Can TMS Make Anxiety Worse?

Treatment for mental health disorders can come with a whole host of unwanted side effects. Some treatments aren’t effective and some may make symptoms worse. Often, before beginning a TMS treatment, some patients with anxiety are worried that the therapy will be ineffective or wonder, “can TMS make anxiety worse?” However, when a patient is accurately diagnosed and treatment is performed correctly, TMS is incredibly effective for treating depression, PTSD, OCD, and anxiety.

Transcranial magnetic stimulation (TMS) has been effectively used for decades to treat a range of mental health disorders. It is a noninvasive treatment that can usually be performed in under 30 minutes. During a TMS session, your treatment professional uses a magnetic coil to send magnetic pulses to neurons to stimulate brain activity in the dorsolateral prefrontal cortex (DLPFC). The stimulated neurons then form new communication pathways to other parts of the brain, in order to disrupt patterns that have contributed to anxiety, depression, and OCD. These new pathways help to relieve symptoms associated with mental health disorders.

Although there are some indications that repetitive TMS increases anxiety when treating depression, there’s no evidence that the therapy worsens anxiety in most patients. On the contrary, most patients treated with TMS report feeling calmer, with improved ability to cope with stressors, and less anxiety symptoms overall. Generally speaking, anxiety is not listed as a side effect of TMS treatment and may only sporadically trigger certain conditions (mania or seizures) in a handful of rare cases.

TMS “Dip”

Most patients have virtually no to mild side effects from TMS treatment. However some may experience what is known as a “TMS Dip.” TMS dips are a temporary worsening of symptoms that occurs about halfway through treatment. Although this “dip” can be worrisome for patients, it is only brief, and patients should begin to feel relief from their symptoms over time.

Common Side Effects of TMS Treatment

TMS can cause temporary side effects such as lightheadedness, headaches, and skin tingling, but these usually disappear after a few sessions. However, if your anxiety symptoms are getting worse over time, speaking to your health care provider. Your doctor will be able to adjust the treatment to help alleviate potential symptoms you may be experiencing.

While TMS therapy is a safe an effective treatment for many individuals, not everyone is a good candidate for TMS. Because TMS therapy uses a powerful magnet, those with any type of metal implanted in or near their head or neck are considered a risk. Metal in areas of the body more than 10 cm away from the head is generally acceptable.

Other types of devices or metal that might make you ineligible for treatment are:

• Aneurysm clips
• Cochlear implants
• Any medical implant containing metal
• Metal stents
• Tattoos containing magnetic or magnet-sensitive ink
• Shrapnel or bullet fragments

It is important to let your TMS treatment professional know if you have any medical devices or metal in your body, before you begin treatment.

TMS does not worsen symptoms in patients who have been correctly diagnosed with a condition the therapy can treat, such as anxiety or depression. For patients who have been incorrectly diagnosed or who have a diagnosis of a disorder that TMS does not treat, such as schizophrenia or bipolar disorder, anxiety symptoms may be exacerbated.

Because TMS is a relatively new treatment, more research is needed to fully understand the effect of TMS on bipolar disorder symptoms. Currently, evidence is inconclusive about the effectiveness of minimizing or eliminating the mania effects of some types of bipolar disorder.

A review of clinical studies on the effects of TMS on patients with schizophrenia reveals that it does not improve symptoms very much. TMS appears to help slightly boost the negative symptoms of schizophrenia, such as difficulty speaking and showing no emotion. Another study found that TMS exacerbated patients’ positive symptoms of schizophrenia, such as delusions and hallucinations.

Depression and anxiety are believed to originate in the part of the brain responsible for regulating emotions. The imbalance of activity from the prefrontal cortex is adjusted by targeting TMS treatment to that area. For individuals suffering from “anxious depression” or depression with comorbid anxiety, a relief from anxiety symptoms generally accompanies relief from depression symptoms. 

However, anxiety isn’t a simple disorder. Anxiety is thought to be the result of hypo (decelerated) and hyper (accelerated) active areas of the brain. This is why people with anxiety may worry excessively and experience physical symptoms like a racing heart, and also be frozen with indecision. 

Studies conducted worldwide have demonstrated positively successful results in the use of TMS for the treatment of some anxiety disorders. Can TMS make anxiety worse? While there is still more to be understood about effective treatments for anxiety disorder, TMS is a promising avenue for relief of symptoms. 

Contact My TMS today if you are suffering from depression or anxiety and want to learn more about how TMS might help you. We are the leading South FL TMS clinic and have psychiatric professionals who are leaders in the industry. We also provide you with the best mental health services by using the most technologically advanced resources for our therapy offerings. Call us at 954.332.0740 or contact us to schedule a comprehensive consultation.