The most useful things you can do for someone having TMS are practical and quiet: help them get to a daily appointment for several weeks, notice small changes they may not see yet, and know which warning signs call for action the same day. You do not need to understand the physics or push them to feel better faster.
This guide is for partners, parents, adult children and close friends. It covers what the course involves, how to help without taking over, what change usually looks like, the signs that need a call to the treatment team or a crisis line, and how to look after yourself while you do this.
What your loved one is signing up for
TMS uses magnetic pulses from a coil held against the scalp to stimulate an area of the brain involved in mood. The person is awake, seated and can talk; there is no anesthesia. The commitment is mostly time. Expert consensus says a standard acute course of 20 to 30 sessions over about 6 weeks, on weekdays, will very likely be needed. Each session can take from a few minutes for theta-burst protocols to around 19 to 37.5 minutes for standard ones.
The most common side effects are scalp discomfort and headache, which are usually temporary and tend to ease after the first week or so. Seizures are a rare but recognized risk, and in a large survey they occurred at fewer than 1 per 60,000 sessions when guidelines were followed in people without risk factors. For a fuller picture, what TMS therapy is and TMS side effects are good starting points to read together.
Helping with logistics, without taking over
Depression makes daily tasks feel heavy, and a daily appointment for weeks is exactly the kind of thing it erodes. Logistics are where support makes the biggest practical difference.
- Ask what would help, then offer specifics. "Can I drive you Mondays and Wednesdays?" is easier to accept than "Let me know if you need anything."
- Protect the time slot. Cover a school pickup, a dog walk or a meeting so the appointment does not slip.
- Help with the paperwork. Insurance calls, prior authorization letters and medication histories are draining; see the TMS preparation checklist.
- Plan the route together. Fitting daily TMS sessions into a Brooklyn week has transit and timing ideas.
- Support sleep and steady habits. Sleep deprivation and alcohol withdrawal lower the seizure threshold, so an evening routine that protects sleep and avoids heavy drinking helps. More in caffeine, alcohol and sleep during TMS.
- Let them own the treatment. Offer to come to the consultation, but let them decide what to share with the team and with you.
Noticing change
Improvement with TMS is usually gradual, and the person having it is often the last to notice. Depression colors memory, so "nothing has changed" can be said sincerely while you see differences.
Early changes are often practical rather than emotional. Look for things like:
- Getting up with less struggle, or showering without prompting.
- Answering messages, making a phone call they had been avoiding.
- Cooking, eating more regularly, taking an interest in a show or a book.
- Small moments of humor or irritation, which can mean emotions are coming back online.
Share what you see gently and specifically: "You went for a walk three times this week." Avoid "You seem fine now," which can feel dismissive if they still feel low. Early change matters clinically, too: in one naturalistic study of 196 people who had rTMS together with psychotherapy, early improvement at session 10 was highly predictive of response by the end. Your observations can sit alongside their questionnaire scores; tracking progress during TMS explains how.
Be prepared for slower change, too. National guidance in England asks clinicians to make sure patients understand TMS may not give them benefit. If the course does not help, it is not a failure of effort; what if TMS does not work covers next steps.
Warning signs that need action
Most of a TMS course is uneventful. A few situations, though, need a prompt response. FDA guidance for TMS devices asks for a prominent warning about worsening depression or suicidal thoughts, so the team expects to hear about these.
| What you notice | What to do |
|---|---|
| Talk of wanting to die, being a burden, or having no reason to live; making a plan; giving away belongings; saying goodbye | Stay with them. Call or text 988, or go to the nearest emergency room if they are in immediate danger |
| Much less need for sleep, racing thoughts, talking fast, feeling unusually up, wired or irritable | Contact the TMS team or psychiatrist the same day |
| Depression clearly worsening over several days | Contact the team within a day or two |
| Drinking or drug use increasing | Raise it gently and encourage them to tell the team |
| A seizure or collapse | Call 911 |
The suicide warning signs above come from the National Institute of Mental Health, which advises getting help as soon as possible, particularly if the behavior is new or has increased recently. The mania symptoms come from NIMH's description of a manic episode.
Mania with TMS is uncommon. A 2021 meta-analysis of 25 blinded trials found the risk of a switch into hypomania or mania was not significantly different from sham treatment. It is still worth knowing the signs, especially if your loved one has bipolar disorder, which FDA's guidance for TMS devices lists among the groups lacking evidence for effectiveness or safety. The physician's guide covers TMS for bipolar depression in depth.
If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.
If your loved one is a teen or young adult
Several TMS devices are FDA-cleared as an add-on (adjunct) treatment for major depressive disorder in people aged 15 to 21, meaning alongside other treatment such as medication. Parents usually have a bigger logistics role and a closer view of daily change. Read TMS for teens and young adults for what is known and what is not, and keep therapy and school supports going during the course.
What not to say
- "This is your last chance." Pressure adds weight to every session and is not true; there are other options.
- "Are you better yet?" every day. Pick a weekly check-in instead.
- "You just need to try harder." Depression is a medical condition; effort is not the missing ingredient.
- "I read it works for most people." Success rates vary widely by study design, and comparisons are easy to misread.
Helpful alternatives are simpler: "I'm glad you're doing this," "Want company on Tuesday?" and "What's been hardest this week?"
Caring for yourself
Supporting someone with depression is tiring, and it often runs for months before treatment starts. You are more useful over six weeks if you are not running on empty.
- Share the load. Split driving or check-ins with another friend or relative.
- Keep one thing that is yours. Exercise, a class, time with friends.
- Get your own support. Individual therapy, a caregiver support group or family therapy can help. The practice also has a piece on how family support aids depression recovery.
- Watch your own mood. Caregivers can become depressed too. If you notice that in yourself, it deserves care in its own right.
After the course
The end of daily sessions can feel abrupt. Help them keep the routines that helped, such as walks, regular sleep and therapy, and keep an eye out for early signs of relapse. Life after TMS: building a relapse-prevention plan is worth reading together. For an overview of treatment, see the TMS therapy page and the full patient's guide to TMS.
Sources
- Warning Signs of Suicide. National Institute of Mental Health, 2025. nimh.nih.gov
- Bipolar Disorder. National Institute of Mental Health, 2025. nimh.nih.gov
- Simultaneous rTMS and psychotherapy in major depressive disorder: Clinical outcomes and predictors from a large naturalistic study. Brain Stimulation, 2018. pubmed.ncbi.nlm.nih.gov
- Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression. Journal of Clinical Psychiatry, 2018. pmc.ncbi.nlm.nih.gov
- K173620 510(k) Summary – MagVita TMS Therapy System w/Theta Burst Stimulation. U.S. FDA, 2018. accessdata.fda.gov
- Transcranial magnetic stimulation in the treatment of major depressive disorder: a comprehensive summary of safety experience from acute exposure, extended exposure, and during reintroduction treatment. Journal of Clinical Psychiatry, 2008. europepmc.org
- Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. Clinical Neurophysiology, 2019. europepmc.org
- Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines. Clinical Neurophysiology, 2021. europepmc.org
- Repetitive transcranial magnetic stimulation for depression (HTG396, formerly IPG542). NICE, 2015. nice.org.uk
- Class II Special Controls Guidance Document: Repetitive Transcranial Magnetic Stimulation (rTMS) Systems. U.S. FDA, 2011. fda.gov
- Hypomanic/manic switch after transcranial magnetic stimulation in mood disorders: A systematic review and meta-analysis. World Journal of Psychiatry, 2021. europepmc.org
- 510(k) Premarket Notification database records (K231926 and later adolescent clearances). U.S. FDA, 2024. accessdata.fda.gov
- Daily left prefrontal transcranial magnetic stimulation therapy for major depressive disorder: a sham-controlled randomized trial. Archives of General Psychiatry, 2010. pubmed.ncbi.nlm.nih.gov
FAQs
Can I sit in the room during a TMS session?
Some clinics allow a companion, others do not. Ask the TMS team. Hearing protection is required in the treatment room, so you may be asked to wear earplugs too.
Should I tell the TMS team what I notice at home?
Ideally, your loved one shares it, or invites you to. If you are worried about safety, such as suicidal talk or signs of mania, contact the team or a crisis line directly.
How will I know if TMS is working?
Change is usually gradual and often shows up first in daily functioning, such as getting up more easily, eating regularly or reconnecting with people. Questionnaire scores tracked by the team show the trend over weeks.
My partner wants to stop halfway. What should I do?
Listen to why. Side effects, logistics or feeling no change are common reasons and can often be addressed. Encourage them to talk with the TMS team before stopping rather than deciding alone.
Is it normal to feel frustrated or exhausted as a supporter?
Yes. Caring for someone with depression is demanding. Sharing the load and getting support for yourself is part of helping them, not a distraction from it.
