Transcranial magnetic stimulation (TMS) and eye movement desensitisation and reprocessing (EMDR) are two very different kinds of mental health treatment.
TMS is a non-invasive procedure that applies magnetic pulses to activate the parts of the brain involved in mood regulation. EMDR is an organized psychotherapy that helps a person process disturbing or traumatic memories.
Neither treatment is necessarily better than the other. The most appropriate choice relies on the condition being treated, the symptoms involved, past experiences with treatment and examination by a skilled healthcare professional.
TMS vs EMDR Compared
| Feature | TMS | EMDR |
| Treatment type | Non-invasive brain stimulation | Structured psychotherapy |
| Commonly considered for | Depression, effective for those with PTSD experiencing treatment resistant depression. | PTSD and trauma-related symptoms |
| Treatment process | Magnetic pulses are delivered through a coil positioned against the scalp | The person is guided through a distressing traumatic event while engaging in bilateral stimulation |
| Trauma discussion | Not required | Re-processing distressing memories is part of treatment |
| Medication used during sessions | No | No |
| Treatment provider | A qualified clinical team specialising in TMS treatment | A licensed and accredited mental health specialist qualified in EMDR |
What is TMS therapy?
Transcranial magnetic stimulation (TMS) uses an magnetic coil to deliver targeted pulses to specific areas of the brain.
The treatment is non-invasive. It does not require hospitalisation, an anaesthetic or medication being administered during the session. Patients remain awake and can usually return to normal activities afterwards.
TMS is commonly considered for adults experiencing major depressive disorder, particularly when antidepressant medication or psychological treatment has not provided adequate relief.
The Australian Government’s Department of Health, Disability and Ageing notes that Medicare benefits may be available for eligible patients receiving repetitive TMS for major depressive disorder under specific clinical criteria.
People in Sydney considering non-invasive depression treatment should first have their medical history, symptoms and previous treatments reviewed by a qualified practitioner.
What is EMDR therapy?
Eye movement desensitisation and reprocessing (EMDR) is a structured form of psychotherapy. It was developed to reduce distress associated with traumatic memories.
During EMDR, a therapist may ask the person to focus briefly on a distressing memory while following guided eye movements, sounds or tapping. These are forms of bilateral stimulation.
EMDR generally follows a planned series of phases rather than asking someone to describe every detail of a traumatic event immediately. Preparation and emotional stabilisation are important parts of the process. It requires a qualified clinican who has specialized in EMDR to conduct and guide this therapy.
RACGP recognise EMDR as one of the trauma-focused psychological treatments that may be offered to adults with PTSD.
What is the main difference between TMS and EMDR?
The main difference is how the treatments are delivered and the symptoms they are intended to address.
TMS uses magnetic stimulation
TMS applies magnetic pulses to areas of the brain associated with mood regulation. It does not require the patient to discuss traumatic events during treatment. Know how TMS works and when changes may occur.
EMDR is a psychological therapy
EMDR involves active participation in a structured therapeutic process. It is primarily associated with PTSD, trauma, and distressing memories.
The person may experience uncomfortable emotions while processing a memory, although the therapist will introduce strategies to help manage distress before reprocessing begins.
They commonly address different clinical needs
TMS is most established as a treatment for major depression, particularly treatment-resistant depression. It can be a highly effective treatment for someone with PTSD who also has chronic depression or treatment resistant depression. It also works well when coupled with other treatments including EMDR. Helping a patient improve depression symptoms will improve their outlook and quality of life. This also assists with their coping skills when undertaking other treatments.
EMDR is most established as a trauma-focused therapy for PTSD.
Depression and PTSD often occur together. In those circumstances, a clinician may consider several treatment options rather than assuming that one therapy should address every symptom.
Which treatment may be right for you?
A clinician may consider:
- Your primary diagnosis and most disruptive symptoms
- Whether trauma-related memories contribute to your symptoms
- Your response to antidepressants and psychological therapies
- Your physical and mental health history
- Possible TMS contraindications
- Your readiness to participate in trauma-focused therapy
- Treatment availability and the time required for appointments
For someone whose main difficulty is depression that has not improved with medication, TMS may form part of the treatment discussion.
For someone whose symptoms are primarily connected to trauma or PTSD, assessment by an appropriately trained trauma therapist may determine whether EMDR or combination treatments may be suitable.
Some people may receive both TMS and EMDR. All treatment options or combined treatment plans should be coordinated by the treating clinical team involved.
What happens during a TMS assessment?
Before treatment begins, a referral is provided to the TMS clinic. The TMS clinical team reviews the person’s symptoms, treatment history, relevant medical conditions and suitability for TMS during an assessment session.
The practitioner will explain the expected treatment schedule, possible side effects, costs and answer any questions or concerns the patient may have. Sometimes the treating team may suggest alternative avenues that could be explored prior to starting TMS. Contact Sydney TMS for additional information about TMS suitability. A TMS guide is also available by enquiring at info@sydneytms.com.au
Frequently asked questions
Is TMS the same as EMDR?
No. TMS is a non-invasive brain-stimulation treatment, while EMDR is a structured psychotherapy. They use different methods and are commonly considered for different clinical needs. Both treatments require specialized care by experienced and accredited clinicians.
Is TMS or EMDR better for depression?
TMS has an established role in treating major depression, particularly when previous treatments have not been sufficiently effective. EMDR is a specialized treatment for trauma. It is not unusual for a patient to undergo both treatments. An individual assessment is necessary for both. Each type of treatment has its own criteria that needs to be met before treatment can take place.
Do you have to talk about traumatic memories in TMS?
No. You don’t have to talk about or relive the traumatic experience during a TMS session. Treatment involves sitting in a chair while magnetic pulses are administered via a coil held near the head.
Is it possible to employ TMS and EMDR together?
It certainly is possible and this is not uncommon. You may have TMS and psychotherapy as part of the treatment strategy. The timing and appropriateness of each treatment will be addressed with the treating physicians.
How will I know if TMS is the right treatment for me?
Only on a clinical basis can suitability be assessed. The practitioner will assess your diagnosis, how you have responded to previous therapy, your medical history and any variables that may make TMS unsuitable. For example, if a patient has metal implants above the shoulders, TMS may not be compatible with the type of metal the person has.
Veteran mental health support is making TMS treatment more accessible through the Department of Veteran’s Affairs scheme (DVA). This scheme means that DVA patients do not have out of pocket expenses when it comes to treatment. For more information please contact Sydney TMS 1300 177 144 or send a referral to info@sydneytms.com.au to book in for your referral.
Being an informed treatment decision maker
TMS and EMDR are completely different. TMS is a physical treatment using magnetic stimulation. It is successfully utilised in the care of depression. EMDR is a psychotherapeutic treatment used for trauma and PTSD.
TMS is a treatment that can work very well when used concurrently with other treatments including pharmacology, psychotherapy like EMDR as well as a range of many other treatments.
A trained health expert are qualified to guide you through your treatment options and recommend a treatment plan that is best for you.
Disclaimer: This material is of a general nature and is not a substitute for medical advice, diagnosis or treatment by a qualified health professional.
Disclaimer: This information is general in nature and is not a substitute for personalised medical advice, diagnosis or treatment.
