The Science Behind TMS

By: Jayson Tripp, MD


The brain is one of the most integral organs of the human body. Its complex neural connections and functions have intrigued scientists for centuries, prompting continuous research. In the last few decades, neuroscientists and psychologists have made revolutionary advances towards a deeper understanding of the human brain. One of these technologies is called TMS.

Transcranial Magnetic Stimulation

Transcranial Magnetic Stimulation (TMS) is an effective brain stimulation treatment for OCD and MDD. TMS uses magnetic pulses to re-energize slow or even inactive neurons in the areas of the brain responsible for mood regulation, obsessions, compulsions, and more. This magnetic stimulus creates new neural pathways, thus healing inactive or ineffective brain areas.

Two Kinds of TMS

Serenity uses Deep TMS treatment, developed by Brainsway. This new and highly effective technology helps to stimulates areas of the brain linked to depression and OCD for a different kind of mental illness treatment, with fewer side effects, longer lasting results and higher remission rates  compared to the older technology of a Figure-8 TMS machine. What sets Brainsway’s H-coil Deep TMS machines apart is the depth into the brain  it is able to stimulate; an average of 3-4 cm compared to 1.5-2 cm for the Figure-8  machines.

How it Works

During Deep TMS, a cap containing an electromagnetic coil is placed over your head. The electromagnet produces a series of magnetic pulses that stimulates nerve cells in the region of the brain which controls mood regulation (for depression treatments). In the case of OCD treatments, a slightly different helmet is used and the position is changed to send pulses to the area of the brain which controls compulsions and thought processing.

Major Depressive Disorder

Major Depressive Disorder (MDD) is the leading cause of disabi lity in people ages 15-44. MDD affects roughly 6.7% of adults (18+) in the United States, totaling more than 17.3 million individuals, and is more frequently diagnosed in women than men. Depression affects men and women differently. Men frequently experience irritability, anger, and exhaustion, while women more commonly experience sadness, guilt, increased self-blame, and feelings of worthlessness.

An MDD diagnosis requires the individual to have at least 5-9 common symptoms. One of these symptoms must be either loss of interest in previously enjoyed activities or an overwhelming feeling of sadness. A few more of the most common symptoms are:

  • Drastic Appetite Changes
  • Feelings of fatigue
  • Excessive feelings of Guilt
  • Decreased Concentration Capability

Many of these symptoms make treatments like talk therapy or CBT less effective because of lack of energy or drive to put in the work necessary. Unfortunately, most psychotropic drugs have negative side-effects that must be weighed against the benefits they offer. Many of these medications even become less effective over time, resulting in increased dosage and, as a result, amplified side-effects. Deep TMS allows individuals who feel limited by their MDD and/or medication an alternative or supplemental treatment with less side-effects and a high success rate.

Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) is defined by the American Psychiatric Association  as a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to take a particular action (compulsions). Like many other mental illnesses, individuals diagnosed with OCD are at higher risk  of developing other comorbidities, or additional mental health conditions. Among them, the most common is major depressive disorder (MDD). Research shows that as many as two-thirds of people diagnosed with OCD will experience a major depressive episode . Causes can differ, ranging from excessive stress to obsessive or compulsive behavior to biochemical changes in the brain that results in mood swings and sometimes alter behavior.

OCD is most often treated with SSRI’s, a class of medications often associated with significant side-effects, although treatment plans vary from individual to individual. Another common treatment is Exposure and Response Prevention (ERP) . This is a form of Cognitive Behavioral Therapy (CBT) in which you are deliberately exposed to triggers to help you gradually increase tolerance to them. This strategy is highly effective for many individuals, but requires a high level of commitment and focus. Because a large portion of people with OCD also have MDD, motivation can be hard to find at times, and thankfully, with the FDA-approval of TMS  for OCD there is now another effective option available.

Common Side Effects

Because TMS is a non-invasive type of stimulation of the brain, unlike vagus nerve stimulation, TMS does not need surgery or require electrode implantation. And, unlike electroconvulsive therapy (ECT), TMS does not trigger seizures, cause memory dysfunction or blood pressure alterations, and does not require anesthesia.

In general, TMS is known to be safe and well tolerated. However, just like any treatment, it’s important to be aware of the possible side effects. Most of these side effects are typically mild, manifesting immediately after the first individual sessions and decrease with time with subsequent sessions. They may include:

  • Mild Headaches
  • Temporary Scalp Irritation

Your doctor can change your stimulation level to minimize symptoms or recommend additional medications or treatments to reduce any discomfort.


After treatment concludes, many individuals experience full remission of their symptoms, and roughly 75% of patients experience a significant response . Some patients choose to take supplemental medications, continue talk therapy, or visit with their psychiatrist regularly, while others discontinue treatment all together. Every individual is unique, so the best course of action after TMS treatment is completed should be discussed with your psychiatrist.

Still have questions about TMS or want to know if it could be for you? Give us a call at (844) 692-4100  or submit a form on our website and we will reach out to you as soon as we can.

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*All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.