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    I receive TMS 5 days a week and am on my 20th session. The first week was a noticeable improvement. But for the last two weeks my depression is horrible – worse than when I began treatment. My doctor says that especially because I responded early on, this type of dip is not abnormal. I am so desperate for TMS to work, and the current increased depression is really troubling. Does anyone have experience with a dip at this point in their treatment? If so, when did the dip end and did TMS make you better? Any answers are much appreciated.

    • This topic was modified 5 years, 7 months ago by  Lasthope97.
    • This topic was modified 5 years, 7 months ago by  Lasthope97.


    Welcome Lasthope97:

    First I want to acknowledge that your choice to consult with your doctor (and treatment team) is the best way to start your inquiry regarding your response to treatment because there are as many responses and reactions to TMS as there are individuals undergoing treatment.

    With that said there are similarities too. Fear can very much be a part of the cycle of depression and can often be part of what some have described as the roller coaster response to treatments. The ‘dip’ is a common experience in many but not all patients’ treatment. Personally I experienced a scary (at the time) ‘dip’ about the 10th day and it lasted for approximately 2 weeks. My depression scores were higher than my worst depression episodes before treatment. And the rise out of the ‘dip’ was gradual for me, not quick.

    In the end, TMS works well for me; I am 66. I had the initial 6 weeks of treatment, had some real difficulties during treatment and now have about 3 booster treatments a year. I was depressed all my life and I underwent the initial treatment at 60. I was on $20,000 worth of medication, which stopped working. After TMS, I no longer take medication and when I feel the annual down feeling I immediately call my doctor and set up the 3 treatments.

    It is difficult to hear someone say, “Be Patient” and let the treatment do whatever it is going to do for you, but that is what needs to be done, in addition to eating right, getting some exercise, even a small walk, change environments (inside/outside), when you can, talk with supporters, write on this site, etc. The more positive thoughts you can create the better. (And I know that is difficult, almost impossible most days).

    You are undergoing a medical treatment that has provided hope. Hang on to that and try not to project at any point because there is no black and white outcome across the board. Take good care of yourself – this is most important as other things fall into place when treatment works. Please write if you have additional questions or want to offer your own perspective.

    Sending my best. Colleen



    Thank you so much, Colleen. Your response really helped and I am hopeful I have good results like you have experienced. Thanks again!



    Glad that this was helpful. Please stay in touch and let us know how you are doing. 🙂


    Martha Rhodes

    Dear Lasthope97,
    I did my first round of TMS (6 weeks) in 2010 and was what I call “a shell of a woman”. No hope, complete darkness and anger that my doctors couldn’t help me with medications. (I had just come off of a suicide attempt.) Needless to say, when I found TMS as a pathway to climb out of the darkness, I had renewed hope. Expectations weren’t high, but hope prevailed.

    Soooo….. when after my first 10-13 treatments I suddenly found myself feeling WORSE than I had when I’d started, I completely freaked out. I was certain TMS wasn’t going to work for me, especially since my TMS doctor and treating nurse had warned me that TMS isn’t a quick fix and that it doesn’t work for everyone although the response/remission rates were pretty darn good. I asked what percentage of patients at my clinic DIDN’T respond and she said, “10% — but that’s because they didn’t come for the full six weeks.” I assumed I’d be part of that 10%, even though I had the determination to do the full 30-36 treatments. So I spent the next 7 treatments sitting in a puddle of tears, wishing I was dead, and having NO confidence in TMS whatsoever. It is THE WORST place to be as I’m assuming you’re feeling right now. Do NOT give up!!! The Dip has become almost a regular thing with patients, although it doesn’t happen to everyone. By treatment #20 for me I woke up one morning and the disgusting UGGGHHHH feeling had lifted (which is why I call it my “TMS Lift”).

    There’s no clinical data explaining why this Dip phenomenon occurs, but my instinct tells me it’s just a sign that the brain is waking up. The TMS process is a cumulative one that starts at the outermost part of the brain. As it wakes up the neurons in the prefrontal cortex, which is where executive function and mood neurons perform, I think that a variety of emotions are activated, increased sadness being one of them. So I look at the Dip as a good thing. Kind of like that old adage, “It’s always darkest before the dawn.”

    Since that time, I’ve used TMS for seven years for maintenance and it has allowed me to remain medication free. Last Fall my doctor recommended I do another “full course – 30 treatments – because she had redone my Motor Threshold and it had increased. Since I had been on TMS for so long, she also felt a full course would make the once-a-month maintenance treatments either more effective or maybe I wouldn’t have to come so often for them.

    Well, lo and behold — the exact same response trajectory occurred. I found myself in another Dip in the second week of treatment and didn’t even realize it was the same timeframe as the first time around! It lasted about 10-14 days, and then voila! — The Lift! So at least I was consistent, right?

    Please hang in there and know that you’re doing a good thing for your brain. The response/remission rates are excellent and as long as you are doing your part as colleencasey so astutely pointed out in her post to you (exercise, sleep and eat well, stay away from stressful situations and toxic people, surround yourself with support, etc.) you are following the right path. Please stay in touch and ask more questions, let us know how you’re doing and don’t give up on TMS or on yourself!



    How are you feeling now? Got some relief in your anxiety and depression?



    Hi Lasthope97:
    Was thinking about you and wondering how you are doing. Let us know as we are here to support you and learn from you.



    Thanks so much for your responses. I am still feeling very depressed. I just got back from a week-long Caribbean vacation and, while I certainly felt happier with all that sunshine and beautiful water, the deep depression was just under the surface. The doctor didn’t feel that being away from treatment for a week at this point would cause a problem. I started back on TMS this morning. I am still incredibly depressed and feel so hopeless. I feel like Martha describes above — want to cry all of the time, can’t do any of the things I need to do in terms of daily life, etc.
    If this doesn’t work, I don’t know what I will do. I have literally tried 50+ medication options (probably more) in my years of depression – about 25 years. Some drugs and drug combinations worked for a while and then stopped working. I am seeing the TMS through and wishing for the best. But I have lost hope even though my doctor has said that she believes it will work since I had such good initial results. I was remapped once and I believe she is going to re-map me this week, so maybe that will make a difference.

    Your comments and caring mean more than you know. People who don’t suffer from depression cannot really understand it, even though they may be sympathetic. Hearing from those of you who have gone through it is so helpful. Thanks and I will let you know what happens over the next few weeks. I don’t know what I will do if this doesn’t work.



    Also, the advice to take care of myself is excellent. I am working on it:). Your stories are very encouraging and I am so glad you are doing well.



    Good to hear from you. You are spot on taking care of yourself. A patient who suffers with a similar brain disorder once told me that if you eat right – that may make you feel 1% better, if you get some exercise – that may make you feel 3% better, if you make one social contact every couple of days – that may make you feel 2% better – added up that is 6% better than previously. That is a gain! And all efforts help as you travel this road to feeling better.
    I am sending positive vibes that TMS is successful for you. If by chance it works out different from the way you would like, my doctor has told me over the years, with the current brain research there will always be something else to try as a result of this current research. Depression is a multifaceted disorder so treatments may evolve or be discovered in one area or another that can improve your specific situation.
    It can be so very difficult most days until major improvements can be achieved. Support can help us get through whether it be close or from afar. This forum, groups such as NAMI and/or social or religious connections can offer needed support too.
    Google Alerts can provide you with updated information on many subjects via email. You may want to check it out and set up an alert for research regarding depression.
    Let us know how you are progressing through the rest of your treatment. I did not notice improvement until after treatment ended. I have heard other patients describe the same outcome. And others feel better at different intervals throughout treatment.
    I don’t know if this will help, but I listen to a gentleman named Mo Gawdat who suffered with depression. He set on a journey to find happiness and suffered some tremendous losses along the way. He has a unique perspective and beliefs that have helped me change my thinking which limits the amount of suffering I experience from day to day. You might want to take a listen on youtube. I will try anything to improve my perspective and positive thinking. And there are many people now speaking (on youtube) on different methodologies to achieve this.
    Stay in touch. We are here to support your journey and learn from you as well.



    Just an update. My TMS doctor and my psychopharmacologist met and discussed my case. Since I clearly responded to TMS at the beginning, they both feel confident that it can work for me. My TMS doctor is going to remap me again, and she is also researching increasing me to 5000 pulses, rather than 3500 (which I think is the standard). I am on Day 25, so they are also extending my treatment. Fortunately, my insurance will cover it. The bilateral treatment has not made a difference, so she is discontinuing that. Plus, I don’t have a history or indication of anxiety. My doctor feels personally responsible for my continuing dip and is doing everything she can to make it work. She evaluated my results and feels 100% sure that my initial improvement was due to TMS and was real, not psychosomatic or due to medication, etc. I feel confident that she will do everything she can to make this work for me.

    I am still severely depressed and pretty hopeless now. I feel that TMS is my last option for getting well. I have even thought about running away to Aruba and totally changing my life. Unfortunately, depression follows you wherever you go, so that is not a real solution.

    I am following Colleen’s suggestion to learn / hear Mo Gawdat. I am also trying to exercise and adjust my diet to eliminate sugars and other things that can affect depression. However, as you know, when you feel this bad it is hard to even brush your teeth, much less exercise.

    Thanks for all of your continued insight and support! The people in my life, including my family, don’t really understand what I am going through and are, frankly, getting tired of it. So y’all are more appreciated than you know.



    Your sentence, “However, as you know, when you feel this bad it is hard to even brush your teeth, much less exercise,” could not be more true. So often the lethargy that accompanies depression is unbearable and routinely prevents us from functioning even minimally.
    With that said I applaud your continuous efforts even in the midst of the challenges that are a part of depression.
    It is good to know that your doctor is professional and responsible – working with your individual case in regard to the course of treatment. That is one of the advantages of TMS; its not a one method treatment. The treatment can be tailored to the individual patient. Your doctor and treatment team can be some of your strongest supporters.
    I also agree that those who do not experience depression don’t understand it (kind of like everything in life I guess). Because depression is a family illness so to speak, as our families are affected by our depression challenges, they are a part of the ups and downs. This complicates family life and relationships. There are support groups and organizations such as NAMI, that offer patients, family and concerned individuals education, insight and support. You may be aware of this already. They can be very helpful for all.
    Fighting the discouragement that erupts with depression is difficult. Please know you will find support on this site and also that it is a resource of information for many aspects of TMS treatment as well as other brain disorders.
    Stay in touch and let us know how you are doing. We all want the same for each other – remission or at least a marked improvement.
    Thanks for your update and contribution. It helps so many.




    I was just wondering how you were doing? Let us know if you have a chance.

    🙂 Colleen



    Thanks for following up. I was remapped on May 22, 3 weeks ago. The remapping matched my initial mapping. The doctor thinks the intermediate mapping that led to such deep depression was a bad mapping. 3 weeks into the remapped treatment, I am still experiencing serious depression. On a scale of 1-10, where 1 is ‘rock bottom’ and 10 is ‘not depressed’, I have been varying between 2 to 4. So still depressed, but not completely non-functional. I don’t know yet how long this round of TMS will continue. I have lost hope that this treatment will work, but will continue down this path until the doctor feels we have maximized the benefits.

    Thanks so much for your continuing interest and support.



    TMS made my depression so severe it’s 2 years later and i’m sick. I had to go onto disability and suffer everyday pain and sickness i never had before. It’s a freakin Dangerous procedure. There messing with your brain with powerful magnets. There is no reversal if you get worse. It stays that way. I’m just waring you. This treatment is dangerous. I’ve never recovered and have lost everything spent thousands on Doctors since TMS.




    Sorry to hear that TMS did not work for you and that you are dealing with the challenges you identify. I hope you find a treatment that is effective for you.

    I did have NeuroStar TMS Treatment and it did work for me and has changed my life in a positive way.

    There are a few questions that I wonder about with your treatment because there is no clinical evidence that these treatments make depression worse. It is sad that this treatment is not effective for everyone. That is the case for most medical treatments – they work for some but not all.

    Did your doctor inform you that this is a treatment that does not work for everyone?

    What type of machine was used to administer your treatments, as contact at the treatment site is critical to administer the correct dose (that should have been determined ahead of time)? Contact percentage varies from machine to machine.

    There is constant brain research being conducted world-wide. There are new treatments being developed on a continuum that are bringing hope and relief to more and more of us who are dealing with the challenges of MDD.

    Sending hopeful thoughts for recovery.




    So, I’m on treatment 29 and I think I might be dipping but there’s a lot of variables.

    TMS immediately started working for me from about the first week. I was told to anticipate the dip around week 3, but it never happened. During the remapping, my doctor ended up raising the dosage of my pulse trains which is uncommon but not unheard of.

    Now it’s week six. I am about to start my period and sometimes I have bad mood swings during this time, so that could be to blame for my low mood.
    I also just had to end a friendship which has been difficult personally, but I have been administering CBT on myself and KNOW that I made the right decision and am ready to move on in my heart, – but despite this, my mood is low and I’m behaving irrationally as though I would’ve when I was in the throes of deep depression which leads me to believe that I may be experiencing “The Dip” at this time.



    Keep going! I also thought TMS wasn’t going to work for me, I needed 46 treatments, but it finally did. I was very severe, not even functioning, crying almost all day with repeated suicidal thoughts. It’s so nice to have an end to that & be able to enjoy things again. I have a neuro/movement disorder that changed a lot of my healthy life, but this got me out enough to do things. There are other options such as Ketamine, Psylocibin in 2020, and DBS clinical trials (I know a brain implant sounds extreme, but hey if it gives you your life back) Good luck 🍀



    Hi. I started experiencing a dip about 10 days ago, on day 20 of treatment. TMS was doing wonders for me – I have been less angry and irritable and felt more energetic and interested in doing activities that were harder for me before. I have been exercising more and playing with the kids more. I’ve not been as reactionary and was calm overall. But then the dip hit and I’ve been not only depressed, but tired and sluggish, irritable, and have had body pains and headaches. It is hard to deal with, especially after feeling good for weeks, and then being hit with depression and symptoms that have been even worse than before.

    I was told this could happen and I’ve read, here and elsewhere, that it could happen and what to expect, so I am being positive and hoping for the best. Not only hoping, but doing positive things and listening to positive podcasts, etc., to keep me in a positive frame of mind. I’m needing more sleep, which I am getting, and trying to continue to eat well, etc. I am a bit scared that the lift won’t happen and I’ll be stuck in depression, but I want this dip to lift so badly, so that I can get back to feeling good, that I am going to focus on that being the outcome. I can’t settle for less at this point. It’s only up from here! Wish me luck!




    Just curious if any of your depressive symtoms
    ever lifted ??



    Hey there – I’m new to TMS as well as this forum. I go into treatment 23 today and started looking for answers when I fell into the dip between session 19 and 20. I’m hoping that the dip will lift.

    I’m also curious as to whether @lasthope97 experienced anything positive since the last time we heard from her/him?



    I just started TMS last week. Yesterday I had a good day and was uncharacteristically productive. Today I feel very lethargic. The levels started on 85 last week and today I was up to 105 and slowly working my way up to 120, which is the therapeutic dose of treatment. I don’t know why I’m having a reaction already and don’t know why my reaction is not like described here. Any ideas?



    I started TMS on June16th. I’ve had about 11 sessions so far. I seem to have some incremental improvements. How’s everyone else’s sessions going?



    @niko47 were you able to come out of the dip?

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