Transcranial Magnetic Stimulation (TMS)
You’ve done what you were told to do. Tried the tablets, waited the weeks, tried the next ones. And still, the heaviness hasn’t lifted. It’s exhausting, and it can leave you wondering whether anything will ever work for you.
TMS offers another option. You sit awake in a chair while a coil delivers magnetic pulses to areas of the brain involved in mood. There’s no surgery or anaesthetic.
What is it?
01What if the next step didn’t have to be another prescription?
Transcranial Magnetic Stimulation, or TMS, is a non-invasive brain stimulation treatment. A magnetic coil rests against your head and sends brief magnetic pulses to a specific area of the brain.
When the pulses are delivered in a repeated pattern, it’s called repetitive TMS (rTMS). There are also newer forms, including theta burst stimulation, which takes just a few minutes a session, and deep TMS, which reaches a little further into the brain.
In Australia, TMS for depression is typically prescribed and overseen by a psychiatrist. You stay awake throughout the session.
What may it help with?
02People often come to TMS after a long road. Medication hasn’t helped enough, or the side effects have been too much, and they’re looking for something else.
The strongest evidence for TMS is for depression, especially when antidepressants haven’t helped enough. Specific TMS protocols are also used for obsessive-compulsive disorder (OCD). Research on generalised anxiety and post-traumatic stress disorder (PTSD) is opening up possibilities, especially as an addition to existing care.
If you’ve tried several treatments and you’re still struggling, there are other options worth exploring.
How does it work?
03For depression, a common target is an area behind the left side of the forehead called the dorsolateral prefrontal cortex. It’s part of a network involved in mood and thinking.
Magnetic pulses create small electrical currents in the targeted area. Different patterns of stimulation can change how active that area is. With repeated sessions, researchers think these changes can influence how the wider network works.
Targets vary with the condition being treated. Some anxiety and PTSD studies have used the corresponding area on the right side of the brain. Researchers are still working out which targets and stimulation patterns help most.
“The opposite of depression is not happiness, but vitality.”
Andrew Solomon
What does the evidence say?
04For people who’ve tried several treatments for depression and are still struggling, TMS offers an established option with a different way of working.
Depression
A review of 113 trials found that several forms of TMS helped more people with depression improve than sham stimulation, which mimics treatment [1]. A separate trial of 414 adults found that three-minute theta burst sessions worked as well as standard sessions lasting about 37 minutes [2].
Accelerated TMS for depression
In a 2026 Stanford trial of 48 adults with treatment-resistant depression, 50% of those who received five days of active Stanford Neuromodulation Therapy were in remission a month later, compared with 21% who received sham treatment. Remission means symptoms had eased to below the study’s clinical threshold. This was an encouraging result from a small trial with short follow-up [3].
OCD
A review of four trials involving 252 people whose OCD hadn’t responded to other treatment found that more people improved with deep TMS than with sham stimulation [4].
Anxiety
A 2025 review found that adding rTMS to medication reduced symptoms of generalised anxiety more than medication with sham stimulation [5].
Trauma and PTSD
In a 2026 trial of 119 military personnel and veterans with combat-related PTSD, both groups received intensive residential trauma therapy. At one month, 85% of those who also received active, MRI-guided TMS reported a meaningful reduction in symptoms, compared with 59% of those who received sham stimulation. That’s a promising result for TMS alongside trauma therapy in this setting [7].
Tim Ferriss on accelerated TMS
On his podcast, author Tim Ferriss described how rumination and anxiety had been affecting his sleep and wearing him down. After his first five-day course, he noticed little change for two to three weeks. Then, he said, the anxiety and rumination all but disappeared for three to four months. “I’ve never experienced anything like it,” he said. He also shared that later booster sessions didn’t bring the same relief [8].
What does a session look like?
05Your first appointment with the psychiatrist includes an assessment and “mapping“, to find the right spot on your head and the right strength of stimulation for you.
You sit in a chair, fully awake, while the coil rests against your head. You’ll hear clicks and feel a tapping sensation on your scalp. You’ll usually wear earplugs. Standard sessions often take around 20 to 40 minutes, and theta burst sessions can take just a few minutes.
After a standard session, many people go straight back to their day.
A standard course usually involves one session most weekdays over several weeks.
Accelerated courses
Several short sessions are scheduled each day. The Stanford protocol, originally called SAINT, uses a brain scan to personalise the target and delivers 10 short sessions a day for five days, with breaks between sessions. The sessions are brief, but they take up much of the day [3].
Medicare and eligibility
Medicare rebates can cover up to 35 sessions in a first course for eligible adults with a major depressive episode. Eligibility generally includes adequate trials of antidepressants from two different classes, unless contraindicated, and psychological therapy where clinically appropriate. A psychiatrist trained in rTMS assesses eligibility and maps the treatment target [9].
If depression returns after remission, Medicare can subsidise up to 15 further sessions when retreatment criteria are met. Ask the clinic whether your proposed schedule is eligible and what you’d pay out of pocket [9].
Finding the right clinic
Look for a team that can explain why it recommends a particular protocol, how it will track your progress and who you can speak to if you feel unwell during the course.
Risks and considerations
06Headache and scalp discomfort are the most common side effects and are usually mild. Tell the clinic if they persist or make sessions hard to tolerate [6].
Screening comes first. Seizures are a rare but serious risk, so your psychiatrist will review any history of seizures and other risk factors. Tell the team if you have a cochlear implant or other metal or electronic devices in or near your head [6].
Make room for recovery time. Speaking with Jay Shetty, Ferriss recalled feeling mentally drained after his first session. If you’re planning an intensive course, leave some flexibility around work and other commitments [10].
Questions to ask a practitioner
07- Which type of TMS do you recommend for me (standard, theta burst or accelerated), and why?
- How do you find and personalise my treatment target?
- If my symptoms return, can I have a top-up course?
You’ve read about it. Now what can you actually do?
You don’t need to have the perfect plan. Choose the next step that feels most useful for where you are right now.
Always speak with a qualified health professional before starting something new. If you are struggling right now, find immediate support.
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This is educational information. It is not a recommendation that this approach is right for you. Always speak with a qualified health professional.
