What to Expect During TMS Treatment
TMS (Transcranial Magnetic Stimulation) is a non-invasive treatment designed to help retrain neural pathways in the brain associated with mood, focus, and emotional regulation. The goal of TMS is to stimulate underactive areas of the brain, supporting long-term relief from depression and other mental health conditions without medication or sedation. Each session is quick, targeted, and personalized to your needs.
A Look Inside Your TMS Session
- Getting started: When you arrive, you’ll be welcomed into a private treatment room where you’ll get comfortable in a reclining chair. Your provider will review your treatment plan and answer any last-minute questions.
- Customizing your session: At your first session, we perform a motor threshold mapping to find the exact location and intensity needed for your unique brain. This ensures your treatment is both effective and comfortable.
- During treatment: You’ll remain seated while the magnetic coil is placed gently against your scalp. You can relax, listen to music, or simply sit quietly. No specific focus or effort is required on your part—TMS works passively while you're awake and alert.
- After the session: There are no lasting physical or cognitive effects immediately afterward. Most people feel completely fine and can drive themselves home or return to normal activities right away.
TMS Equipment
The TMS device includes a cushioned headrest and a magnetic coil shaped like a figure-eight, positioned next to your scalp. It delivers focused magnetic pulses to specific brain regions. Nothing is inserted into the body, and the setup is entirely external and non-invasive. The coil is adjusted and secured in place for each session to ensure precise and consistent stimulation.
What Does TMS Feel Like?
TMS feels like a light tapping on your scalp—many compare it to a woodpecker rhythm or someone tapping their finger quickly on your head. This sensation comes from the magnetic coil delivering rapid pulses. While it can feel odd at first, most people adjust quickly, and we always fine-tune the intensity to keep you comfortable.
If not delivered thoughtfully, the tapping can be uncomfortable, similar to a rubber band snap—but we take care to make sure your treatment is both effective and gentle. You control the intensity, and we work with you each step of the way.
The most common feedback we hear? It feels surprisingly ordinary. There are no changes to your thoughts or emotions during the session—just a quiet moment for your brain to get what it needs.
TMS Session Frequently Asked Questions
TMS has been approved by the FDA for treatment of resistant depression since October 2008 (situations where multiple medication and therapeutic failures to effectively manage depressive symptoms).
The interest in magnetic fields started in the mid 1980s as evidence began showing they possessed potential therapeutic value. The first controlled trials in North America started in 1999 and since then many subsequent trials and clinical experiences have further elucidated the therapeutic value of using Transcranial Magnetic Stimulation as a tool in the treatment of depression. In December 2010 the American Psychiatric Association guidelines in the treatment of depression were modified to include TMS as an appropriate treatment to consider after failing at least one adequate trial of antidepressants, (although some insurance companies require at least 4 failed medication/therapeutic trials).
The accelerated TMS protocol refers to multiple sessions that are given on the same day (rather than 1 session per day). This protocol can be used for clinical presentations outside of a diagnosis of depression.
Between each session, there is a rest period of approximately 50 min.
The Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT) protocol is the fastest treatment time approved by the FDA. It has been found that SAINT significantly reduced depressive symptoms and suicidal ideation in patients with treatment-resistant depression within 5 days, without negative cognitive side effects and the remission rate observed is higher than reported open-label remission rates for standard FDA-approved TMS protocols. This protocol requires the use of the SAINT Neuromodulation System TMS machine through which the stimulation site is located based on functional MRI targeting.
Our accelerated TMS SAINT-based protocol is completed in as little as two weeks 5 sessions/day for 10 days (M-F for 2 weeks). We use the MagStim TMS machine through which the stimulation site is located based on measurements on the scalp. Treatment cost is $5950. Self-pay only.
Please note that while this accelerated protocol is approved by the FDA, it is not yet covered by insurance.
It feels like someone is lightly tapping on your head with their finger very quickly, similar to the frequency of a woodpecker. The tapping is caused by a magnetic coil that is precisely positioned next to the scalp. If the treatment is not considerately delivered, it may be painful, like a rubberband snapping exposed skin. Our treatments are delivered in such a way that it is painless while retaining efficacy. The intensity of the tapping depends on the machine level and can always be adjusted to ensure comfort. You direct the level.
The typical remark from people's first experience with TMS relates to how ordinary it feels. During the treatment there are no noticeable changes in thought or emotion.
You won’t notice any major changes in awareness, thoughts, or mood immediately after treatment. However, people often report feeling brighter and more engaged later in the day (even after the first treatment). Others have reported difficulty or improved sleeping. Because your head muscles have been lightly stimulated, you may experience a very mild headache which is typically only an issue during the first 2-3 treatment sessions, until you adapt.
Some people report feeling temporarily worse towards the beginning of treatment before they feel improvement, which is common. This is known as the 'dip' and typically lasts several days up to a week. However, some individuals report ongoing benefit starting early and maintaining throughout treatment.
Benefits can take a while to take hold. Results are often felt after treatment is completely finished. Neurons take a while to fully respond to an intervention. In fact, some people report feeling temporarily worse before they feel improvement, which is not uncommon. Some report ongoing benefit starting early and maintaining throughout treatment.
"Things are brighter", "I feel more present", "Thinking isn't as effortful", and "I can sustain good moods and thinking better" are things we've heard as patients progress through treatment.
For insurance coverage, the FDA approved protocol recommends 30-36 sessions performed 5 times per week over a 7-8 week course.
For self-pay, we can shorten the duration of TMS treatment by utilizing an accelerated protocol. Such an option can reduce the total treatment length by half.
Before beginning treatment it can be helpful to have an idea of the different areas of life that can be impacted on the road to feeling better.
Nope! You can perform your normal daily activities prior to and after the treatment with no restriction of eating, drinking, or driving.
If you are on regular medications make sure you keep the same schedule whether they are psychiatric or non-psychiatric medications. If you take medications as needed for anxiety or pain, make sure you mention it to the doctor prior to treatment; there are typically no restrictions.
TMS treatment often augments current medication regimens and can even fully or partially replace some. It can also allow some medications to be used in different ways. This issue should be addressed on a case by case basis and discussed with your medication provider.
We keep up with the latest research on TMS findings, led by a literature-competent, TMS-experienced psychiatrist. As a private practice in Chicago, we are able to allow for greater appointment flexibility and treatment customization based on need. Such adjustments may allow us to do an accelerated protocol bringing the time to remission to within a few weeks.
We believe in delivering high performance, versatile TMS solutions so you receive the best treatment possible. We go through the TMS journey with you, ensuring that each day and treatment guides the next, because we know a one-size-fits-all approach does not always yield the best results for everyone.
Although practice standards have only approved stimulation over the left dorsolateral prefrontal cortex, there are alternate treatment protocols we can add to enhance your results (this is in addition to your treatment, safe, and at no additional cost if we feel like it would be effective). If you'd like to see the space and machine, feel free to come in. We can discuss day-to-day logistics such as parking, etc.