Deciding to try a new treatment brings a lot of small, practical worries, the kind that don’t always make it into a brochure but keep you up the night before. Here are honest answers to the questions people most often ask us before their first TMS session.
1. Will it hurt?
Most people find TMS very tolerable. The most common sensation is scalp discomfort or a mild tapping feeling where the device sits against your head. Some people describe it as odd at first rather than painful. For most, any discomfort eases considerably after the first week of treatment as you get used to it.
2. What are the side effects?
TMS has no systemic side effects, which is one of its biggest advantages over medication. The most common effects are mild to moderate scalp discomfort, occasional muscle twitches during treatment, and sometimes a headache, which can be managed with over-the-counter ibuprofen if needed. Some people feel mildly tired afterward. These effects tend to decline markedly after the first week.
3. Is it safe? Any serious risks?
TMS is safe and well established, approved by Health Canada since 2002 and used worldwide. The only serious risk is seizure, which is rare, at less than 1%. Your provider reviews your history beforehand specifically to keep that risk as low as possible.
4. Will I be awake? What do I actually do?
You’re fully awake and alert the whole time. You sit in a comfortable chair. Many people read, listen to music, or simply relax. There’s no anesthetic and no recovery from sedation, because none is needed.
5. Can I drive home afterward?
Yes. Because there’s no sedation and no systemic effect, you can drive yourself home and carry on with your day. This is a big practical difference from some other treatments.
6. How long is a session?
It depends on the specific protocol your physician designs for you. Some formats are longer and some are condensed, so the best answer is the one your provider gives you for your individual plan.
7. How many sessions will I need?
TMS is a course of treatment rather than a one-off, and the number of sessions varies by person and by the protocol chosen. Your physician designs an individualized plan and will set your expectations clearly at the start.
8. Does it work right away?
Usually not immediately. As with many depression treatments, improvement tends to build over the course of treatment rather than after a single session. Your team will track your progress along the way.
9. What does it cost, and is it covered?
Cost depends on the course of treatment pursued. As a physician-prescribed treatment, TMS may be eligible under a Health Spending Account and can qualify as an eligible medical expense with the CRA for income-tax purposes. In BC, a provincial committee recommended public funding for TMS for depression back in February 2022, but at this time that remains a recommendation rather than active funding. Your provider can walk you through the specifics.
10. How do I know if I’m a good candidate?
That’s what an individual assessment is for. TMS is physician-directed, and suitability is determined person by person, based on your history, your condition, and what you’ve already tried.
The takeaway
The nervousness before a first session is completely normal, and usually the reality is far less daunting than the imagination. If you’re on Vancouver Island and still have questions the list above didn’t cover, just ask. Our team would rather answer ten more questions than have you wondering.
This article is for general information and is not a substitute for individual medical advice. TMS at Optimind is physician-directed; your specific plan, risks, and suitability are determined through individual assessment.