Relapsing Depression: Why TMS Therapy Doesn’t Mean You Have to Start from Zero
When someone struggles with depression, they often take medication. When the medications don’t help their symptoms, they often switch to a proven treatment method like TMS therapy.
But what happens when depression symptoms return?
Relapsing depression, which doctors define as a depressive episode that returns fewer than six months after treatment, can make a person feel completely hopeless, like nothing they tried actually worked. However, this isn’t the case: a recent study has shown that a second course of TMS therapy can be even more effective than the first round when it comes to treating returning symptoms of depression.
Anew Era TMS & Psychiatry offers TMS therapy and more at our offices in California and Texas.
TMS Study: TMS Found to be Effective in Treating Relapsing Depression
The landmark study, published in Acta Psychiatrica Scandinavica, was a collaboration between Discovery Behavioral Health (our parent company), Harvard Medical School and Mass General Brigham Hospital. It examined 259 patients from 20 of Discovery’s outpatient TMS therapy centers over a three-year period. All of these patients returned for a second course of TMS therapy.
Here’s what the study found:
- 5% of patients responded during their second treatment course, compared with a 66.8% response rate seen across the system during first courses.
- 2% achieved remission during retreatment versus a 39.0% first‑course remission rate system‑wide.
- Among patients who fully remitted in their first course, 1% responded again during retreatment and 71.3% achieved remission again.
This study includes one of the largest real‑world groups of patients who received a second course of TMS. The results give clinicians practical, easy‑to‑use information to help patients decide whether retreatment is a good option when their depression returns.
Seeking TMS therapy is almost always a good decision. Noninvasive, fast, and with no anesthesia needed, TMS offers people struggling with treatment-resistant depression, relapsing depression, and other mental and physical health conditions real hope.
What Is Relapsing Depression?
Although it’s not an official medical term, “relapsing depression” refers to when a person experiences significant symptoms of depression after recovering from an earlier depressive episode. Basically, it’s depression that comes back from remission.
It’s important to remember that relapsing depression is different from recurring depression. A depressive relapse occurs before full management is sustained, after weeks or months of improvement. Recurring depression involves a new depressive episode after a longer period of recovery.
Why Does Depression Relapse?
Like other mental health disorders, depression is often a chronic condition, meaning it’s not unusual to experience multiple episodes of depression throughout life.
As for why depression relapses, there’s no one cause. Many factors affect when and how the symptoms of depression return, even after treatment:
Biological Causes
Some of us have a nervous system that is more vulnerable to mood disruption or stress. This vulnerability can be caused by genetics, experiences early in life, or the brain’s patterns in how it regulates mood. This can cause:
- Greater amounts of stress hormones like cortisol that stay elevated after certain triggers
- The brain to return to depressive patterns more easily
- Fragile neurotransmitter systems and sleep-wake cycles even after depression symptoms improve
Residual Symptoms
Depression can be a little bit like a fire. Residual symptoms like low energy and disrupted sleep can be like embers that can reignite a depressive episode even months after treatment. Unfortunately, these lingering symptoms often make the brain less resilient to stress…and are among the strongest predictors of relapsing depression.
Life Events and Stress
Stress can be fuel for depression. When you’re under stress and feeling overwhelmed, it’s common for the brain to slide back to familiar patterns.
Stress triggers include:
- Work pressure
- Burnout
- Financial strain
- Relationship issues
- Grief and major life changes
- Chronic pain and/or illness
Stress doesn’t necessarily cause depression by itself, but it can certainly contribute to it.
Stopping Depression Treatment Too Early
Ending treatment for depression too early can seriously raise the risk of relapse. Our brains need time to relearn new coping mechanisms, behavior patterns, and mood regulation. It’s also common to need maintenance treatment, too – something Anew Era offers. Finally, if you’re on medications, stopping them too quickly can cause your symptoms to rebound.
Underlying Chronic Patterns
Depression is often a recurring condition for many people. Instead of a single episode of depression, many people experience multiple, ongoing episodes. Unfortunately, these episodes can increase the likelihood of another depressive episode, even helping our brains become more used to depressive thought patterns and responses.
This is why many people recommend long-term management for depression instead of short-term treatment. TMS maintenance treatment can be very successful long-term.
Lifestyle
Certain habits can make relapse more likely, especially when they disrupt the brain’s stability. Examples include:
- Poor sleep
- Social isolation
- Substance use
- Irregular routines
- Lack of physical activity
These don’t cause depression by themselves, but they can weaken resilience.
What Is TMS Therapy?
Transcranial magnetic stimulation (TMS) is a noninvasive, drug‑free treatment that uses gentle magnetic pulses to stimulate specific areas of the brain involved in mood regulation. It’s FDA‑approved for depression and several other conditions and is often recommended when traditional treatments like medication or talk therapy haven’t provided enough relief.
During a TMS session, a small electromagnetic coil is placed against the scalp. This coil sends magnetic pulses through the skull, creating tiny electrical signals that activate underactive brain regions linked to depression. Over time, this stimulation helps improve communication between brain cells and supports healthier mood regulation.
How Does TMS Treat Depression?
Depression is linked to reduced activity in a key region of the brain called the left dorsolateral prefrontal cortex (DLPFC), an area involved in motivation, decision‑making and emotional regulation.
TMS uses magnetic pulses to activate this underactive region. When the DLPFC becomes more active, it strengthens its connection to deeper emotional centers like the amygdala, helping the brain regulate mood more effectively. Each pulse creates a tiny electrical current in the targeted brain cells. Over repeated sessions, this stimulation leads to:
- Increased neural activity in areas that are sluggish during depression
- Improved communication between mood‑related brain networks
- Strengthening of healthy neural pathways
- Reduction of overactive stress circuits
This process is called neuroplasticity, the brain’s ability to reorganize and form new, healthier patterns.
Repeated Sessions Matter
TMS isn’t a one‑time treatment. The brain changes gradually, which is why a typical course involves daily sessions for several weeks. With consistent stimulation, the brain begins to “learn” new patterns of activity, similar to physical therapy for the brain.
As these neural circuits strengthen, people often experience:
- More stable mood
- Improved motivation and energy
- Better concentration
- Reduced anxiety
- Less emotional reactivity
- Greater ability to enjoy activities again
Many patients start noticing changes around the second or third week, though some respond earlier or later.
Relapsing Depression isn’t Your Fault
Relapsing depression isn’t your fault, and it’s important to say that plainly. When symptoms return after you’ve worked hard to get better, it’s easy to blame yourself or feel like you “should have done more.” But depression doesn’t work that way. Here’s why:
Depression involves changes in brain chemistry, stress‑response systems, and neural circuits. These aren’t things you control through willpower. They’re biological processes, just like blood pressure, thyroid function, or insulin regulation. When symptoms return, it reflects how the condition behaves, not anything you did wrong.
Many people experience depression in episodes, with periods of improvement followed by periods of return. This pattern is extremely common. Relapse doesn’t mean you didn’t try hard enough, didn’t stay positive, or didn’t “want recovery” enough. It means your brain is still healing, and sometimes it needs additional support.
Here’s something else to consider: Major stressors, grief, burnout, illness, or big life changes can activate underlying vulnerabilities. You can be taking care of yourself, using your tools, staying connected…and still experience a relapse.
That’s not failure. That’s being human.
Build On Your Success with TMS Therapy at Anew Era TMS & Psychiatry
If you’re experiencing relapsing depression, don’t lose hope. Many people who respond well to TMS the first time continue to benefit from additional sessions when symptoms return. Anew Era TMS & Psychiatry offers retreatment plans designed to help you regain momentum, rebuild stability, and feel like yourself again.
Relapse doesn’t mean you failed: it simply means your brain may need another round of support. Because TMS strengthens the neural pathways involved in mood regulation, retreatment often works faster, more predictably, and with higher response rates than the first course. It’s a powerful way to build on the progress you’ve already made.
If you’re noticing symptoms creeping back in, you don’t have to wait for them to get worse. Our team can help you explore whether a second course of TMS is right for you and guide you toward the next step in your mental wellness journey.
Reach out to Anew Era TMS & Psychiatry today to learn more.
Frequently Asked Questions
What is relapsing depression?
Relapsing depression is when symptoms return after you’ve previously improved or reached remission. It’s a common pattern of major depressive disorder and not a sign of personal failure.
Why does depression relapse?
Depression can relapse due to biological vulnerability, stress, residual symptoms, or stopping treatment too early. Even when you’re doing everything “right,” the brain sometimes needs renewed support.
Is relapsing depression my fault?
No. Depression is a medical condition involving brain circuits and stress‑response systems. Relapse reflects how the condition behaves, not anything you did wrong.
How does TMS help treat relapsing depression?
TMS re‑stimulates the brain’s mood‑regulation network, strengthening underactive areas linked to depression. This helps restore healthier neural activity and reduces symptoms.
Does TMS work again if symptoms come back?
Yes. Research conducted by our parent company shows that people who responded to TMS before often respond again (and sometimes even faster) during retreatment.
Why is TMS effective for relapse?
Because TMS builds neuroplasticity. A second course reinforces the pathways strengthened during the first course, helping the brain regain stability.
