If you’re starting TMS therapy for depression, it’s completely normal to wonder how long it will take before you start to feel better. At Clear Path Psychiatry, we’ve treated many patients in Seattle with TMS, and we understand how important it is to set realistic expectations while offering hope.
I started treating patients with TMS back in 2015 using the original BrainsWay H1 coil. It was exciting to see people improve—especially without the side effects that often come with daily antidepressant medications. However, one of the biggest challenges with conventional, once-daily TMS treatment is that it works gradually. Most people don’t feel immediate relief. In fact, symptom improvement typically begins after two to four weeks of daily treatment. For many patients, the changes are subtle at first—things like better sleep, improved focus, or a more stable mood.
While some notice improvement earlier, it’s common to reach the end of four weeks and still feel little to no change. This doesn’t mean the treatment isn’t working. Research shows that 72.7% of people who don’t respond during the first four weeks (often called “acute phase non-responders”) go on to experience significant improvement during the continuation phase, when TMS is reduced to twice per week. This is why most standard TMS depression protocols involve 44 total sessions: once-daily TMS for four weeks, followed by twice-weekly sessions for twelve more weeks.
Still, waiting three to four months for full symptom relief can feel like a long time—especially if you’re in crisis. In recent years, there’s been a growing shift in psychiatry to view major depression as a brain emergency—something that deserves fast, effective treatment options. This is driving interest in accelerated forms of TMS, which aim to deliver faster relief than traditional protocols.
