By Dr. David Woo - October 15, 2021

Deep TMS, also called dTMS, is a type of TMS (transcranial magnetic stimulation) technology. It uses magnetic pulses to help regulate neuron activity, and therefore relieve symptoms, in people who have been diagnosed with certain mental health conditions, like depression and OCD (obsessive-compulsive disorder). Deep TMS helps relieve symptoms when patients haven’t seen an improvement with other treatment options and is performed in the same manner as traditional standard TMS.

How is Deep TMS Performed?

Like rTMS (which is the “standard” type of TMS performed), dTMS is an outpatient procedure and doesn’t require anesthesia.

Before starting a dTMS session, a technician carefully fits a helmet over your head. Inside of this helmet is a magnetic coil that safely emits magnetic pulses throughout the session (one session typically lasts approximately 20 minutes). Patients can drive themselves home or to work immediately following a TMS treatment session. 

Why Does Deep TMS Have the Word “Deep” in the Name?

Many of my patients are curious why dTMS is called “deep,” if it’s performed the same way as standard TMS. Deep TMS gets its name from its ability to safely activate neurons in deeper parts of the brain, compared to standard TMS that activates neurons that are closer to the surface of the brain. 

Deep TMS uses a unique H-shaped magnetic coil that allows magnetic pulses to reach deeper areas of the brain (3.2 cm) associated with mood regulation.(1) Standard TMS uses a figure-eight coil shape that can reach approximately 1-2cm in depth.(2)

How Effective is Deep TMS?

Deep TMS is clinically proven and FDA-approved to relieve symptoms of depression, OCD, and tobacco cigarette cravings and urges.

Clinical studies show that dTMS is safe and effective in patients who have been diagnosed with treatment-resistant depression (meaning that they don’t respond to antidepressants and talk therapy). One study, in particular, showed that patients with treatment-resistant depression who receive dTMS treatment are twice as likely to achieve remission compared to patients who received placebo treatment.(3)

A recent analysis of real-world clinical data tells us that dTMS is successful in treating symptoms of OCD in patients who do not respond to medication and behavioral therapy. This analysis also found that patients continued to see a reduction in the severity of their symptoms with additional treatment sessions.(4)

Studies also show that dTMS is safe and effective in helping people achieve short-term smoking cessation. Deep TMS can help reduce cravings and improve the quit rate among long-time smokers.(5)

While dTMS is only FDA-approved to treat depression, OCD, and smoking cessation, research shows that it may be safe and effective for other conditions. 

Who Can Benefit From Deep TMS?

Deep TMS is recommended for patients diagnosed with certain conditions who do not find relief from their symptoms with medication and talk therapy. 

Deep TMS is FDA-approved for the treatment of:

• Depression
• OCD
• Smoking cessation

Research shows that deep TMS may also be a safe and effective treatment for people with:

• Fear and anxiety disorders(6)
• Addiction(7)
• Migraines(8)

Most patients who are candidates for standard TMS (rTMS) are also good candidates for dTMS. 

Women and mental health is a critical topic that deserves attention, as research shows that women are more susceptible to certain mental health conditions, such as depression, compared to men. Women often face unique challenges related to hormonal changes, gender roles, and societal expectations that can impact their mental well-being. Additionally, women’s mental health issues can manifest differently, and they may encounter barriers or discrimination when seeking treatment. At Madison Avenue TMS & Psychiatry, we are committed to providing compassionate care and effective treatment options tailored to the specific needs of women, including talk therapy, medication management services, and transcranial magnetic stimulation (TMS). Let´s break down the state of women’s mental health issues today, and how innovative treatments can help patients overcome traditional barriers to wellness.

Jump to:

• Are Women More Susceptible To Certain Mental Health Conditions?
• Do Women Manifest Different Mental Health Symptoms?
• Gender Differences In Symptoms Of Mood Disorders
• Barriers Women Face In Mental Health Treatment
• Treatment Options For Women’s Mental Health Issues
• Get Compassionate Mental Health Care At Madison Avenue TMS & Psychiatry

Are Women More Susceptible To Certain Mental Health Conditions?

Studies indicate that women are more likely than men to experience certain mental health disorders. This discrepancy between the sexes is influenced by a combination of biological, psychological, and social factors. Key statistics include:

• Depression: Women are nearly twice as likely to be diagnosed with depression compared to men (1, 2). Hormonal fluctuations during puberty, menstruation, pregnancy, postpartum, and menopause can contribute to this increased risk.
• Anxiety Disorders: Women are more likely to experience anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, and phobias (4).
• Post-Traumatic Stress Disorder (PTSD): Women are more than twice as likely as men to develop PTSD after experiencing traumatic events. Women are also more likely to experience certain types of trauma, such as sexual violence, which further increases the risk of PTSD (5).
• Obsessive-Compulsive Disorder (OCD): OCD affects both men and women, but women tend to have a later onset and are more likely to develop OCD related to contamination fears and compulsive cleaning (6, 7).
• Attention-Deficit/Hyperactivity Disorder (ADHD): ADHD is often underdiagnosed in women, who may present with inattentive symptoms rather than hyperactivity. As a result, many women remain undiagnosed until adulthood (8).
• Bipolar Disorder: Women are more likely to experience rapid cycling (more frequent mood changes) and mixed states of bipolar disorder compared to men, making it essential to identify gender-specific symptoms and treatment plans (9).
• Borderline Personality Disorder (BPD): Approximately 75% of those diagnosed with BPD are women, with symptoms often linked to trauma, emotional instability, and interpersonal difficulties (10).

Do Women Manifest Different Mental Health Symptoms?

Women’s mental health issues often manifest differently compared to men, which can impact diagnosis and treatment. Mental health is not one-size-fits-all, and symptoms can present across the entire gender spectrum. However, women as a demographic display some differences in symptoms in certain conditions, such as:

• Depression: Women with depression may experience more physical symptoms such as fatigue, changes in appetite, and sleep disturbances, while men may report more irritability and anger.
• Anxiety: Anxiety in women often manifests as internalizing symptoms like excessive worry, phobias, rumination, and physical complaints (e.g., headaches, fatigue), whereas men tend to present externally, with a higher prevalence of irritability and risky behaviors.
• PTSD: Women are more likely to experience symptoms such as hypervigilance, avoidance, and emotional numbing, while men may exhibit higher levels of aggression.
• ADHD: Women with ADHD often show inattentiveness, forgetfulness, and disorganization, which can be mistaken for anxiety or depression.
• Bipolar Disorder: Women with bipolar disorder tend to have more depressive episodes and fewer manic episodes than men, which can affect how the disorder is perceived and treated.
• OCD: Women are more likely to develop OCD symptoms related to caretaking, contamination, and morality.

Hormonal changes in women, including pregnancy and the menstrual cycle, may also account for variations in symptoms. Pregnant women, new mothers, and pre- and post-menopausal women all experience changes in their body chemistry that can affect their vulnerability to certain mental health disorders as well as the presentation and severity of symptoms. It´s important to note that hormonal factors should not be an excuse for anyone to dismiss or minimize mental health symptoms—our mental health is intimately linked to our biochemistry, and hormones are a natural part of that.

Gender Differences In Symptoms Of Mood Disorders

This table presents an overview of gender-based differences in symptom manifestation in common mental health conditions:

Barriers Women Face In Mental Health Treatment

Despite the higher prevalence of mental health disorders among women, many face significant barriers to accessing effective care due to the negative impacts of sexism and societal expectations of women (11).

• Misdiagnosis: Women are often misdiagnosed or have their symptoms attributed to hormonal changes or emotional overreaction, leading to delayed or inadequate treatment.
• Financial and time constraints: Caregiving responsibilities and lower income levels can prevent women from seeking timely mental health care.
• Gender discrimination: Some women report experiencing discrimination in the healthcare system, where their concerns are not taken seriously or dismissed, impacting their willingness to seek treatment.

Treatment Options For Women’s Mental Health Issues

At Madison Avenue TMS & Psychiatry, we offer a range of treatment options designed to address women’s mental health issues. These include:

• Medication management: Personalized treatment plans to manage conditions such as depression, anxiety, ADHD, and bipolar disorder
• Telehealth consultations: Convenient access to mental health care from the comfort of home, making it easier for women to prioritize their mental well-being.
• Transcranial magnetic stimulation (TMS): A non-invasive and effective treatment option for depression, OCD, and anxiety, particularly for those who have not responded to medication or therapy. 

As a drug-free depression treatment, TMS is safe for women who want to avoid the potential pharmaceutical interactions and side effects that come with taking antidepressants. This means that TMS is an effective treatment to undergo for women who are pregnant, breastfeeding, or on hormonal medications for birth control, menopause, or other reasons.

Get Compassionate Mental Health Care At Madison Avenue TMS & Psychiatry

Women face unique challenges when it comes to mental health, but effective treatments are available.

At Madison Avenue TMS & Psychiatry, we provide compassionate care tailored to the specific needs of women in a supportive environment. Our clinic stands for gender equality and mental health equity, and we encourage women with mental health concerns to contact us for a consultation without fear of discrimination or judgment.

If you or a loved one is struggling with mental health issues and based in the New York area, contact us today via our website or by calling (212) 731-2033. Our team of professionals is here to help you regain control of your mental well-being and lead a healthier, more fulfilling life.

More Resources On Women And Mental Health:

• Understanding Menopause Mood Swings
• BPD In Women: Know The Signs
• Bipolar Disorder In Women: Prevalence, Symptoms, And Treatment

Sources

1. Hyde, Janet S. PhD; Mezulis, Amy H. PhD. Gender Differences in Depression: Biological, Affective, Cognitive, and Sociocultural Factors. Harvard Review of Psychiatry 28(1):p 4-13, 1/2 2020. Link. Accessed September 16, 2024.
2. Albert, P. R. Why is depression more prevalent in women? Journal of Psychiatry & Neuroscience.. 2015;40(4), 219-221. Link. Accessed September 16, 2024.
3. Farhane-Medina, N. Z., Luque, B., Tabernero, C., & Castillo-Mayén, R. Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review. Science Progress. 2022. Link. Accessed September 16, 2024.
4. Javaid, S.F., Hashim, I.J., Hashim, M.J. et al. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Curr Psychiatry 2023;30, 44. Link. Accessed September 16, 2024.
5. Hiscox, L.V., Sharp, T., Olff, M. et al. Sex-Based Contributors to and Consequences of Post-traumatic Stress Disorder. Curr Psychiatry Rep 25. 2023; 233–245. Link. Accessed September 16, 2024.
6. Tiyatiye, B., & Akosile, W. (2022). A systematic review of prevalence of comorbid obsessive-compulsive disorders and substance use disorders in clinical settings, 1990-2021. Journal of Substance Use. 2022;29(2), 180–185. Link. Accessed September 16, 2024.
7. Dr. Noreena Kausar, Amna Ishaq, & Dr. Muneeb Ahmed Toor. (2023). Prevalence of Obsessive-Compulsive Disorder in Psychiatric Patients. PAKISTAN JOURNAL OF LAW, ANALYSIS AND WISDOM, 2023;2(02), 1032–1041. Link. Accessed September 16, 2024.
8. Hinshaw SP, Nguyen PT, O’Grady SM, Rosenthal EA. Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. J Child Psychol Psychiatry. 2022;Apr;63(4):484-496. Link. Accessed September 16, 2024.
9. Miola, A., Fountoulakis, K. N., Baldessarini, R. J., Veldic, M., Solmi, M., Rasgon, N., Ozerdem, A., Perugi, G., Frye, M. A., & Preti, A. (2023). Prevalence and outcomes of rapid cycling bipolar disorder: Mixed method systematic meta-review. Journal of Psychiatric Research. 2023;164, 404-415. Link. Accessed September 16, 2024.
10. Bozzatello, P., Blua, C., Brandellero, D., Baldassarri, L., Brasso, C., Rocca, P., & Bellino, S. Gender differences in borderline personality disorder: A narrative review. Frontiers in Psychiatry. 2024;15, 1320546. Link. Accessed September 16, 2024.

Garb, H. N. Race bias and gender bias in the diagnosis of psychological disorders. Clinical Psychology Review. 2021;90, 102087. Link. Accessed September 16, 2024.

 If you’d like to learn more about deep TMS and whether it can help you, contact us online or call 212.731.2033 to make an appointment. 

Resources:

1. BrainsWay TMS. How does Deep TMS compare to standard rTMS? Link. Accessed September 10, 2021.

2. McClintock SM, Reti IM, Carpenter LL, et al. Consensus Recommendations for the Clinical Application of Repetitive Transcranial Magnetic Stimulation (rTMS) in the Treatment of Depression. Journal of Clinical Psychiatry. Jan-Feb 2018;79(1):16cs10905. Link. Accessed September 13, 2021.

3. Levkovitz Y, Isserles M, Padberg F, et al. Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry. February 2015;14(1):64–73. Link. Accessed September 13, 2021.

4. Roth Y, Tendler A, Arikan MK, et al. Real-world efficacy of deep TMS for obsessive-compulsive disorder: Post-marketing data collected from twenty-two clinical sites. J Psychiatr Res. 2021;137:667-672. Link. Accessed September 10, 2021.

5. Zangen A, Moshe H, Martinez D, et al. Repetitive transcranial magnetic stimulation for smoking cessation: a pivotal multicenter double-blind randomized controlled trial. World Psychiatry. 2021;20(3):397-404. Link. Accessed September 13, 2021. 

6. Cirillo P, Gold AK, Nardi AE, et al. Transcranial magnetic stimulation in anxiety and trauma‐related disorders: A systematic review and meta‐analysis. Brain Behav. 2019;9(6):e01284. Link. Accessed September 13, 2021. 

7. Bolloni C, Badas P, Corona G, and Diana M. Transcranial magnetic stimulation for the treatment of cocaine addiction: evidence to date. Subst Abuse Rehabil. 2018;9:11–21. Link. Accessed September 13, 2021.

8. Rapinesi C, Del Casale A, Scatena P, et al. Add-on deep Transcranial Magnetic Stimulation (dTMS) for the treatment of chronic migraine: A preliminary study. Neurosci Lett. 2016;623:7-12. Link. Accessed September 13, 2021.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.