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By Dr. David Woo - May 16, 2023
Published on May 16, 2023. Updated on January 17, 2024
If you’re researching TMS, you may occasionally see discussions online where people write about how TMS made them worse or report that “TMS ruined my life.” TMS has a high success rate in treating people with depression who do not find relief with antidepressants with few to no side effects, but it’s true that TMS will not work for everyone and that some people may have a negative experience with it.
However, negative experiences with TMS are rare, and it’s important to remember that the fact that someone else had a negative experience doesn’t mean that your experience with TMS will be negative. I’d like to address why someone might have negative feelings toward TMS and why you shouldn’t worry when it comes to considering TMS treatment.
What Is TMS Therapy?
TMS stands for transcranial magnetic stimulation. It is a non-invasive therapy that is FDA-approved for the treatment of depression as well as obsessive-compulsive disorder (OCD) in individuals for whom medications have proven unsatisfactory.
TMS therapy involves the application of tiny magnetic pulses through the scalp using a helmet-like device called a coil. It can be targeted to specific areas of the brain, such as the prefrontal cortex or amygdala (the areas of our brain associated with emotions), in order to stimulate the appropriate neurotransmitters that alleviate the symptoms of mood disorders like depression.
Can TMS Make Depression Worse?
While TMS has demonstrated positive outcomes for many individuals with depression, there are cases where the treatment may not be as effective. Factors such as the severity of depression, individual response to the treatment, and underlying physiological conditions can influence its success. In response, new TMS techniques such as theta burst stimulation or deep TMS, also available at Madison Avenue TMS & Therapy, have been developed to treat individuals for whom standard TMS was ineffective (1). However, there is no evidence to suggest that TMS can make depression worse in individuals whose conditions were correctly diagnosed.
Can TMS Make Anxiety Worse?
TMS is primarily recognized for its application in treating depression. However, research on TMS for anxiety is ongoing (2). Although results so far are promising, individual responses may vary.
Understanding TMS Reviews
Whether you are considering TMS for depression, anxiety, or another mood disorder, it is only natural to look at online reviews of TMS therapy and read other people’s experiences. Below, we outline some common reasons why someone might report a less-than-satisfactory experience with TMS. In all cases, remember that individual experiences are not necessarily reflective of the majority or directly applicable to everybody. It is crucial for individuals with mental health concerns to consult with mental health professionals to explore suitable treatment options tailored to their specific needs.
Some People Experience A “Dip” During TMS Treatment
Most patients go through TMS treatment with little to no side effects. However, there are some patients who experience a TMS “dip” about halfway through treatment. During a dip, a patient may experience a temporary worsening of depression or anxiety symptoms. In our clinic, roughly 20% of our patients experience a temporary dip around week two or three of treatment.
The TMS dip could be the result of the changes that occur in the brain after TMS. TMS uses magnetic pulses to electrically stimulate underactive neurons (brain cells). When underactive neurons are stimulated, they begin to release more neurotransmitters than before (chemical messengers in the brain). This can affect the way that neurons connect and communicate with each other, essentially causing a “reset.” Learn more about what happens in the brain after TMS, here. Patients generally begin to feel better from the TMS dip three to four weeks later.
TMS isn’t the only depression treatment that can cause a dip. For example, patients taking antidepressants may also feel a dip at the beginning of treatment. At first, patients may notice a worsening of their symptoms and may experience unpleasant side effects before feeling better. Antidepressants take time to work and for patients to get the full benefits. For this reason, doctors encourage patients to stick with an antidepressant for 6 to 8 weeks before deciding if it’s not working.
If you’re experiencing a dip in your symptoms while being treated for depression, talk to your doctor. It’s important to continue treatment, even if you experience a dip. Your doctor can help you manage symptoms during a dip.
Some People May Require a Second Round Of TMS Or TMS + Another Treatment
Everyone responds to different depression treatments differently. Depression treatment often involves a long-term plan that involves trying different treatments and finding what works best for that person. People with difficult-to-treat depression may not respond to antidepressants, and it can be a challenge to find the right treatment. Some patients may require a second round of TMS, maintenance sessions, or TMS combined with another treatment option, like an antidepressant.
Some People May Need to Confirm Their Diagnosis
While it’s not common, it’s possible for someone who has bipolar disorder to be diagnosed with depression. TMS is not an approved treatment option for bipolar disorder and may make bipolar symptoms worse (3). If you’ve ever experienced symptoms of mania or hypomania, or if you have a family member who has experienced these symptoms or who has been diagnosed with bipolar disorder, it would be advisable that you get a second opinion.
“TMS Cost Me My Marriage”: Relationships And Therapy
In some instances, individuals undergoing TMS therapy have reported challenges in their personal relationships. It’s essential to recognize that the impact of mental health treatments—not just TMS—on relationships can vary greatly from person to person. Changes in mood, energy levels, and overall well-being during and after treatment may affect the dynamics of a relationship. Open communication, education, and involvement of partners in the treatment process can contribute to a more supportive environment.
The Bottom Line: TMS is Proven to Be Safe and Effective in Treating Depression
Studies show by and large that TMS is extremely safe and highly effective when used correctly and when the patient is diagnosed correctly with a disorder that TMS is known to treat, like depression (4).
Additionally, patients meet regularly with their psychiatrist during and after TMS treatment. During this time, your doctor will ask how you are handling treatment and will make adjustments if needed.
While some people may have a negative experience with TMS and may say that “TMS ruined my life,” we don’t recommend that patients make their decisions based on what happened to a few people. Based on the results from numerous real-world clinical studies, chances are that TMS will work for you.
Ready to take the next step towards a brighter, healthier mind? Our team at Madison Avenue TMS & Psychiatry is dedicated to providing compassionate, innovative care. With TMS therapy, many have found a path to improved well-being and relief from depression symptoms. Don’t let another day pass in the shadows. Click here to schedule your consultation or call (212) 731-2033 to start your journey to recovery today. Your mind deserves the best care, and we’re here to provide it. Take action now and rediscover your joy!
Resources:
- Cheng, CM., Li, CT., Tsai, SJ. Current Updates on Newer Forms of Transcranial Magnetic Stimulation in Major Depression. In: Kim, YK. (eds) Major Depressive Disorder. Advances in Experimental Medicine and Biology, vol 1305. Springer, Singapore. 2021. Link. Accessed Jan 03, 2024.
- Trevizol, A. P., Downar, J., Vila-Rodriguez, F., Konstantinou, G., Daskalakis, Z. J., & Blumberger, D. M. Effect of repetitive transcranial magnetic stimulation on anxiety symptoms in patients with major depression: An analysis from the THREE-D trial. Depression and Anxiety. 2021;38(3), 262-271. Link. Accessed Jan 03, 2024.
- Hyde, J., Carr, H., Kelley, N., Seneviratne, R., Reed, C., Parlatini, V., et al. Efficacy of neurostimulation across mental disorders: systematic review and meta-analysis of 208 randomized controlled trials. Mol Psychiatry. 2022;27:2709–19. Link. Accessed January 03, 2024.
- Tendler, A., Goerigk, S., Zibman, S., Ouaknine, S., Harmelech, T., Pell, G., Zangen, A., Harvey, S., Grammer, G., Stehberg, J., Adefolarin, O., Muir, O., MacMillan, C., Ghelber, D., Duffy, W., Mania, I., Faruqui, Z., Munasif, Fi., Antin, T., Padberg, F., Roth, Y. Deep TMS H1 Coil treatment for depression: Results from a large post marketing data analysis. Psychiatry Research. 2023;324. Link. Accessed January 03, 2024.
Dr. David Woo is the owner and head clinical psychiatrist at Madison Avenue TMS and Therapy in New York City. Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.
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