Should You Try Magnetic Therapy for Depression? Here’s What to Know

Nearly 1 in 5 people in the U.S. are diagnosed with depression at some point in their lives. It's common and normal to feel sad, stressed, or lonely sometimes. But with major depression, symptoms last for 2 weeks or more. And they interfere with everyday life. Those symptoms can include low mood or energy, difficulty sleeping or eating, and troubling thoughts or feelings.

Most depression can be treated with therapy, medication, or a combination of both. But around 30% of people with depression have a form that doesn't respond well to treatments. This is called treatment-resistant depression.

Repetitive transcranial magnetic stimulation (TMS) is a treatment for this kind of depression. Deep TMS is a form of TMS. It uses a different type of coil that stimulates deeper parts of the brain.

What is magnetic therapy for depression?

To better understand what TMS is, it helps to take a closer look at the name.

• Repetitive: TMS treatments deliver a series of magnetic pulses that stimulate brain cells.

• Transcranial: The TMS device touches the outside of the head and directs pulses through the skull, or cranium. There's no surgery, injection, or implant.

• Magnetic: An electrical current in the device creates a magnetic field.

• Stimulation: The magnetic field stimulates nerve cells in the part of the brain beneath the device.

In other words, a device placed near the head creates a magnetic field. This stimulates neurons and neuronal circuits in the brain. This might make you think of electroconvulsive therapy (ECT), which is another effective treatment for depression. Both ECT and TMS influence your brain's electrical activity. But there are important differences (more on this below).

The most common use of TMS is for severe or treatment-resistant depression. The FDA first approved TMS for this in 2008. But this treatment is now also approved to treat:

• Obsessive-compulsive disorder (OCD)

• Migraine headaches with aura

• Depression with anxiety

• Smoking cessation

TMS is a more recent therapy for severe depression. In general, it hasn't been as effective or fast as ECT in treating severe depression. But newer forms of TMS may be changing that.

How does magnetic therapy for depression work?

During a TMS session, a device with a metal coil is placed near your head. It gives off electromagnetic pulses, which pass through your skull to the brain. Specifically, it targets the prefrontal cortex of the brain, which has a large role in behavior, decision-making, and personality.

Repeated stimulation of the nerve cells in this part of the brain has been found to help with depression. Some of the ways that TMS may do this include:

• Activating the release of neurotransmitters

• Changing the way some genes are expressed

• Affecting brain cell response to hormones

• Helping to protect and repair brain cells

In contrast to ECT, which affects the whole brain, TMS targets a particular part of the brain. And the magnetic pulses of TMS are less likely to cause a seizure, unlike the electrical activity of ECT.

Can magnetic therapy be combined with other depression treatments?

You may receive TMS as a stand-alone treatment for depression. Or your team may recommend that you continue medication, therapy, and lifestyle changes during or after your course of TMS. It's best to discuss the entire treatment plan with a mental health professional.

What can I expect during TMS treatment?

Before starting treatment, you'll meet with one or more members of the TMS team. They'll take a thorough history and may perform a physical exam. Be sure to let them know about all aspects of your physical and mental health, including:

• A personal or family history of seizures

• Past head injuries, concussions, or loss of consciousness

• History of brain tumors or strokes

• Any implanted medical devices

• Anything metal in your body, especially in the head or neck

• All prescribed and over-the-counter (OTC) medications, vitamins, and supplements

• Use of alcohol or other substances

At the first treatment session, they'll take extra time to test for the right placement of the TMS device. For some people, this may include brain imaging studies, but not always. When combined with brain imaging, TMS can target more precise areas of the brain.

The amount of time a treatment takes will depend on the particular protocol. Most TMS sessions last between 3 and 40 minutes. Treatments are usually given 5 days a week for 4-6 weeks. A mental health professional will discuss your individualized treatment plan with you before you start.

Treatments aren't painful, and they aren't likely to induce seizure activity like with ECT. So TMS treatments don't require anesthesia or sedation. Most people note a tapping sensation on the head with each magnetic pulse. You'll probably be able to return to your normal activities after each treatment, but you may need to adjust your schedule to attend treatment sessions.

What are the side effects of magnetic therapy?

Most reported side effects of TMS are mild and don't last long. Some of these common side effects include:

• Mild head discomfort where the magnetic device is placed

• Tingling or twitching of the scalp or face during treatment

• Mild headache, lightheadedness, or dizziness

There's less risk of significant side effects with TMS than with ECT. Magnetic therapy is not known to cause memory loss. And the risk of seizure with TMS is less than 1% for most people. Some factors that may increase the risk of having a seizure with TMS include:

• Having epilepsy or a seizure disorder

• Having had a seizure with previous TMS treatments

• A past head injury

• Drinking alcohol

• Poor sleep

• Taking certain medications that may make a seizure more likely

The team may ask you questions at each visit to assess your risk of seizures. Especially about sleep, alcohol, and any medication changes.

So far, there don't seem to be significant long-term side effects from TMS. But more studies are needed to know for sure.

How long does magnetic therapy take to work for depression?

Each person will respond differently to TMS therapy. And there may be variations in symptom relief based on the protocol used.

In general, most people receiving TMS will begin to notice a change in their symptoms within a few weeks. This is similar to the time frame for antidepressant medications and ECT.

A rapid TMS protocol for depression was cleared in 2022. The rapid treatment form is given over 5 days rather than weeks, in order to speed up results. Currently, it's mostly used in emergency situations when a person's health or safety is at immediate risk.

Who is a candidate for magnetic therapy for depression?

Antidepressant medications and psychotherapy are still the first-line treatments for major depression. A person may be a candidate for TMS if:

• Their symptoms haven't improved with antidepressant medications.

• They have unacceptable side effects from antidepressant medications.

• Their symptoms have improved before with TMS therapy.

• They're switching to TMS from current ECT treatments.

• Their symptoms haven't improved with psychotherapy.

• They are 15 years of age or older.

Because TMS uses magnets, some people may not be candidates for this type of therapy. Anyone with metal objects implanted in the head or neck cannot receive TMS. This may include:

• Metal plates or clips

• Electrodes, chips, or pacemakers

• Cochlear implants

• Permanent piercings

• Tattoos with magnetic ink

Metal in other parts of the body is lower risk. But the healthcare team still needs to know about surgeries, implants, or joint replacements that may include metal. Dental fillings or braces are considered to be low-risk. And metal jewelry should be removed before treatment.