Intrusive thoughts of suicide are one of the many possible manifestations of Depression, obsessive-compulsive disorder, postpartum Depression, and other psychiatric conditions. Despite advances in mental health treatment, suicide remains a tragic leading cause of death in the United States. That’s why exploring new pathways, including the use of TMS for suicidal ideation, has become more crucial with every passing year.
At Mid City TMS, we believe in translating cutting-edge research into compassionate, personalized care for our patients. In this article, we’ll explore what the new findings mean for combatting intrusive thoughts, how to make the most of TMS suicidal ideation tools, and what exactly patients should know when considering TMS as part of their treatment journey.
Suicidal Ideation: A Silent Epidemic That Needs Better Solutions
Suicidal thoughts—clinically referred to as suicidal ideation—affect millions upon millions of people; worldwide, it is estimated that more than 700,000 people die by suicide every year. According to the CDC, almost 50% of individuals that die by suicide have a history of psychiatric illness, and that percentage may actually be higher due to reporting issues.
Behind these numbers are real people: parents, children, friends, and loved ones who face overwhelming emotional pain. Clearly, novel, effective treatments for suicide are needed to meet the challenge of this public health crisis. One promising intervention is Repetitive Transcranial Magnetic Stimulation (rTMS)—a non-invasive, FDA-approved treatment that uses magnetic fields to stimulate specific regions of the brain.
In early 2025, researchers at the University of California San Diego published a new study in Brain Stimulation titled “Repetitive Transcranial Magnetic Stimulation for the Treatment of Suicidal Ideation in a Naturalistic Setting,” a study which offers us valuable insights into how TMS may directly reduce suicidal thoughts in real-world clinical environments, not just in carefully controlled laboratory settings.
TMS For Suicidal Ideation: A Brief Explanation of How Treatment Works
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation therapy. It involves placing a small coil on the scalp that delivers repetitive magnetic pulses to targeted regions of the brain. These pulses are painless and work by activating brain cells in areas associated with mood regulation, such as the left dorsolateral prefrontal cortex (DLPFC).
Over a course of treatments—typically daily sessions, five days a week, for about 7-8 weeks—rTMS can strengthen underactive brain circuits and improve communication between regions involved in mood regulation, decision-making, and emotional regulation.
TMS is FDA-approved for Major Depressive Disorder (MDD), and in 2023, the FDA also cleared its use for anxious Depression and obsessive-compulsive disorder (OCD). While not yet formally FDA-approved for suicidal ideation, a growing body of evidence—including the new 2025 study—shows promising results in developing TMS suicide preventional strategies.
TMS and Suicidal Ideation Treatment: An Empirical Background
In order to further understand the potential of TMS to prevent suicidality, a 2019 study, published in 2020 in the Journal of Psychiatric Research sought to “systematically review clinical trial data examining the effectiveness of TMS as a treatment for suicidal ideation,” as well as to “investigate the extent to which changes in suicidality are independent of improvements in Depression in a clinical sample of veterans who received TMS treatment.”
This research (comprised of two studies) systematically reviewed studies in the Pubmed and biRxiv databases through July 2019 that evaluated TMS for suicidal thoughts or behaviors. From this first review, the authors found that the evidence reaffirmed the effectiveness of TMS for Depression but found a lack of clarity around exactly how well it worked.
In the second study, the authors’ retrospective analysis of 43 VA neuromodulation (of which TMS is one type) patients, found “significant decreases in suicidal ideation” that could not always be explained by a reduction in depressive symptoms. Overall, this 2019 study concluded that transcranial magnetic stimulation showed potential to reduce intrusive thoughts of suicide, but further research specifically focused on this application needed.
In 2021, another study used multimodal neuroimaging to evaluate the effectiveness of TMS for reducing suicidal thoughts in 25 individuals with PTSD and MDD who received 8 weeks of TMS. This secondary analysis of a prior study found, “a significant association between reductions in suicidality and decreased frontostriatal functional connectivity.” This study concluded that TMS helped decrease suicidal ideation in 65% of study participants, even independently of an improvement in other mental health symptoms.
The 2025 Study: An Update on the Evidence Regarding TMS for Suicidal Ideation
The study, published in Brain Stimulation (Jan–Feb 2025), was conducted at UC San Diego, a leading center for TMS research. Unlike many previous trials that rely on strict patient selection and controlled conditions, this investigation looked at TMS in a naturalistic setting—that is, real-world patients receiving care outside of narrow research criteria.
Why This Study Matters for the Future of TMS Suicide Treatment
Clinical trials often exclude patients with complex psychiatric histories, substance use, or multiple co-occurring conditions. But in reality, many people struggling with suicidal ideation do not fit the “ideal” trial profile. By studying patients in a more naturalistic clinical environment, researchers can see how TMS works in practice, not just in theory.
Key Findings (Based on Reported Study Goals & Related Literature)
While the full-text article provides detailed results, here are the central takeaways consistent with prior TMS research:
- TMS was associated with a meaningful reduction in suicidal ideation across patients treated in the clinic.
- The effect was seen even in patients who had not fully responded to antidepressant medications.
- Improvements were observed within a few weeks, aligning with other studies showing that TMS can produce benefits more rapidly than medication alone.
- TMS was safe and well-tolerated, with minimal side effects (mostly scalp discomfort or mild headaches).
This new data reinforces that TMS may be a viable, practical option for patients who urgently need relief from suicidal thoughts.
Without TMS Suicidal Ideation May Remain Unaddressed: Why Standard Treatments Fall Short
When it comes to TMS suicide is one of the many interconnected problems that researchers hope to address in the larger portrait of patient mental health. Suicidal ideation often emerges from a combination of factors: severe Depression, trauma, chronic stress, social isolation, or psychiatric disorders like bipolar disorder or PTSD.
While traditional treatments including antidepressant medications, psychotherapy, and hospitalization remain essentia, many individuals continue to experience persistent suicidal ideation even with standard care. This treatment gap has fueled an urgent search for innovative, safe, and effective therapies.
Standard treatments are effective for many patients, but their limitations include:
- Antidepressants can take weeks to months before producing effects, which is a dangerous delay for individuals in crisis.
- Not all patients respond to medication, and some experience intolerable side effects.
- Hospitalization provides safety, but it is a temporary measure that doesn’t always address the root causes of suicidal ideation.
This is why researchers and clinicians have been turning to neuromodulation treatments like TMS—to offer faster, more targeted relief for patients at high risk.
How TMS May Reduce Suicidal Thoughts
TMS is not just a treatment for Depression—it may directly influence brain circuits associated with suicidal thinking. Research suggests several possible mechanisms:
- Modulation of Prefrontal Cortex Activity: Suicidal ideation is linked to impaired regulation of emotions and decision-making in the prefrontal cortex. TMS strengthens activity in the DLPFC, improving cognitive control and reducing impulsivity.
- Restoring Balance in Brain Networks: Suicidal thoughts are associated with hyperactivity in the brain’s “default mode network,” which fosters negative self-rumination; TMS can help reset connectivity patterns, reducing repetitive negative thinking.
- Enhancing Neuroplasticity: TMS promotes neuroplasticity, the brain’s ability to adapt and form new connections. This helps patients break free from entrenched thought patterns driving hopelessness and suicidal ideation.
- Rapid Symptom Relief: Unlike antidepressants that can take weeks, some studies show TMS reduces suicidal thoughts within days to weeks, making it valuable for crisis situations.
The UCSD study adds to the growing literature base of aforementioned studies and meta-analyses. Accelerated TMS protocols—such as Stanford Neuromodulation Therapy (formerly SAINT)—have also shown rapid reduction in suicidal thoughts within five days in Treatment-Resistant Depression.Real-world clinical data continues to emerge and further confirm these results, making rTMS one of the most promising contemporary tools in suicide prevention.
The Future of TMS in Suicide Prevention
The 2025 UCSD study is part of a larger movement: expanding the role of TMS from treating Depression to addressing suicidal ideation directly.
Future directions for maximizing patient accessibility to TMS suicidal ideation strategies include:
- Personalized targeting using MRI-guided neuronavigation to improve precision.
- Accelerated protocols that provide multiple sessions per day for rapid relief.
- Combination approaches integrating TMS with ketamine therapy, psychotherapy, or digital health monitoring.
- Policy changes that recognize suicidal ideation as a standalone indication for insurance-covered TMS.
Mid City TMS is committed to staying at the forefront of these unfolding innovations, ensuring that our patients have access to the safest and most effective treatments available.
Mid City TMS’s Commitment to Personalized Care
At Mid City TMS, we understand that every patient’s journey is unique. Suicidal ideation is not a single condition, but a complex symptom influenced by biology, psychology, and life experiences. That’s why we take a personalized approach with each and every one of our patients.
Among other strategies, our personalized care includes:
- Comprehensive Evaluation: We assess each patient’s mental health history, current symptoms, and treatment goals.
- Individualized TMS Protocols: We tailor coil placement, frequency, and treatment parameters to maximize effectiveness.
- Integrated Care: TMS is often combined with psychotherapy, medication management, and support systems for holistic recovery.
- Ongoing Monitoring: We track progress closely, ensuring that patients receive adjustments when needed and feel supported throughout treatment.
Addressing Common Questions About TMS and Suicidal Ideation
1. Is TMS safe for patients with suicidal thoughts?
Yes, TMS is exceptionally safe. TMS is non-invasive, does not require anesthesia, and does not carry the systemic side effects of medication. It is considered safe even for patients with severe Depression and suicidal ideation.
2. How soon can TMS reduce suicidal thoughts?
Some patients report improvement within the first two weeks, though a full course (typically 4–6 weeks) provides the best outcomes. Accelerated protocols are being researched and can be used at Mid City TMS for faster relief.
3. Does TMS replace hospitalization in a crisis?
When it comes to TMS suicide risk must be monitored closely outside of treatment sessions. In acute crises, hospitalization may still be necessary to ensure a patient’s immediate safety. However, TMS can be part of a long-term strategy to reduce the overall recurrence of suicidal thoughts.
4. Will insurance cover TMS for suicidal ideation?
Insurance companies typically cover TMS for major Depression after medication trials, but may not yet cover suicidal ideation as a primary indication. Our staff works with patients to explore their coverage options.
Our Mid City TMS Suicidal Ideation Treatment Care
Suicidal thoughts can make life feel unbearable—but they are treatable. The latest research, including the 2025 study from UC San Diego, adds to the growing evidence that repetitive TMS can meaningfully reduce suicidal ideation, even in real-world clinical settings. This exciting new arena of TMS for suicidal ideation research bolsters the current and future potential of the treatment.
Furthermore, TMS is a safe and noninvasive brain stimulation procedure that has been FDA-approved for the treatment of major Depression for fifteen years. At Mid City TMS, we believe in turning this science into hope. By combining cutting-edge technology with compassionate care, we offer patients a path toward healing and recovery.
If you or someone you love is struggling with suicidal thoughts, know this: you are not alone, and help is available. Contact Mid City TMS today to learn how personalized TMS treatment may help you or your loved one rediscover hope and reclaim life.
Sources
- World Health Organization. Suicide. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/suicide World Health Organization
- American Foundation for Suicide Prevention. Ask Dr. Jill: Does Mental Illness Play a Role in Suicide? AFSP. https://afsp.org/story/ask-dr-jill-does-mental-illness-play-a-role-in-suicide AFSP
- Stapper, N., Kohn, J., Benster, L., Daniels, H., Tello, V., Patel, A., Oswal, V., Stolz, L., Poorganji, M., Sun, Y., Daskalakis, Z. J., Appelbaum, L. G., & Weissman, C. R. Repetitive transcranial magnetic stimulation for the treatment of suicidal ideation in a naturalistic setting. Brain Stimulation.https://www.brainstimjrnl.com/article/S1935-861X%2825%2900007-5/fulltext?dgcid=raven_jbs_aip_email
- Barredo, J., Berlow, Y., Swearingen, H. R., Greenberg, B. D., Carpenter, L. L., & Philip, N. S. (2021). Multimodal elements of suicidality reduction after transcranial magnetic stimulation. Neuromodulation: Technology at the Neural Interface, 24(5), 930–937. https://doi.org/10.1111/ner.13376
- Bozzay, M. L., Primack, J., Barredo, J., & Philip, N. S. (2020). Transcranial magnetic stimulation to reduce suicidality: A review and naturalistic outcomes. Journal of Psychiatric Research, 125, 106–112. https://doi.org/10.1016/j.jpsychires.2020.03.016
