Transcranial magnetic stimulation (TMS) is a non-invasive treatment that helps people struggling with conditions like depression and anxiety. While many patients see positive results, it’s common for some to go through a temporary phase known as TMS dip, meaning symptoms feel worse before they improve.
We’ll break down how to prepare for TMS dip and what to expect during this period, so you’ll feel more equipped and confident as you go through treatment.
TMS dip is a temporary phase during transcranial magnetic stimulation therapy where symptoms feel worse before they start to improve. While TMS helps many people, some may experience this initial setback, which can feel frustrating or discouraging. The good news is that TMS dip is a normal part of the process for some and typically means the brain is adjusting to treatment.
The brain’s response to TMS varies from person to person due to things like treatment protocols, individual neurobiology, and concurrent therapies (e.g., medication). TMS therapy works by stimulating areas of the brain to encourage positive changes in neural activity. During this process, TMS temporarily disrupts the brain’s usual communication patterns. To understand why this happens, here’s what’s going on in the brain during a treatment session:
Essentially, the brain needs time to adapt to these changes. Over time, the brain will form healthier communication patterns that support long-term improvement.
TMS dip can start after the first few sessions and often lasts a few weeks. This phase ends as the brain adjusts to the therapy. For some patients, symptom improvement may be delayed, even after a standard 36-session treatment course. Research shows that extending treatment may help those who respond more slowly to the therapy.
During the TMS dip, some people may notice an increase in their depression symptoms. Symptoms may include:
In addition to depression-related symptoms, some individuals may also experience a temporary increase in anxiety. This is because many TMS protocols for anxiety are adapted from those intended for depression. Furthermore, stimulation that targets the frontal cortex can occasionally feel unpleasant or mildly painful, thus intensifying feelings of restlessness, worry, or unease. While distressing, these symptoms may subside as treatment continues; however, it’s important that you stay in communication with your doctor as they monitor your response to the therapy.
It’s also important to distinguish the difference between TMS dip symptoms and other potential side effects of the therapy, so that you have a better understanding of what you’re experiencing. Most TMS side effects are mild and go away on their own after a session. They include:
Serious side effects are very uncommon but can happen in rare cases. These can include:
While not everyone will experience a TMS dip, it’s a good idea to be prepared in case it does happen. Being proactive will ensure that the dip is manageable and will keep you on track toward long-term improvement and benefits. Here are some strategies to consider.
Your doctor is your most important ally during TMS therapy, and talking openly with them is one of the best ways to prepare. If you’re feeling nervous or have concerns about what to expect, bring those up preferably before treatment begins.
Once you start your treatment, keep track of how you’re feeling. If your symptoms change, let your doctor know. This could mean:
Sharing these updates with your doctor allows them to adjust your treatment plan if needed so that you can get the most benefits out of TMS.
Like with any mental health intervention, TMS can be a rollercoaster journey with ups and downs that feel impossible to handle. Taking care of yourself throughout treatment will allow you to better manage these unexpected hurdles. Include activities that help you relax and recharge, such as:
Make sure you’re getting enough sleep by sticking to a consistent bedtime. A well-rested brain will adjust to treatment more easily. Eating balanced meals, with plenty of fruits, vegetables, and whole grains, can also give your body the energy it needs to heal.
Going through TMS therapy can feel stressful at times, but having someone to lean on when you need it most can make it easier to manage. Start by reaching out to people you trust, like close friends or family members. Share what you’re going through and let them know how they can help, whether that’s:
You could also connect with others who have gone or are going through transcranial magnetic stimulation therapy by joining a TMS support group. It might be scary to reach out for help, but having a support system can truly have a positive impact on your well-being as you go through treatment.
It’s easy to hope for immediate results, but remember that TMS therapy is a gradual process. Some days might feel like a step forward, while others might feel like a step back. This is normal, and keeping realistic expectations can help you stay positive throughout your treatment.
Focus on long-term benefits rather than looking for quick fixes. Celebrate small milestones along the way, such as:
Experiencing a TMS dip doesn’t necessarily mean the treatment isn’t working or that your depression is untreatable. Instead, it’s a sign that your brain is in the process of rewiring itself, which can take time and patience.
One study found a connection between two weeks of TMS treatment and noticeable improvements in depression symptoms. While some patients might feel better during the course of treatment, others may not see progress until the therapy is complete. Either way, sticking with the full treatment plan gives your brain the time it needs to adjust.
While everyone responds to treatment differently, there are some common signs that TMS is starting to work:
Keep in mind that while many people experience these benefits, TMS doesn’t work for everyone. Also, some patients may need maintenance sessions to maintain the progress they’ve made. Maintenance therapy often begins one to four weeks after the acute treatment phase. Studies suggest that having more than two sessions per month helps reduce relapse risk.
TMS therapy can be effective for treating depression and other mental health disorders, even if you experience a temporary setback like worsening symptoms at first. Knowing how to prepare for a TMS dip can help you stay on track and get the most out of your treatment.
If you’re ready to explore TMS as a treatment option, Cura Behavioral Health is here to help. Reach out today to learn how we can support you on your mental health journey.
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
