Can TMS Make Depression Worse? Understanding Risks, Side Effects & Safe Treatment Options

Transcranial Magnetic Stimulation (TMS) has gained attention as a non-invasive treatment for depression, especially when traditional therapies fall short. Many people wonder if this promising approach could actually make symptoms worse instead of better. Understanding the potential risks and benefits is crucial for anyone considering TMS as part of their mental health journey.

Understanding TMS and Its Role in Treating Depression

Transcranial Magnetic Stimulation (TMS) uses targeted magnetic pulses to stimulate nerve cells in the brain. Treatment targets areas linked to mood regulation, supporting people with major depressive disorder. Clinicians like Dr Shanek Wick at Neuralia TMS in Melbourne provide this therapy mainly when patients haven’t responded to antidepressants or psychotherapy.

TMS sessions occur in a clinical setting. Each session lasts about 20 to 40 minutes and doesn’t require anaesthesia. Neuralia TMS addresses treatment-resistant depression, with Medicare covering eligible patients for $0 out-of-pocket. Studies report that patients receiving TMS, including those at Melbourne clinics, frequently experience improved mood and daily functioning. Practitioners monitor for side effects, which include headaches or scalp discomfort, but serious complications, such as seizures, remain rare.

Neuralia TMS, located in Moonee Ponds, also offers tDCS and pharmacogenetic testing, providing a comprehensive approach to mental health. For eligible people seeking an alternative to traditional depression treatments, TMS offers a non-invasive, evidence-based solution under the care of experienced professionals like Dr Wick.

Exploring Concerns: Can TMS Make Depression Worse?

Transcranial Magnetic Stimulation (TMS) typically offers effective relief from depression, though some individuals experience short-term symptom changes during treatment. Clinics like Neuralia TMS in Melbourne, directed by Dr Shanek Wick, monitor patients closely to manage these concerns and maintain patient safety.

Possible Negative Reactions to TMS

TMS may cause a temporary worsening called a “TMS dip,“ with symptoms such as low mood or increased anxiety lasting for several days or weeks. Headaches and scalp discomfort affect about 10-20% of patients in early treatment phases. Rarely, TMS can trigger seizures, with an incidence rate below 0.1%. Misdiagnosis, such as undetected bipolar disorder, may result in poor symptom improvement and persistence of underlying issues. Neuralia TMS provides thorough assessments to reduce these risks and ensure suitability for depression treatment.

Factors That May Influence Worsening Symptoms

Worsening symptoms during TMS may arise from four main sources. Inaccurate diagnosis leads to less effective treatment if depressive symptoms stem from another condition, like bipolar disorder. Insufficient session frequency or low stimulation intensity, which can occur if protocols aren’t tailored, reduce the likelihood of positive outcomes. Untreated coexisting disorders, such as anxiety, often interact adversely with TMS responses. Finally, individual neurological traits, including differences in brain structure and chemistry, affect how patients respond to brain stimulation. Neuralia TMS uses evidence-based protocols and ongoing monitoring to address these variables and optimise patient care.

Clinical Evidence and Expert Insights

Transcranial Magnetic Stimulation (TMS) does not commonly cause depression to worsen for most patients when clinical guidelines are followed. Specific evidence shows a generally favourable safety profile for those with correctly diagnosed depression.

What Research Says About TMS and Symptom Worsening

Clinical studies indicate TMS reduces depression severity, improving mood and function for many patients with major depressive disorder. Data show a small number of individuals may experience a temporary “TMS dip,“ including increased low mood or anxiety, which usually resolves as treatment continues [1][2]. Documented serious side effects, such as seizures, remain rare, and side effects like headaches or tingling sensations are the most frequent complaints. Researchers highlight that symptoms could potentially worsen if TMS protocols aren’t tailored to each patient’s clinical profile or if the underlying diagnosis isn’t accurate [3]. Research further notes mixed results for patients with coexisting mental health conditions, emphasising the importance of careful assessment before treatment.

Perspectives from Mental Health Professionals

Mental health professionals, including Dr Shanek Wick at Neuralia TMS in Melbourne, agree that TMS is safe when protocols are individualised. Dr Wick reports most patients see improvement, echoing international findings that highlight symptom relief with a low risk of harm. Experts advise that careful monitoring helps detect rare symptom worsening early, enabling clinicians to adapt treatment quickly. Clinical teams screen for factors such as misdiagnosis, concurrent psychiatric disorders, or unsuitable stimulation settings, reducing risks of adverse outcomes during courses at Neuralia TMS. Medicare eligibility supports access, with eligible patients incurring no cost for TMS therapy. Professional consensus stresses the value of tailored, team-based care to optimise safety and clinical response in patients undergoing brain stimulation therapies.

Safety Considerations and Managing Risks

TMS remains a safe and well-tolerated depression treatment for most patients when supervised by qualified clinicians. Clinics like Neuralia TMS in Melbourne maintain strict safety protocols and continuous assessment to protect patient wellbeing during therapy.

Recognising and Responding to Adverse Effects

Recognising possible adverse effects early helps ensure TMS safety. Common effects include scalp discomfort, mild headaches or rare temporary worsening in mood, sometimes labelled as a “TMS dip“. These symptoms usually resolve within days and don’t progress into serious complications when managed promptly. Staff at Neuralia TMS and similar clinics monitor each session’s outcomes and encourage reporting of any change in mood or unusual symptoms, using validated symptom-tracking tools. If serious adverse effects such as increased suicidal thoughts or psychiatric hospitalisation are observed, immediate clinical intervention can prevent escalation. Effective response hinges on routine assessments and patient transparency throughout the course.

Communicating with Your Treatment Team

Communicating openly supports personalised TMS therapy and risk management. Patients attending Neuralia TMS can share real-time feedback by contacting the clinical team at any visit or using the phone (03 9122 5246) if symptoms change between sessions. Consistent sharing of experiences—such as shifts in mood, sleep or anxiety—allows the treatment team, led by Dr Shanek Wick, to tailor protocols or pause therapy when needed. Adjustments might involve modifying pulse intensity, frequency, or exploring additional options like tDCS or pharmacogenetic testing. Team-based collaboration ensures fast and informed responses, maximising both safety and clinical benefit for each eligible patient in Melbourne.

When to Consider Alternative Treatments

Patients can consider alternative treatments when no clear improvement occurs after completing a full TMS course, which usually spans 20 to 30 sessions[3]. If treatment at Neuralia TMS in Melbourne produces minimal response, clinicians might suggest ketamine infusion or electroconvulsive therapy as next steps. Severe psychiatric comorbidities, like psychosis or complex psychiatric disorders, signal a need for tailored interventions beyond standard TMS protocols[2]. Refractory cases, especially those involving schizophrenia, often benefit from individualised care plans under expert supervision.

Persistent or intolerable side effects, including scalp discomfort, frequent headaches or sustained mood changes, may prompt reconsideration of continued TMS therapy[5]. While Neuralia TMS closely monitors for adverse events during treatment, patients reporting ongoing or worsening symptoms should discuss these promptly with their care team. Dr Shanek Wick, Medical Director at Neuralia TMS, recommends ongoing review and possible adjustments for patients experiencing suboptimal outcomes or unwanted effects.

Patients in Melbourne access additional services at Neuralia TMS, such as tDCS and pharmacogenetic testing, to further individualise care. Alternative therapies become relevant only after careful assessment and monitoring, which remain key components of safe, effective brain stimulation for depression.

Contact Details:

Neuralia TMS

Suite 102/149-155 Pascoe Vale Rd, Moonee Ponds 3039 VIC

About Neuralia TMS

Neuralia TMS is a leading mental health clinic located in Moonee Ponds, Victoria, specialising in innovative, non-invasive neuromodulation therapies. Under the medical direction of Dr. Shanek Wick, Neuralia TMS provides Transcranial Magnetic Stimulation (TMS) for the treatment of depression, anxiety, PTSD, OCD, chronic pain, and Parkinson’s disease. The clinic also offers transcranial Direct Current Stimulation (tDCS) for at-home therapy and pharmacogenetic testing to personalise mental health care based on each patient’s genetic profile.

Contact:
Dr. Shanek Wick, Medical Director
Phone: 03 9122 5246
Email: [email protected]
Address: Suite 102/149-155 Pascoe Vale Rd, Moonee Ponds 3039 VIC
Website: www.neuraliatms.com.au

Conclusion

TMS remains a promising option for those struggling with depression that’s resistant to standard treatments. While there’s a small risk of temporary symptom worsening, most patients tolerate the therapy well under expert supervision. Open communication with clinicians and ongoing monitoring help ensure that any challenges are quickly addressed. For anyone considering TMS in Melbourne, seeking care from experienced providers like Neuralia TMS can make a real difference in both safety and outcomes.

Frequently Asked Questions

What is Transcranial Magnetic Stimulation (TMS)?

TMS is a non-invasive treatment for depression that uses magnetic pulses to stimulate brain areas involved in mood regulation. It is mainly offered to people who have not responded well to antidepressants or psychotherapy.

Can TMS make depression worse?

A small number of patients may experience a temporary worsening of symptoms, known as a “TMS dip“. However, serious or lasting worsening is rare when TMS is provided by qualified clinicians following best-practice protocols.

What are the side effects of TMS?

The most common side effects are mild headaches and scalp discomfort during or after the session. Serious complications are rare. Most side effects are temporary and resolve shortly after treatment.

How long does a typical TMS session take?

A standard TMS session usually lasts between 20 and 40 minutes. No anaesthesia is required, and patients can return to their daily activities straight after.

Is TMS covered by Medicare in Australia?

Yes, eligible patients in Australia can access TMS at no cost through Medicare at accredited clinics like Neuralia TMS in Melbourne.

How do clinics minimise the risks of TMS?

Clinics such as Neuralia TMS use thorough pre-treatment assessments, evidence-based protocols, and continuous monitoring during therapy to identify and manage any risks or unwanted effects early.

What should I do if my symptoms worsen with TMS?

Contact your treatment team immediately if you notice a worsening of symptoms. Open communication allows for quick adjustments in your treatment to protect your safety and wellbeing.

When should alternative treatments be considered?

Alternative options, like ketamine infusion or electroconvulsive therapy, may be considered if there is no clear improvement after a full course of 20–30 TMS sessions, or if side effects are persistent or severe.

Who is a good candidate for TMS?

TMS is suitable for adults with major depressive disorder who have not found adequate relief from medication or therapy. A thorough clinical assessment is essential to determine suitability.

Can TMS be combined with other treatments?

Yes, TMS can be part of a comprehensive care plan including medication, talking therapies, and other innovative treatments like tDCS and pharmacogenetic testing, as offered at Neuralia TMS.