What actually happens in your first TMS session?

Day one is the longest day of your TMS course — usually 60 to 90 minutes, compared to 20-37 minutes for standard sessions after that (or just 3-9 minutes if you're on a theta-burst/iTBS protocol). Here's why: your clinician has to find your motor threshold first. That means placing the coil over your motor cortex and slowly raising the intensity of single pulses until your thumb twitches involuntarily. That twitch sets your dose for the rest of the course — it's calibrated to your brain, not a standard setting. Expect a tapping or knocking sensation on your scalp during this part, sometimes described as "a woodpecker." It's uncomfortable for most people, not painful. Once your threshold is set, the coil moves to your actual treatment target — usually the left side of your prefrontal cortex — and the real session begins. You'll hear a loud clicking sound (earplugs handle it), maybe some brief facial twitching, and mild scalp soreness afterward that usually fades within an hour. What you generally won't feel: any cognitive change. TMS doesn't sedate you or affect your ability to drive. Most people go straight back to work or errands after. Don't expect a mood lift on day one — that tends to show up in weeks two and three, not the first session. https://tmslist.com/blog/preparing-for-first-tms-session/ If you've done your first session, what surprised you most? And if you're about to start, what are you most nervous about? This is general information, not medical advice.