This is a question we get more often than almost any other. It’s great to read reviews from other clients and hear stories from friends or loved ones who have had good experiences with TMS treatment, but that doesn’t answer your most pressing question before you invest in a treatment like this. How can you know if TMS will work for you?The good news is, TMS is an appropriate treatment for most people. It can be unsafe if you have a history of seizures, psychosis, or metal implants in your scalp or skull, but for most prospective patients, the treatment itself is a good fit. While there is no way to guarantee or know for sure that TMS will help in any specific case, here are ten things you can do before and after treatment to improve your odds of a positive outcome.
Regular aerobic exercise has solid evidence behind it for improving depression, and it pairs well with TMS. You don't need a gym membership. A brisk 30 minute walk five days a week adds up to the 150 minutes most guidelines recommend. Exercise also helps your sleep and your energy, which supports everything else on this list.
If you're looking for TMS treatment, odds are you've tried therapy in the past and it hasn't worked, or you're currently in therapy but still aren't where you want to be. While it may be tempting to view TMS as a quick fix to bypass sitting down with a therapist, mental health treatments aren't designed to work alone. Seeing a therapist before TMS treatment can help you recognize the areas in your life that need healing or improvement, and continuing your appointments after TMS treatment can help your brain process the changes TMS is making to your brain’s pathways.
TMS usually works gradually. Most people notice changes over several weeks rather than after a single session, and some people respond more than others. Before you start, decide what "better" would look like for you. It could be sleeping through the night, getting out of bed without dread, or enjoying a meal with your family again. Then ask your provider to track your symptoms with a standard questionnaire like the PHQ-9 at the beginning of treatment and at regular points afterward. Those numbers help on the days when it feels like nothing is changing, and they show us when something is.
Treatment goes better when you aren't doing it alone. Let a partner, family member, or close friend know what you're doing, what to expect, and how they can help. That might mean a ride to an appointment, a check-in text, or someone who notices when you seem more like yourself. The people who love you often see changes before you do.
Some medications can make TMS less effective. Benzodiazepines and certain anticonvulsants are the most common examples, and other medications can affect how your brain responds or how safe treatment is for you. Bring a full list of everything you take, including supplements, to your prescriber before you begin. Please do not stop or change a medication on your own. Some can cause serious problems if they are stopped suddenly, and any adjustment should be planned with the person who prescribed it.
TMS works through repeated stimulation, and the effect builds over the course of treatment. Skipped sessions can slow that down. Whether you're on a standard schedule or an accelerated protocol like iTBS, plan your calendar so you can finish the full course on time. Arrange work, childcare, and transportation before day one so a rough morning doesn't turn into a missed appointment.
Poor sleep makes mood, concentration, and anxiety worse, and it works against what treatment is trying to do. Keep a steady bedtime and wake time throughout your course, including weekends. Eat a real meal and drink water before your sessions, and keep your caffeine about the same each day. Cutting back suddenly can cause headaches, and too much can leave you jittery and disrupt your sleep at night.
Both can interfere with your mood and your sleep, and both make it harder to tell how treatment is going. Heavy alcohol use, and withdrawal from it, can also lower your seizure threshold, which matters for TMS safety. If you drink or use cannabis regularly, tell your provider so we can plan with you. If you drink heavily every day, talk to a medical professional before stopping, since alcohol withdrawal can be dangerous.
Regular aerobic exercise has solid evidence behind it for improving depression, and it pairs well with TMS. You don't need a gym membership. A brisk 30 minute walk five days a week adds up to the 150 minutes most guidelines recommend. Exercise also helps your sleep and your energy, which supports everything else on this list.
As treatment starts to work, many people feel more capable than they have in a long time. That is a good moment to put some structure around your days. Get outside in the morning light, plan your meals, schedule something social each week, and do one thing a day that matters to you, even when you don't feel like it. Therapists call this behavioral activation. Acting first and letting motivation catch up helps turn the momentum from treatment into habits that last.
Relief from TMS can last a long time, but depression does return for some people. Before treatment ends, talk with your provider about what to watch for, such as changes in your sleep, pulling away from people, or losing interest in things you usually enjoy. Ask whether booster sessions make sense for you and how quickly you could be seen if symptoms start to come back. Catching a slip early is much easier than starting over. Keep filling out your questionnaire and keep going to therapy, too.
No list can promise a result, but these ten steps give treatment the best conditions to work. If you're wondering whether TMS is a good fit for you, reach out to our team and we'll talk it through with you.
