TMS Integration Guide

Prepare. Stimulate. Integrate.

A guide for getting the most from your TMS treatment — before, during, and after each session.

Set Your Intention

What are you working toward in this treatment?

Through this treatment, I am building toward

TMS is cumulative. Returning to your intention helps you track subtle shifts over weeks.

Before Your Session
  • 💧Hydrate wellDrink plenty of water beforehand — a well-hydrated brain responds better to stimulation
  • 🍳Eat a balanced mealDon't arrive hungry. Stable blood sugar helps you stay comfortable and alert
  • ☕Limit caffeine and alcoholReduce or skip caffeine before your session to minimize jitters and restlessness. Avoid alcohol the night before — even a mild hangover can reduce treatment effectiveness by increasing inflammation, disrupting sleep quality, and leaving your brain in a less receptive state
  • 🧽Clean, product-free hairAvoid gels, sprays, or heavy products on your hair — they can interfere with coil contact
  • 🎧Bring headphones or a podcastYou'll be awake and seated. Music, podcasts, or audiobooks can help you relax during the session
After Your Session
  • 🌙Prioritize sleep tonightYour brain consolidates the stimulation during sleep. Protect your rest, especially early in treatment
  • ✅Resume your day normallyYou can drive, work, and do everything you normally would — no recovery time needed
  • 📝Track how you feelJournal mood, energy, sleep quality, and motivation. Changes are often subtle at first
  • 💊Take OTC pain relief if neededMild headache or scalp tenderness is normal early on — it usually fades as treatment continues
  • 💬Communicate with your care teamReport any changes — mood shifts, sleep changes, discomfort. They can adjust intensity and positioning
🔬

The Science

How TMS Rewires Your Brain

TMS delivers focused magnetic pulses to the left dorsolateral prefrontal cortex (DLPFC) — a brain region often underactive in depression. Each pulse generates a small electrical current that activates neurons, and over repeated sessions, this stimulation strengthens synaptic connections through a process called Long-Term Potentiation (LTP). Think of it like physical therapy for the brain: just as muscles rebuild through consistent exercise, neural circuits rebuild through consistent stimulation. This is why completing the full course of treatment is critical — each session builds on the last.

Completing Your Full Course Matters

In a study of more than 7,000 TMS patients, those who completed a full course of treatment experienced significantly better outcomes:

82%greater improvement in
remission rates
43%greater improvement in
response rates

TMS is cumulative — most people don't feel dramatic changes after session one. Real shifts typically emerge in weeks 2–4. Each session builds on the last. Skipping sessions disrupts the neural rewiring process.

Support Your Brain's Work

😴 Consistent sleep🥗 Balanced nutrition🚶 Regular movement🧘 Stress management📵 Reduced overstimulation
Track Your Shifts

Changes with TMS are often subtle. Tracking helps you — and your care team — see progress that daily awareness might miss.

Mood
  • Overall mood
  • Irritability
  • Motivation
  • Joy · Interest
  • Hopelessness
  • Emotional range
  • Crying spells
Energy
  • Morning energy
  • Afternoon crashes
  • Physical fatigue
  • Mental fog
  • Desire to move
  • Engagement level
  • Recovery time
Sleep
  • Falling asleep
  • Staying asleep
  • Sleep quality
  • Dreams
  • Morning alertness
  • Nighttime anxiety
  • Restfulness
Thinking
  • Rumination
  • Negative self-talk
  • Focus · Clarity
  • Decision-making
  • Problem-solving
  • Future outlook
  • Self-compassion
Integration Journal Prompts

Use these weekly throughout your treatment course. They help you notice changes that happen gradually.

1Compared to last week, my mood has been...
2Something I noticed this week that I wouldn't have noticed before is...
3My energy and motivation to do things I used to enjoy feels...
4The negative thoughts I usually have feel... (louder / quieter / different)
5One small action I took this week that I'm proud of is...
6The thing I most want to tell my care team about is...
7My sleep this week has been... and I think it's because...
8The relationships in my life feel... (closer / strained / different)
9I'm starting to believe that I can...
10Something that used to feel overwhelming but now feels manageable is...
11What I'm most looking forward to right now is...
12If this treatment could give me one thing, I'd want it to be...