
- Any other concerning symptoms
Insurance & Costs
Many major insurance plans cover TMS for treatment-resistant depression, including:
- UnitedHealthcare
- Blue Cross Blue Shield
- Aetna
- Cigna
- Medicare (with documentation requirements)
Prior authorization: Most insurance plans require documentation that you've tried and not fully responded to antidepressant medications. Our team will handle the authorization process for you.
Self-pay options: If insurance doesn't cover TMS or you prefer to pay out-of-pocket, we offer transparent pricing and payment plans. Contact our billing team at (405) 934-1681 to discuss options.
Learn more about insurance coverage and payment options.
Frequently Asked Questions
Will TMS hurt?
Most people describe TMS as feeling like light tapping on the scalp. It's not painful, though some experience mild scalp discomfort during the first few sessions that typically lessens as your body adjusts.
Can I keep working during TMS treatment?
Yes! TMS is an outpatient procedure with no downtime. Most people continue working, driving, and maintaining their normal routines throughout treatment.
How long until I feel better?
Everyone's timeline is different. Some people notice improvements within 2-3 weeks, while others see gradual changes over 4-6 weeks. Full benefits often become more apparent after completing the full course of treatment.
Is TMS covered by insurance?
Many insurance plans cover TMS therapy for treatment-resistant depression. Our team will help verify your benefits and handle prior authorization requirements.
What if I'm on medication?
You can continue most medications during TMS. In fact, TMS often works well alongside medication management. Your psychiatrist will coordinate both treatments.
Are there any side effects?
The most common side effects are mild headache and scalp discomfort during or after sessions, which typically resolve quickly. Serious side effects like seizures are extremely rare (less than 0.1%).
What happens after I complete treatment?
We'll monitor your progress and create a maintenance plan. Some people benefit from occasional 'booster' sessions to maintain improvements, while others find one course sufficient.
Can TMS help if I haven't tried medications?
TMS is FDA-cleared for people who haven't responded well to at least one antidepressant. It's not typically a first-line treatment, but your doctor can discuss whether it's appropriate for your situation.
How is Deep TMS different from regular TMS?
BrainsWay Deep TMS™ uses an H-Coil that reaches deeper brain structures (up to 6cm) compared to traditional figure-8 coils (1.5-2cm). This allows treatment of a broader range of conditions.
What should I avoid during TMS?
Avoid wearing anything with metal near your head (earrings, hairpins). Tell your doctor about any metal implants, medical devices, or history of seizures. Alcohol and recreational drugs should be avoided as they can affect results.
In a Crisis?
If you're in immediate danger or thinking about hurting yourself, please get help right away:
- Call 911for emergency services
- Call or Text 988Suicide & Crisis Lifeline (24/7, free, confidential)
- Text HELLO to 741741Crisis Text Line
Plain-Language References
- 1. FDA Clearance: FDA permits marketing of transcranial magnetic stimulation for OCD
- 2. BrainsWay Clinical Data: BrainsWay Knowledge Center - Clinical Studies
- 3. Success rates based on: Levkovitz Y, et al. (2015). "Efficacy and safety of deep transcranial magnetic stimulation for major depression." World Psychiatry.
- 4. Safety data: Rossi S, et al. (2021). "Safety and recommendations for TMS use in healthy subjects and patient populations." Clinical Neurophysiology.