Depression is a common, serious medical illness affecting more than 1.5 million adults in the UK at any point in time. 

It is defined as a persistent state of sadness that may interfere with an individual’s thoughts, behaviour, mood, and physical health.


Symptoms may include:

  • Persistent low mood.
  • Lack of interest in usual activities or an inability to experience pleasure
  • Difficulties with thinking, memory or concentrating and decision making
  • Feelings of worthlessness, hopelessness, helplessness, or guilt
  • Changes in sleep habits and decreased energy
  • Loss of appetite or significant weight gain or weight loss
  • Thoughts of death or suicide
  • Negative outlook, self-perception and self-critical thoughts


Problems caused by depression may include:

  • Diminished personal relationships with family and friends.
  • Physical health problems including increased pain.
  • Side effects from antidepressant medication.
  • Inability to participate in hobbies and activities
  • Limited motivation and desire to do anything.
  • Limited ability to work, missed promotion and career opportunities.


While the exact cause of depression is not known, it is known that depression is characterised by an imbalance of the brain’s neurotransmitters, as well as decreased activity in the frontal lobes of the brain. Neurotransmitters are chemical messengers that send signals between brain cells.

Video: What causes depression?

Dr Leigh Neal explains:

Are you suffering from Clinical Depression?

The PHQ-9 is a questionnaire for diagnosing clinical depression, which is often used by General Practitioners in the UK. A score of 10 or more indicates you may be suffering from clinical depression and you should seek medical advice. The PHQ-9 test can be downloaded below:

Conventional Treatments

Depression can be treated with psychological therapy such as Cognitive Behaviour therapy, but this is not suitable for everyone.

Depression can also be treated with antidepressant medication.  It is believed that antidepressant medication works by increasing the levels of neurotransmitters in the brain. Although antidepressants can be effective for many patients, they do not work for everybody. Additionally, antidepressant medication circulates in the bloodstream throughout the body, and can result in unwanted side effects such as: feeling detached, weight gain, decreased sex drive, nausea, sleepiness, and dry mouth.

Millions of patients do not receive adequate benefit from antidepressants and/or cannot tolerate the side effects caused by them. In addition, anti-depressants in pregnancy can lead to complications and they are not usually recommended when breast feeding.

More infrequently persistent or more severe forms of depression can be treated in specialised centres in the UK with Electro-Convulsive Therapy (ECT), which requires the patient to be anaesthetised and paralysed in an operating theatre and can cause memory impairment.

rTMS Treatment for Depression

NICE Approved Treatment of Depression with rTMS

NICE approved rTMS as a safe and effective treatment for depression in December 2015 (NICE Guidelines, 2015). 

The rTMS treatment for depression stimulates the pre-frontal cortex area of the brain.  This area controls mood, motivation, and social skills.  In particular, the left side of the pre-frontal cortex is associated with positive feelings.  It is this area of the brain that is stimulated by rTMS. Stimulation of the pre-frontal cortex by rTMS in depressed patients can lead to complete remission from depression with patients reporting that they feel much more positive; they are more sociable, motivated and talkative.


NICE Guidelines (2015)

Depression During Pregnancy

There are potentially harmful effects from drugs crossing the placenta during pregnancy. Avoiding the use of drugs in the treatment of depression in pregnancy is desirable because of the risk to the developing and growing foetus.

For these reasons TMS may be a suitable treatment for depression during pregnancy, which you can discuss with your doctor.

Postnatal Depression/Breastfeeding


Postnatal depression is a very common illness affecting more than 1 in every 10 women within a year of giving birth. However, medication for depression may contaminate the mother’s milk.

TMS may be a suitable treatment for depression while breast-feeding, during the postnatal period and is probably a preferable form of treatment to taking drugs for depression.

rTMS Treatment Clinics

Transcranial Magnetic Stimulation therapy treatment for depression is available at all Smart TMS clinics. See our clinic locations for more information.

Treatment Protocol

At Smart TMS we provide a bespoke rTMS depression treatment, using our extensive experience of rTMS in the treatment of depression and our ongoing discussions with various researchers. Each treatment session takes 25 minutes.

The treatment protocol as outlined by NICE is typically 2-6 weeks.  We have developed treatment protocols which allow for multiple treatments per day, allowing for the full treatment to be delivered in between five days up to six weeks, at the patient’s discretion.  Patients will be assessed over the course of treatment to monitor the effect.  The actual length of the treatment will vary dependent on how quickly a reduction in the depression level is seen.

What our patients say

“I have been on and off medication for about 25 years now, but in the short space of a month TMS has given me back something immeasurable.”

AnnaLondonRead full testimonial

“I’ve been working full time for the last 8 weeks which is incredible, before the treatment I hadn’t worked for a full week for at least 2 years…”

JRead full testimonial

“TMS has been life changing for me.  I am back to how I should be and I am still improving every day.  It really is incredible – I am so glad I did it.”

FreddieRead full testimonial