TMS Therapy in North Carolina

Transcranial magnetic stimulation (TMS) is a therapy that uses magnetic fields to activate nerve cells in the brain. We primarily use it to treat treatment-resistant depression, meaning depression that hasn’t improved with medication or other treatments.

However, TMS can also help with other conditions, including obsessive-compulsive disorder (OCD), anxiety, PTSD, Parkinson’s disease, and smoking cessation.

To understand TMS, it helps to understand what’s happening in the brain when someone has depression.

In people with treatment-resistant depression, certain areas of the brain — particularly the prefrontal cortex, which regulates mood — show reduced activity. The nerve cells in these regions are not communicating the way they should, and antidepressants alone are not enough to fix that for everyone.

TMS targets this directly. The device delivers focused magnetic pulses to the underactive areas of the brain. Those pulses create small electrical currents that stimulate the nerve cells, encouraging them to fire and communicate more effectively. Over the course of a full treatment cycle, this repeated stimulation essentially helps rewire those neural pathways — restoring activity in regions that depression has quieted.

Think of TMS like physical therapy for the brain. Just as repeated exercises rebuild strength in an injured muscle, repeated TMS sessions rebuild healthy activity patterns in areas of the brain affected by depression. The effects are not immediate, which is why a full course of TMS treatment spanning several weeks is necessary to see lasting results.

Unlike medication, TMS does not introduce any chemical into your body. It works entirely through targeted magnetic stimulation, which is why it does not carry the same side effects that many antidepressants do.

Antidepressants can cause a wide range of systemic side effects including weight changes, sexual dysfunction, sleep disruption, and emotional blunting.

TMS side effects are localized and mild — most commonly a slight headache or scalp discomfort during the first few sessions that fades over time.

Time to Results

Both antidepressants and TMS take time to work. Antidepressants typically require four to six weeks before a meaningful change in mood is felt. With TMS, most patients begin noticing improvement within the first one to two weeks of treatment, though the full benefit is usually felt after completing the entire course.

Can TMS and Antidepressants be Combined?

Yes. TMS and antidepressants are able to be combined. Many patients continue their medication while undergoing TMS, and research suggests the combination can improve outcomes for both treatments.

TMS has shown strong results for OCD. In clinical research, 38% of patients who received TMS reported meaningful symptom improvement, compared to just 11% in the placebo group.

Smoking Cessation

In a pilot study, 90% of patients who received TMS for smoking reported staying smoke-free and having fewer cravings at a 25-day follow-up. These results have been supported by other similar studies.

Anxiety and PTSD

While research is still growing, TMS shows early promise for both anxiety disorders and PTSD, particularly for patients who have not found relief through medication or therapy alone.

TMS is done in an outpatient setting. You sit in a reclined chair while one of our team members places a small, lightweight device against your head — similar to a helmet or headset. It rests comfortably near the area of the brain being treated and never breaks the skin or requires any kind of insertion.

Each session typically lasts between 20 and 40 minutes. Most treatment courses run 5 days a week for 4 to 6 weeks. During the session you will hear a clicking sound and feel a gentle tapping sensation on your scalp — most patients adjust to this quickly. You are fully awake the entire time with no sedation needed. When the session ends, you can drive yourself home and return to your normal day right away.

What to Expect After TMS Treatment

Most people can return to their regular routine immediately after each session. Some patients begin to notice mood improvements after the first one to two weeks, though it can take longer depending on the individual. Results vary based on factors like the severity of your condition, your overall health, and whether you are using other treatments at the same time.

Like any other medical treatment, TMS is not right for everyone. Because TMS works by delivering magnetic pulses to the brain, certain medical conditions or implants can make it unsafe or less effective.

That is why a thorough evaluation with your provider is always the first step — not just to confirm you are a good candidate, but to make sure treatment is tailored to your specific situation.

You may not be a candidate for TMS if you have:

• Metal implants in or near your head (pacemakers, cochlear implants, aneurysm clips, etc.)
• A history of seizures or epilepsy
• A history of traumatic brain injury
• Bipolar disorder (requires careful evaluation)
• Current pregnancy

This list is not exhaustive. Always share your full medical history with your provider before starting TMS, including any medications you are taking and any past procedures or surgeries. If something disqualifies you from TMS, our care team will work with you to find an alternative path forward — being ineligible for one treatment does not mean you are out of options.

This can be a common concern, especially if you’ve tried multiple depression treatments. While TMS is effective for many people, it is not a guaranteed solution for everyone. If you complete a full course of TMS and do not see the improvement you were hoping for, that does not mean you are out of options. Depression and other mental health conditions often require trying more than one approach before finding what works.

Our team will work with you to review your response, adjust the treatment plan if needed, and explore other evidence-based options. You deserve care that fits your needs — and we will keep looking until we find it.