ADHD can make it difficult to keep up with daily tasks, maintain healthy relationships, and perform well at school or work. It’s one of the most common mental health disorders in the U.S. – about 13% of males and 5% of females will receive an ADHD diagnosis at some point in their lives.
For many of these people, traditional treatments like medication and therapy can provide relief. But these options don’t work for everyone. Some people experience unwanted side effects from medication or find their symptoms persist no matter how hard they try.
In these situations, transcranial magnetic stimulation therapy (TMS therapy) offers a promising alternative. TMS is an innovative, non-invasive treatment that uses MRI-strength magnetic pulses to gently rebalance activity in parts of the brain associated with ADHD. It’s painless, doesn’t rely on medication, and has minimal side effects.
This article will share everything you need to know about TMS therapy for ADHD, including what it is, how it works, and what the research says.
What is ADHD?
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that involves persistent patterns of inattention, hyperactivity, and impulsive behavior. These symptoms can interfere with the way a person functions in their everyday life, affecting their self-confidence, relationships, and work or school performance.
While ADHD is often associated with childhood, its symptoms can continue into adulthood, although they may appear very differently. For example, hyperactivity may decrease in adults while impulsiveness, inattention, and restless often persist.
Adults with ADHD may struggle to maintain steady employment, sustain healthy relationships, keep appointments, or stay organized with daily responsibilities. They may find themselves restless, struggling to do one thing at a time, and engaging in risky or impulsive behavior.
Treating ADHD is similar for both children and adults, typically involving a combination of medications and psychotherapy. For adults, alternative therapies such as transcranial magnetic stimulation (TMS) may also be an option.
ADHD symptoms in adults
Symptoms of adult ADHD can range from mild to severe and affect multiple areas of a person’s life. While many adults will notice fewer symptoms as they age, others will continue to deal with challenges related to inattention, impsulveness, and restlessness.
Common symptoms of adult ADHD include:
- Impulsiveness: This can manifest as acting without considering the consequences, struggling to wait (e.g. in lines or in traffic), interrupting conversations, or making rash decisions.
- Disorganization: This can manifest as poor time management, struggling to prioritize tasks effectively, frequently missing deadlines or forgetting appointments, and difficulty following through on plans.
- Inattention: This can manifest as difficulty focusing during conversations or tasks, becoming easily distracted by external stimuli or unrelated thoughts, or starting projects and not completing them.
- Restlessness & hyperactivity: This can manifest as always feeling ‘on the go’, difficulty sitting still or engaging in calm activities, and a sense of internal restlessness.
- Emotional challenges: People with ADHD may be easily frustrated, experience frequent irritability or mood swings, and struggle to cope with stress.
Many adults with ADHD are unaware that they have a condition and instead believe their challenges are a result of personality traits or external factors. On top of that, almost everyone experiences these symptoms from time to time.
However, ADHD is only diagnosed when these symptoms persist and significantly disrupt multiple areas of life. Usually, they can be traced back to early childhood.
Read More: ADHD in Teens: Symptoms, Treatment, Medication, Driving
ADHD treatment options
Managing ADHD symptoms in adults often involves a combination of medication, psychotherapy, and skills training. While these treatments will not cure ADHD, they can significantly relieve symptoms and help improve a person’s daily functioning.
Medications
Medications are usually the first line of treatment for ADHD. These can can include stimulants or nonstimulants.
Stimulants are medications that contain methylphenidate or amphetamine, which help increase levels of brain chemicals like dopamine, serotonin, and norepinephrine. Commonly prescribed stimulants include:
- Amphetamine (e.g. Adzenys, Adderall)
- Dextroamphetamine (e.g. Dexadrine, ProCentra, Zenzedi)
- Dexmethylphenidate (Focalin)
- Lisdexamfetamine (Vyvanse)
- Methylphenidate (e.g. Ritalin, Concerta).
Stimulants can come with unpleasant side effects, including anxiety, insomnia, loss appetite, increased blood pressure, difficulty sleeping, dry mouth, and mood changes. Because of these side effects, certain people shouldn’t take stimulants. This includes people with bipolar disorder, anxiety, high blood pressure, anorexia, or substance use disorder.
When stimulants aren’t an option, you may be prescribed nonstimulant medications intead. These include atomoxetine (Strattera) and viloxazine (Qelbree). While these medications take longer to show effects, they can be effective for those who cannot tolerate stimulants. Side effects of these medications can include constipation, lower libido, or upset stomach.
Medication works differently for everyone, and it can take some time to find the right medication and dosage for you. It’s important to be patient and tell your medication management provider about any side effects you may have.
Psychotherapy
Psychotherapy, or talk therapy, can help people develop strategies to cope with ADHD-related challenges and improve their quality of life. Psychological counselling for ADHD often includes:
- Cognitive Behavioral Therapy (CBT): This teaches practical skills to help people better manage their behavior, reduce impulsivity, and reognize and change negative thought patterns. CBT can also address specific challenges like emotional regulation, time management, or relationship issues.
- Marital and family therapy: This type of therapy can help family and loved ones understand ADHD-related behaviors and learn what they can do to help. It can also improve communication and problem-solving skills in relationships.
Transcranial magnetic stimulation (TMS)
TMS therapy is a non-invasive, non-surgical procedure that involves stimulating specific areas of the brain using magnetic pulses. This innovative treatment is most commonly used to treat major depression, however it’s also shown to be effective for numerous other mental health conditions, including obsessive-compulsive disorder (OCD), anxiety disorders, and even ADHD – particularly when people haven’t responded to traditional treatments.
What is transcranial magnetic stimulation (TMS)?
TMS uses magnetic pulses to stimulate nerve cells in specific regions of the brain, helping alleviate symptoms of various neurological and mental health conditions, including major depressive disorder (MDD), obsessive-compulsive disorder (OCD), anxiety, post-traumatic stress disorder (PTSD), and Parkinson’s.
The magnetic field used in TMS is similar to the strength of an MRI, making the treatment safe, painless, and well-tolerated for the majority of patients. The treatment involves placing an electromagnetic coil against the scalp and delivering repetitive magnetic pulses to balance activity in parts of the brain associated with mood, anxiety, and motor control.
There are three main types of TMS that offer unique approaches to treatment:
- Repetitive transcranial magnetic stimulation (rTMS): rTMS is the most common type of TMS. It involves delivering magnetic pulses to stimulate nerve cells in surface-level regions of the brain, usually those involved in mood regulation. Sessions last between 20 to 40 minutes and do not require anesthesia.
- Theta burst stimulation (TBS): TBS is a variation of rTMS that uses short, high-frequency bursts of stimulation to mimic the rhythms of natural brain activity. It has the potential to speed up the treatment process.
- Deep transcranial magnetic stimulation (dTMS): dTMS uses specialized H-coils to reach larger and deeper parts of the brain, up to 1.25 inches. Like rTMS, dTMS involves daily sessions administered over the course of 4 to 6 weeks.
- Accelerated TMS (aTMS): aTMS is a more intensive version of traditional rTMS. This type of therapy delivers multiple sessions per day to compress the treatment timeline from several weeks to two weeks. It’s especially suitable for those who want fast results or are unable to commit to the full TMS treatment schedule.
See: Accelerated TMS vs. Traditional TMS: Which One Makes Sense for You?
How does TMS work for ADHD?
TMS combines the principles of magnetism and electricity to modulate brain activity in a painless, non-invasive way. It involves targeting parts of the brain that have unusual levels of activity and sending magnetic waves to stimulate these regions.
People with ADHD often have imbalances in brain activity, particularly in regions that govern attention, executive function, and impulse control. TMS stimulates these regions with targeted magnetic pulses to improve communication between neurons and encourage the production of neurotransmitters, like dopamine and norepinephrine.
Over the course of treatment, this can help rebalance brain activity and alleviate ADHD symptoms like impulsiveness, inattention, and hyperactivity.
Research on TMS and ADHD
TMS is still being explored for its effectiveness in treating ADHD, but so far the research shows promise.
An early study from 2012 assessed the safety of TMS in adolescents and young adults with ADHD and found it to be safe with no serious adverse effects. Additionally, symptoms improved noticably across the study.
In 2015, another paper confirmed the safety of TMS as a safe, non-invasive treatment and therapeutoc tool for ADHD. In a 2021 review of 32 studies, researchers saw a reduction in symptoms in ADHD patients with no major adverse effects in adolescent participants.
Another analysis from 2020 found that ADHD symptoms alleviated through TMS therapy correlated with EEG results. The paper reported that TMS is a positive non-pharmacological treatment for adults with ADHD.
There’s understandably more caution about using TMS therapy for children, however this isn’t reflected in research. In one 2021 study, TMS was considered a valuable reatment for both adolescents and adults with ADHD, thanks to its non-invasive nature and minimal side effects. This was supported by another review of TMS for pediatric ADHD, which concluded that the treatment could be effective for children who don’t respond to traditional treatments.
Keep Reading: How Successful is TMS Therapy?
What happens in a TMS session?
TMS sessions involve laying down while an electromagnetic coil delivers painless magnetic pulses to specific regions of your brain. Here’s what you can expect from a TMS treatment session for ADHD:
- Preparation: Before the session, your TMS technician will seat you in a comfortable chair and answer any questions and concerns. They’ll provide you with earplugs to protect against the clicking sounds from the machine.
- Brain mapping: Your first session involves brain mapping, where the technician measures your head to find the ideal target area for the treatment and the appropriate strength of magnetic pulses.
- Stimulation: With the appropriate treatment area identified, the technician will start delivering gentle magnetic pulses through the coil to targeted regions of your brain. This stimulates nerve cells and releases mood-regulating neurotransmitters like dopamine and serotonin.
- Sensation: You may hear a clicking sound or feel a light tapping on your scalp during the session. Some patients also feel slight twitching or tingling in the facial muscles.
- Monitoring: The TMS technician will be by your side throughout the treatment, monitoring your comfort levels and adjusting the strength of magnetic pulses as needed.
- Post-session: TMS sessions usually last between 20 to 40 minutes. Once it’s over, you can immediately resume your regular activities as normal.
- Follow-ups: TMS therapy is typically administered for a total of 36 sessions over several weeks, although the exact number will depend on your symptoms and how you respond to treatment.
Potential side effects of TMS
TMS therapy is well-tolerated by most people, however there can be some uncommon, mild, and temporary side effects that usually resolve on their own.
Some potential side effects of TMS include:
- Mild headaches
- Lightheadedness
- Neck or scalp discomfort
- Tingling sensations
- Twitching of facial muscles
- Sleepiness.
In extremely rare cases, TMS therapy can trigger seizures, however this is very uncommon and only occurs in about 0.1% of patients.
Related: TMS Side Effects: All You Need to Know
Who can do TMS therapy?
TMS therapy may not be suitable for everyone. You should avoid TMS therapy if you:
- Have a history of neurological conditions, such as seizures or epilepsy
- Are pregnant or nursing
- Have a history of brain illness, traumatic brain injury, brain tumor, or strokes
- Are taking stimulant medications.
You should also avoid TMS if you have non-removable metal objects in your head, such as:
- Deep brain stimulators
- Cochlear hearing implants
- Aneurysm clips or coils
- Stents in the neck, brain, or heart
- Electrodes
- Shrapnel or bullet fragments
- Vagus nerve stimulators.
Because TMS therapy involves magnetic pulses, these objects can interfere with treatment and potentially pose a safety risk. Braces and dental fillings are safe for TMS therapy.
See: Who Qualifies for TMS Therapy? (TMS Requirements)
Try TMS for ADHD
If you or a loved one are struggling with ADHD symptoms and traditional treatments aren’t providing the relief you need, TMS therapy may be an option worth exploring. Don’t hesitate to contact our compassionate team at BestMind Behavioral Health to discuss this treatment and see if it’s suitable for you.
