Starting Transcranial Magnetic Stimulation treatment brings hope for people dealing with depression and other mental health conditions. Many patients notice improvements in their mood and symptoms after just a few sessions. However, some people experience something unexpected during their treatment course: a temporary decline in how they feel, often called the TMS dip.
This phenomenon can be confusing and worrying, especially when you were starting to feel better. Understanding what the TMS dip is, why it happens, and how long it typically lasts can help you stay committed to your treatment plan and maintain realistic expectations throughout the process.
If you’re currently undergoing TMS therapy or considering it as a treatment option, knowing about the TMS dip will prepare you for what might lie ahead. This article aims to educate readers on the normalcy, duration, and management of the TMS dip, helping patients understand what to expect during TMS treatment and how to handle the temporary challenges it may present
What Is the TMS Dip?
The TMS dip refers to a temporary worsening of symptoms that some patients experience during their course of Transcranial Magnetic Stimulation therapy. While you might expect steady improvement throughout treatment, the reality can be more complex. This temporary setback typically occurs after you’ve started to notice positive changes, making it particularly frustrating for patients who were beginning to feel hopeful about their progress.
Explanation of the TMS Dip
During TMS treatment, your brain undergoes significant changes at the neural level. The magnetic pulses stimulate specific areas of your brain, particularly regions involved in mood regulation. As your brain adapts to this stimulation and begins forming new neural connections, there can be periods of adjustment where symptoms temporarily intensify.
Think of it as your brain recalibrating itself during the healing process. The TMS the dip represents a phase where your brain is actively reorganizing, even though it might not feel like progress in the moment.
Symptoms
During the TMS dip, you might notice several changes in how you feel:
- Increased feelings of sadness or low mood that seem to come out of nowhere
- Higher levels of anxiety or restlessness than you experienced before
- Difficulty concentrating or mental fog that affects your daily tasks
- Changes in sleep patterns, such as sleeping too much or having trouble falling asleep
- Reduced energy levels or feeling more fatigued than usual
- Irritability or emotional sensitivity that feels heightened
Why It Happens
The exact mechanisms behind the TMS dip aren’t completely understood, but researchers believe it relates to how the brain responds to stimulation. When TMS activates certain neural pathways, your brain begins rewiring itself. This neuroplasticity—your brain’s ability to form new connections—can cause temporary instability as old patterns break down before new, healthier patterns fully establish themselves.
Some researchers compare it to muscle soreness after a workout: your brain is doing hard work to heal, and there can be some discomfort during the process.
Relation to Other Side Effects
The TMS dip differs from typical TMS side effects like scalp discomfort or headaches. While those side effects result directly from the magnetic stimulation, the dip represents a psychological response tied to your brain’s adjustment process. It’s also distinct from treatment failure—the dip is temporary and doesn’t mean TMS isn’t working for you.
Is the TMS Dip Normal?
Yes, experiencing the TMS dip is considered a normal part of treatment for many patients. You’re not alone if you notice this temporary decline, and it doesn’t indicate that something has gone wrong with your therapy.
Frequency of the TMS Dip
Research and clinical observations suggest that a significant portion of TMS patients experience some form of temporary symptom worsening during their treatment course. While exact numbers vary across studies, many treatment centers report that anywhere from one-third to half of their patients notice the TMS dip at some point during therapy. This makes it a relatively common experience rather than a rare complication.
Expected vs. Unexpected
Your treatment team should inform you about the possibility of the TMS dip before you begin therapy. When you know it might happen, you can recognize it for what it is rather than assuming your treatment has failed. However, not everyone experiences the dip, and some people continue improving steadily throughout their entire treatment course. Both experiences are normal and don’t predict your outcome.
Expert Opinions
Mental health professionals who specialize in TMS therapy generally view the dip as a sign that treatment is creating real changes in brain function. Many clinicians consider it part of the healing process rather than a setback. They emphasize the importance of continuing treatment through this phase and maintaining open communication with your treatment team about how you’re feeling.
How Long Does the TMS Dip Last?
One of the most pressing questions patients have when they notice the TMS dip is how long they’ll feel this way.
Duration of the TMS Dip
For most patients who experience it, how long a TMS dip lasts typically ranges from a few days to about two weeks. The most common duration falls somewhere in the middle of this range, with many people noticing improvement within five to seven days. It’s important to remember that everyone’s experience is unique, and your timeline might differ from someone else’s.
Factors Affecting Duration
Several elements can influence how long the TMS dip lasts for individual patients:
- The severity of your initial symptoms before starting TMS treatment
- Your brain’s individual response to magnetic stimulation and how quickly it adapts
- Whether you’re taking medications alongside TMS therapy
- Your overall physical health, sleep quality, and stress levels
- The specific TMS protocol your doctor is using, including stimulation frequency and intensity
- Your support system and coping strategies for managing difficult feelings
When to Seek Help
While the TMS dip is normal, you should contact your treatment provider if you experience severe worsening of symptoms, particularly if you have thoughts of self-harm or suicide. Your doctor can assess whether what you’re experiencing is a typical dip or something that requires immediate intervention.
Additionally, if your symptoms don’t start improving after two weeks, reaching out to your treatment team can help determine whether adjustments to your treatment plan are needed.
What to Expect After the TMS Dip
Understanding what happens after the dip can help you maintain hope during the difficult period.
Post-Dip Recovery
Most patients who experience the TMS dip report that once it passes, they notice significant improvements in their symptoms. Many people describe feeling better than they did before the dip occurred, as if they’ve broken through to a new level of wellness. The improvement often continues as you complete your remaining TMS sessions, with cumulative benefits building over time.
Benefits of TMS After the Dip
After working through the temporary setback, patients frequently report several positive changes:
- More stable mood with fewer dramatic ups and downs throughout the day
- Improved ability to handle stress and daily challenges without becoming overwhelmed
- Better sleep quality and more regular sleep patterns
- Increased energy and motivation to engage in activities you previously enjoyed
Long-Term Outlook
Research indicates that TMS can provide lasting benefits for many patients, with symptom relief continuing well beyond the end of active treatment. Some people maintain their improvements for months or even years after completing their initial course of therapy. If symptoms do return, many patients benefit from maintenance sessions or additional treatment courses. The temporary nature of how long a TMS dip lasts doesn’t diminish the long-term effectiveness of TMS therapy.
Moving Forward with Confidence
The TMS dip, while challenging, is a normal part of treatment for many patients undergoing Transcranial Magnetic Stimulation therapy. This temporary worsening of symptoms typically lasts anywhere from a few days to two weeks, and it often precedes significant improvement. Understanding that the dip is part of your brain’s adjustment process can help you stay committed to your treatment plan during difficult moments.
If you experience the dip, remember to communicate openly with your treatment team, practice self-care, and remind yourself that this phase is temporary. The majority of patients who work through the dip go on to experience meaningful benefits from TMS therapy.
By knowing what to expect and when to seek additional support, you can approach your treatment with realistic expectations and the confidence that temporary setbacks don’t define your final outcome. Your healing process is unique, and staying patient with yourself during the adjustment period can make all the difference in your overall experience.