Anxiety Treatment in Marylebone, London
Your anxiety is worry you cannot switch off and a body that stays braced for something that never arrives. Magnetic stimulation can help, most clearly where anxiety sits alongside depression. The trial evidence is smaller here than it is for depression, and this page says where the line is.
Overview
Understanding anxiety
Anxiety becomes a clinical problem when the worry runs most days for months, when it spreads beyond any single trigger, and when your body stops standing down. People describe a tight chest, a fast heart, shallow breathing and a mind that will not settle at bedtime. Avoiding things helps for an hour and costs you more over a year.
Underneath that pattern sit two things working against each other. The amygdala flags threat. The prefrontal cortex is meant to moderate that signal and decide how much of it is warranted. In persistent anxiety the first is overactive and the second has less influence than it should. The result is a nervous system held in a state of readiness, which is also why heart rate variability tends to be low.
Magnetic stimulation works on the second half of that pair. Anxiety protocols commonly target the right dorsolateral prefrontal cortex, and the aim is to restore top-down regulation rather than to blunt the threat signal itself.
Now the honest part. Most of the published trial evidence for rTMS is in depression, not in anxiety. NICE has issued interventional procedures guidance for depression and has not done so for anxiety disorders. Studies in generalised anxiety are smaller and fewer, and the clearest signal is in people whose anxiety sits alongside depression, which is a large share of the people who ask us about it.
First-line treatment for generalised anxiety in the UK is psychological therapy, usually cognitive behavioural therapy, with medication where appropriate. If you have not had a proper course of that, your clinician will tell you to start there. We would rather lose the booking than sell you a course of stimulation in the wrong order.
Where stimulation is appropriate, what changes is measured rather than remembered. Your heart rate variability is recorded continuously by a wearable ring through the programme, and the NayaScore assessment is repeated during the course. NayaScore is a measurement tool rather than a diagnostic test, and results are interpreted alongside clinical judgement.
Why it happens
What causes anxiety?
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An overactive amygdala, the part of the brain that flags threat
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Reduced regulation of that threat response by the prefrontal cortex
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A nervous system held in sympathetic dominance, which shows as low heart rate variability
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Learned avoidance, which lowers anxiety in the moment and raises it over months
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Depression alongside the anxiety, each maintaining the other
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A physical cause that mimics anxiety, such as thyroid disease or an arrhythmia
Treatment approach
How do we treat anxiety?
Integrated therapy
On enquiryListed first here on purpose. Psychological therapy is the recommended first-line treatment for generalised anxiety in the UK, and stimulation does not replace it. Where you have already had therapy, running it alongside a course gives you somewhere to put the change. Where you have not, this is where your clinician will start you.
See treatment detail →NayaScore assessment
On enquiryAnxiety is usually tracked by how you say you feel on the day you are asked. This adds continuous heart rate variability from a wearable ring, grip strength and cognitive testing across twelve domains, taken before treatment and repeated during it. It is a measurement tool, not a diagnostic test, and results are read alongside clinical judgement.
See treatment detail →Precision rTMS
From £350 a sessionAnxiety protocols commonly target the right dorsolateral prefrontal cortex, at a dose set as a percentage of your own motor threshold. Your clinician will be specific about which category your case falls into, because the evidence here is smaller than it is for depression and you are entitled to know that before you pay.
See treatment detail →Heart-brain coupling
On enquiryAnxiety is as much an autonomic problem as a cognitive one. Choosing the target by measuring which candidate site produces the clearest heart-rate deceleration means the site treated is one your own vagal system responds to, rather than a coordinate taken from an average head.
See treatment detail →Restore programme
From £350 a sessionThe pathway for people below their baseline with a diagnosed condition. It sets out the assessment, the course, the mid-course reassessment and the decision at the end as one plan, so the commitment is clear before you start rather than session by session.
See treatment detail →FAQ
Common
questions
Is rTMS approved for anxiety?
NICE has issued interventional procedures guidance on rTMS for depression, not for anxiety disorders. That is an important distinction and we will not blur it. Anxiety is treated here where it sits alongside a condition the evidence supports, or after first-line therapy and medication have been tried.
Should I try therapy first?
Usually yes. Psychological therapy, most often cognitive behavioural therapy, is the recommended first-line treatment for generalised anxiety in the UK, with medication where appropriate. If you have not tried it, your clinician will say so at the consultation rather than sell you a course of stimulation.
Which side of the brain is stimulated for anxiety?
It depends on the pattern we find. Anxiety protocols often use the right dorsolateral prefrontal cortex, while depression protocols usually use the left. Where both are present, target selection is a clinical decision made at your assessment, then tested by measuring how your heart responds to each candidate site.
Can stimulation make anxiety worse?
Some people feel more activated in the first week of a course, and it usually settles. Tell your clinician if it does not, because dose, frequency and target can all be adjusted. Mild scalp discomfort and a dull headache are the more common early effects, and both tend to pass quickly.
How will I know whether my anxiety is actually changing?
Your heart rate variability is recorded continuously by a wearable ring through the programme, and the NayaScore assessment is repeated during the course. Those numbers sit next to how you say you feel, not instead of it. NayaScore is a measurement tool, not a diagnostic test.
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Naya • 1 Orchard Street, London W1H 6HJ
BookAppointments typically available within 1–2 weeks