TMS Therapy for OCD

Obsessive-compulsive disorder (OCD) is more than a personality quirk or a desire for neatness. It is a chronic, often disabling condition that traps people in cycles of distressing thoughts and repetitive behaviors. While many benefit from medications and therapy, a large number of individuals continue to experience symptoms even after trying multiple treatment options.

Transcranial Magnetic Stimulation (TMS) offers a new pathway forward. This non-invasive, medication-free therapy for OCD targets the specific brain circuits involved in obsessive and compulsive symptoms. At NeuroHealth Treatment Centers, we specialize in helping patients with treatment-resistant OCD and related conditions find relief when other approaches fall short.

Loading testimonial…

–

TMS for OCD and Related Conditions

The therapeutic potential of TMS extends to a group of conditions known as obsessive-compulsive and related disorders (OCRDs). These disorders often involve patterns of intrusive thoughts, rigid behaviors, and impaired cognitive control.

Neuroimaging studies show that patients with OCRDs share overlapping abnormalities in the cortico-striatal-thalamo-cortical (CSTC) circuit, making them compelling candidates for neuromodulation approaches like TMS. This is especially the case when first-line treatments fall short.

Obsessive-Compulsive Disorder (OCD)

OCD is a chronic and often debilitating condition marked by cycles of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, urges, or images that cause anxiety. Compulsions are behaviors or mental rituals performed to reduce that distress or prevent feared outcomes.

Despite insight into the irrational nature of their thoughts, individuals with OCD often feel powerless to resist them. Although many respond to cognitive-behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs), approximately one-third of patients remain symptomatic. These individuals may be candidates for TMS therapy.

Common OCD symptoms include:

• Persistent fear of contamination or illness
• Repetitive checking of locks, stoves, or health symptoms
• Intrusive thoughts of harming oneself or others
• Obsessions with order, symmetry, or exactness
• Compulsive counting, tapping, or repeating behaviors
• Mental reviewing, reassurance-seeking, or avoidance

Body Dysmorphic Disorder (BDD)

BDD involves a distorted perception of one’s appearance, with individuals obsessing over perceived flaws that are minor or invisible to others. These preoccupations can become all-consuming and result in avoidance of mirrors, social withdrawal, or repeated cosmetic procedures.

Although categorized separately from OCD, BDD shares striking similarities in intrusive thoughts and ritualized behaviors. Research suggests that similar brain circuits are involved. For patients who have not improved with standard therapy and pharmacology, TMS offers a non-invasive alternative aimed at quieting obsessive thought patterns and improving emotional regulation.

Common BDD symptoms include:

• Obsessive focus on specific body parts (e.g., skin, nose, hair, etc.)
• Repetitive mirror checking or avoidance
• Excessive grooming or cosmetic alterations
• Comparing appearance to others constantly
• Avoiding social interactions due to self-consciousness
• Seeking reassurance about looks from others

Hoarding Disorder

Hoarding is a distinct clinical disorder defined by persistent difficulty discarding possessions, regardless of their actual value. It is associated with a perceived need to save items and distress related to parting with them. Hoarding behaviors often emerge in adolescence and worsen over time, leading to dangerous living conditions and impaired functioning.

Although behavior therapy remains a mainstay, many patients struggle to respond due to deficits in decision-making and emotional regulation. TMS may improve symptoms by targeting neural systems involved in executive function and emotional salience.

Common hoarding symptoms include:

• Strong urges to keep items, even if they appear useless
• Severe anxiety or distress when discarding possessions
• Accumulation of clutter that limits use of living spaces
• Difficulty organizing or categorizing belongings
• Social withdrawal due to embarrassment or conflict
• Indecisiveness and fear of making mistakes when discarding

Trichotillomania (Hair-Pulling Disorder)

Trichotillomania is a body-focused repetitive behavior characterized by compulsive hair-pulling, often resulting in noticeable hair loss and significant distress. The behavior is typically preceded by a sense of tension and followed by relief. It is not driven by appearance concerns but by a compulsion to relieve internal discomfort.

Neurobiologically, trichotillomania is associated with abnormalities in motor control, emotional regulation, and cognitive inhibition. TMS can target the areas of the brain responsible for these functions, potentially resulting in relief.

Common trichotillomania symptoms include:

• Recurrent hair pulling from the scalp, eyebrows, eyelashes, or body
• Rising tension or anxiety before pulling
• A sense of relief or pleasure after pulling
• Unsuccessful attempts to stop or reduce pulling
• Visible hair loss and bald patches
• Avoidance of social situations due to appearance

Excoriation (Skin-Picking Disorder)

Also known as dermatillomania, excoriation disorder involves recurrent picking at the skin, often targeting perceived imperfections. It can lead to open wounds, scarring, infections, and significant emotional distress.

Like trichotillomania, skin picking is often triggered by anxiety or boredom and is maintained by momentary relief from internal tension. TMS has shown potential in reducing compulsive behaviors and enhancing impulse control through modulation of prefrontal circuits.

Common excoriation symptoms include:

• Repetitive picking of skin, scabs, blemishes, or perceived flaws
• Use of fingers or tools to manipulate skin
• Inability to resist the urge to pick, despite consequences
• Skin lesions or scars requiring medical attention
• Time-consuming rituals that interfere with daily life
• Feelings of shame, embarrassment, or social isolation

Olfactory Reference Syndrome (ORS)

ORS is a rare but severe disorder involving the fixed belief that one emits an unpleasant body odor. This belief persists despite reassurance and leads to obsessive hygiene rituals, repeated seeking of validation, and avoidance of public or social spaces.

ORS shares core features with both OCD and BDD, including intrusive thoughts, compulsive behaviors, and impaired insight. Though under-researched, TMS may help reduce the hyperactivity in brain regions involved in self-monitoring, perception, and threat appraisal.

Common ORS symptoms include:

• Depression, anxiety, or suicidal ideation due to perceived rejection
• Preoccupation with imagined body odors (e.g., breath, sweat, genital area)
• Excessive use of soap, deodorant, breath mints, or fragrance
• Frequent showering or changing of clothes
• Avoidance of close interactions, workplaces, or enclosed environments
• Repetitive reassurance-seeking from others

What Is TMS Therapy for OCD?

Transcranial Magnetic Stimulation (TMS) is a non-invasive treatment for adults with obsessive-compulsive disorder (OCD) who have not responded to standard therapies such as medication or cognitive-behavioral therapy. It has also shown clinical effectiveness in treating patients with related disorders such as body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation, and olfactory reference syndrome.

TMS is administered in an outpatient setting, without the need for sedation or anesthesia. Patients remain awake and alert during each session, which typically lasts 30–40 minutes, five days per week, over a period of 4–6 weeks.

Treatment is highly personalized, guided by clinical evaluation and individual neuroanatomy, and can be used alongside other forms of care such as psychotherapy and medication management. Key benefits of TMS for OCD include:

• Non-invasive and does not require medication
• Minimal side effects and no downtime
• Targets the source of symptoms in the brain
• Can reduce intrusive thoughts and compulsions when other treatments have failed

For many patients, TMS represents a meaningful next step in their recovery. It is especially promising for those who have undergone previous treatments and not found relief.

Potential Side Effects of TMS Therapy

TMS is considered a well-tolerated and low-risk treatment for OCD. Most side effects are mild and temporary.

The most commonly reported side effects include:

• Mild headache or scalp discomfort during or after treatment
• Temporary facial muscle twitching during stimulation
• Slight dizziness or fatigue, usually resolving within minutes

Serious side effects such as seizure are exceedingly rare (less than 0.1% in clinical trials) and are further minimized by appropriate patient screening and adherence to safety protocols.

Unlike medications, TMS does not cause weight gain, sexual dysfunction, gastrointestinal upset, or systemic sedation. This makes it a strong option for patients seeking a non-pharmacologic treatment with minimal interference in daily functioning.

Find Out If TMS Therapy for OCD Is Right for You

If intrusive thoughts, compulsive behaviors, or co-occurring conditions are interfering with your life (and if traditional treatments haven’t brought relief), TMS therapy may be the next step forward. At NeuroHealth Treatment Centers, we offer clinically proven, personalized care using advanced, evidence-based brain stimulation.

Our experienced team will evaluate your needs, coordinate care with your existing providers, and walk with you every step of the way. Call 954-417-7575 or book online to get started.