TMS for Postpartum Depression: Effectiveness, Safety, and What to Expect

If postpartum depression hasn't responded to treatment the way you'd hoped, you may feel desperate. But you're not out of options. TMS is a treatment that can help even when first-line options like medication and therapy haven’t. Here's what to know about TMS therapy for postpartum depression: how it works, what the research says, and whether it could be a good fit for you.

Unlike the "baby blues," which usually resolves within a few weeks, postpartum depression is a medical condition that causes severe, persistent symptoms. But between caring for a new baby, running on little sleep, and trying to feel like yourself again, figuring out your options can feel overwhelming. Fortunately, there are effective treatments available — including TMS therapy for postpartum depression.

Transcranial magnetic stimulation (TMS) is an FDA-cleared treatment for major depressive disorder. It's a non-invasive treatment that uses magnetic pulses to stimulate areas of the brain involved in mood regulation. While it's not specifically FDA-cleared for postpartum depression, it may be an option if therapy or medication hasn't provided enough relief or if you're interested in a non-pharmaceutical approach. 

Below, learn what the research says about TMS therapy for postpartum depression, what we know about breastfeeding and safety, and what treatment actually looks like.

One note: If you're experiencing hallucinations, delusions, mania, severe confusion, or thoughts of harming yourself or your baby, seek emergency medical care immediately. These symptoms could be a sign of postpartum psychosis, which requires urgent treatment.

Can TMS help postpartum depression?

Yes, early research suggests TMS can relieve postpartum depression symptoms for some people. While the evidence is more limited than it is for major depressive disorder, the results so far are encouraging.

"TMS is absolutely a good option for the treatment of postpartum depression, especially for anyone who has a prior history of depression, and who hasn't improved much with medications and therapy," says Steve Harvey, MD, Radial’s Midwest regional director.

While TMS isn't specifically FDA-cleared for postpartum depression, it is for major depressive disorder. Since postpartum depression is often diagnosed as a major depressive episode after childbirth, healthcare providers may still recommend TMS.

Research on TMS for postpartum depression is still evolving, and studies so far have generally been small. That's why it's too soon to say exactly how well it works for everyone. Still, findings suggest TMS may be a promising option — particularly for people whose symptoms haven't improved enough with therapy, medication, or both.

What does the research say about TMS for postpartum depression?

The biggest challenge in answering this question is that there simply isn't much research specifically on TMS for postpartum depression. Even so, the research that's available points in a promising direction. Here's a closer look at what studies have found:

• A 2010 study in Brain Stimulation showed encouraging early results. Nine women with postpartum depression received four weeks of TMS, and their symptoms improved significantly within two weeks. Eight participants reached remission by the end of treatment, and most remained in remission six months later. However, the study was very small and didn't include a comparison group.
• Another small study from 2020 published in the Journal of Affective Disorders reported similar results. Six women with postpartum depression received 20 TMS sessions over four weeks. Their depression and anxiety symptoms improved during treatment, and those improvements largely lasted for six months. However, the study included only six participants and no comparison group.
• A 2021 review in BMC Pregnancy and Childbirth found much the same. After analyzing 11 studies of peripartum depression (which includes depression during pregnancy and after childbirth), researchers concluded that TMS appears to reduce depression symptoms without serious safety concerns. 
• A 2025 review of TMS during pregnancy published in Brain and Behavior also found encouraging results. While it didn't include postpartum patients, researchers concluded that TMS appeared to safely reduce depression symptoms during pregnancy.

That said, it's important to interpret these findings with context. Most have few participants, used different TMS protocols and treatment schedules, and followed patients for only a short time. Some reviews also include overlapping patient populations, meaning the total amount of evidence isn't as large as it may first appear.

Taken together, the available evidence suggests TMS may be a helpful option for some people with postpartum depression. But larger, well-designed clinical trials are still needed before researchers can say with confidence how effective it is, which patients are most likely to benefit, and which treatment protocols work best.

What is known about TMS during breastfeeding?

If you're breastfeeding, it's completely understandable to wonder how any depression treatment could affect your baby. The good news is that TMS doesn't involve medication, so it doesn't introduce drugs into your bloodstream or breast milk.

"There is no known safety concern to breastfeed while you're having a course of TMS," says Harvey. "In contrast, using antidepressants carries some risk because a small amount of antidepressant medication is present in breast milk."

Even so, it's important to remember that research on TMS while breastfeeding is still limited. While the treatment itself isn't expected to expose a nursing infant to medication, there haven't been many studies specifically about breastfeeding.

It's also important to know that breastfeeding doesn't necessarily mean antidepressants are off the table. Many have been well-studied during lactation and may still be a good option.

At the end of the day, feeding goals are just one part of the decision. The right treatment is the one that best supports both your mental health and your family's needs, whether that's TMS, medication, therapy, or a combination of approaches. Consult with a psychiatric clinician to see what's right for you.

How does TMS fit into postpartum depression treatment?

Postpartum depression looks different for everyone, so treatment does too. Depending on your symptoms, your provider may recommend therapy, medication, TMS, newer postpartum-specific medications, or a combination of treatments.

In fact, for many people, TMS isn't a replacement for therapy or medication. It's another tool that can be added when those treatments haven't provided enough relief. Some people continue seeing a therapist while receiving TMS, while others stay on antidepressants during treatment. 

Ultimately, the best approach depends on your symptoms, treatment history, breastfeeding goals, medical history, and what feels right for you.

When might a clinician consider TMS?

"The short answer is that you're probably a good candidate if you're depressed and medications aren't working for you," says Harvey. 

While every situation is different, TMS may be worth discussing with your provider if:

• Your depression hasn't improved enough with therapy, medication, or both
• Medication has caused side effects that have been difficult to tolerate
• You'd prefer a non-medication treatment
• You've responded well to TMS in the past
• You're able to commit to several outpatient appointments each week for a few weeks
• A psychiatric evaluation shows TMS is an appropriate option for you

Before recommending TMS, your clinician will also check you for conditions like bipolar disorder, mania, psychosis, substance misuse, and previous postpartum psychiatric episodes, since these can affect treatment decisions.

When might another treatment be more appropriate?

Sometimes another treatment may be a better first step. If your symptoms are mild, psychotherapy or medication may be enough to help you feel better, says Harvey. If you're experiencing postpartum psychosis, mania, catatonia, or you're at immediate risk of harming yourself or your baby, you'll likely need more urgent or intensive treatment like hospitalization or ECT. 

The important thing to remember is that choosing another treatment doesn't mean TMS has failed, and choosing TMS doesn't mean other treatments aren't helpful. The goal is to find the approach that gives you the best chance of feeling better, and your provider will help you weigh when options like TMS vs. ECT are best for you.

What is TMS treatment for postpartum depression actually like?

If you're considering TMS, it's natural to wonder how you'll fit treatment into life with a new baby. While everyone's experience is different, knowing what to expect can make the process feel a little less overwhelming.

Consultation

Before treatment begins, you'll meet with your provider to talk through what you've been experiencing and whether TMS is a good fit. 

They'll ask about your symptoms, previous treatments, medical history, sleep, anxiety, breastfeeding goals, and anything else that could help guide your care. They'll also screen for conditions like bipolar disorder or postpartum psychosis, since these may require a different treatment approach.

Length of treatment

One of the biggest commitments with TMS is the schedule. Treatment schedules vary depending on the type of TMS, but according to research in Clinical Psychopharmacology and Neuroscience, common options include:

• Standard repetitive TMS (rTMS): The original FDA-cleared approach involves one 20- to 40-minute session, five days a week, for about six weeks, sometimes followed by a short taper.
• Intermittent theta burst stimulation (iTBS): This newer protocol delivers stimulation in shorter bursts, shortening sessions to just three to four minutes each while following a similar five-day-a-week schedule.
• Accelerated TMS: Rather than spreading treatment over several weeks, accelerated TMS delivers multiple sessions per day over about five to six days. 

No anesthesia

One of the things many people appreciate about TMS is that it doesn't require anesthesia or sedation. During treatment, you'll sit comfortably in a chair while a magnetic coil delivers gentle pulses to targeted areas of your brain. Most people say it feels like a tapping sensation on the scalp.

When the session is over, you can usually drive yourself home and continue with the rest of your day as usual.

Side effects

TMS is generally well-tolerated, and most TMS side effects are mild and temporary. Per research published in Clinical Neurophysiology, the most common include:

• Mild scalp discomfort or tenderness where the magnetic coil rests
• Headache
• Lightheadedness 
• Mild nausea

Many of these side effects become less noticeable as treatment continues. If you're uncomfortable, let your provider know — they can often adjust the coil position or stimulation settings to make treatment more comfortable.

Serious side effects are rare but can occur. For example, TMS carries a very small risk of seizure according to the same article in Clinical Neurophysiology, which is why your provider will carefully review your medical history before treatment begins.

Symptom monitoring

Throughout treatment, your provider will check in to see how you're feeling. They may use questionnaires like the Edinburgh Postnatal Depression Scale (EPDS) or PHQ-9, which track how your symptoms change throughout treatment. They'll also ask about things like your sleep, anxiety, daily functioning, and how you're adjusting to life with your baby.

It's also important to remember that everyone responds to TMS on their own timeline. Some people notice TMS starts working within the first few weeks, while others experience more meaningful changes later in the process, according to a 2024 study in Mental Health Research. 

So if you don't feel better right away, don’t worry — it doesn't necessarily mean the treatment isn't working. Regular check-ins help your provider track your progress and make any adjustments needed along the way.

Practical planning

Committing to appointments five days a week can feel daunting when you're caring for a newborn. For many new parents, the hardest part of TMS is finding the time and support to make it work. You may need to arrange childcare, plan feedings or pumping around appointments, or lean on loved ones a little more than usual. 

But if life with a new baby throws your schedule off, don't panic. If you miss a session, your provider can usually adjust your treatment schedule to keep you on track.

The bottom line

If postpartum depression hasn't improved as much as you'd hoped, you’re not out of options. While research on TMS for postpartum depression is still emerging, early studies suggest it may be a promising treatment for some. 

The best way to know whether it's right for you is to have an open conversation with a provider. And no matter what your treatment plan looks like, know that there are effective options available, and you don't have to navigate postpartum depression alone.

Key takeaways

• TMS may be a promising treatment option for postpartum depression, particularly if therapy, medication, or both haven't provided enough relief.
• TMS is FDA-cleared for major depressive disorder, but some clinicians also use it to treat postpartum depression.
• Early studies suggest TMS can reduce postpartum depression symptoms, but larger, higher-quality clinical trials are still needed.
• TMS doesn't involve medication, so there's no known safety concern with breastfeeding during treatment. However, research on TMS and breastfeeding is still limited.
• TMS is an outpatient treatment that doesn't require anesthesia or sedation, and most people can return to their normal activities after each session.

Frequently asked questions (FAQs)

Can TMS be used while taking antidepressants or attending therapy?

Yes. TMS is often used alongside antidepressants, psychotherapy, or both. These treatments work in different ways, and for many people, a combination approach offers the most relief.

How long does a course of TMS for postpartum depression typically take?

It depends on the treatment protocol. Standard TMS is five days a week for four to six weeks, sometimes followed by a short taper. Newer protocols, like intermittent theta burst stimulation, follow a similar schedule but each session lasts just a few minutes. Some centers, like Radial, also offer accelerated TMS, which delivers multiple treatments per day over five to 6 days.

Is TMS covered by insurance for postpartum depression?

TMS is sometimes covered by insurance. You'll likely need to go through an insurance preauthorization process and show that you've already tried other depression treatments without enough relief, says Harvey. Coverage requirements vary by insurer, so check with your provider and insurance plan before starting treatment.

‍

‍