By Dr. David Woo - August 7, 2023

TMS, meaning Transcranial Magnetic Stimulation, is a noninvasive form of therapy used to treat a range of mental health conditions, notably depression, anxiety, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and borderline personality disorder (BPD). The FDA has approved the marketing of TMS for the treatment of major depressive disorder (MDD), migraine headaches, and OCD, especially in cases in which pharmaceuticals have proven ineffective or intolerable (1). As TMS becomes more widely available, you may see this acronym listed as a mental health treatment option.

TMS Meaning

Cranial? Magnetic? What’s going on? Although we might not be used to hearing these words in the context of psychotherapy, they simply describe how TMS works to help regulate the causes of mental health disorders in the brain. Here’s a helpful breakdown of what TMS stands for and its meaning:

1. Transcranial

The cranium is the name given to the part of the skull that encloses and protects the brain. The prefix trans is Latin for ‘to go across’. When patients undergo TMS therapy, they wear a hat-like device called a coil.  This device uses magnets to deliver tiny, barely perceptible electric charges to the brain which pass through the cranium without breaking the skin, hence transcranial.

2. Magnetic

Our thoughts and emotions are generated by electrochemical activity in the brain. Electrically charged cells (neurons) ‘fire’ electrical signals that are converted into chemical messengers (neurotransmitters) that activate brain areas related to creativity , fear, self-image, logic, mood–anything that takes place inside our minds (2). 

When this electrochemical activity is abnormal or imbalanced, this can lead to disrupted or unstable moods, intrusive thoughts, and other symptoms of mental disorders. The active element of TMS comes from the electromagnetic coil built into the head-mounted device. During a TMS session, the doctor will activate these magnets to send electric pulses to the brain region associated with the patient’s symptoms.

3. Stimulation

The electric pulses emitted by the coil stimulate the targeted area of the brain in order to reach a healthy, balanced level of activity. For example, patients with depression often have lower-than-normal activity in the prefrontal cortex. By stimulating this region to produce more neurotransmitters, TMS helps restore brain activity to a ‘normal’, balanced level. Your doctor will determine the brain region to stimulate based on your symptoms–for example, the left side of the brain is targeted to treat depression, whereas the right side of the brain can be targeted to alleviate anxiety.

After a full course of TMS (usually six weeks), patients usually report improvements in their mood and ability to regulate their emotions as their symptoms recede. Studies have shown these positive effects to last at least a year after TMS treatment (4). 

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.

dTMS vs rTMS

You may sometimes see TMS advertised with the prefix ‘r’ or ‘d’ before the acronym. In short:

• rTMS refers to repetitive TMS, the standard form of TMS that uses repeating alternating electrical currents.
• dTMS refers to deep TMS, a more advanced form of TMS which uses specialized coils to reach wider and deeper into the brain. It is generally considered to be more effective than rTMS.

TMS Clinics in NYC

Psychiatry clinics are increasingly offering TMS therapy in addition to traditional treatments for mood disorders. If you are experiencing mental health difficulties, it is recommended to consult a doctor as soon as possible. Failure to seek medical attention may lead to a worsening of symptoms.

Madison Avenue TMS & Psychiatry offers talk therapy and TMS for treating depression, anxiety, and other mental health disorders. Contact us online or call (212) 731-2033 if you have any questions or to make an appointment.

Sources:

1. FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. U.S. Food & Drug Administration. Updated August 17, 2018. Link. Accessed July 17, 2023.
2. How does the brain work? Dana.org. Updated August 11, 2019. Link. Accessed July 17, 2023.
3. Dunner, DL, Aaronson, ST, Sackeim, HA, et al. A multisite, naturalistic, observational study of transcranial magnetic stimulation for patients with pharmacoresistant major depressive disorder: Durability of benefit over a 1-year follow-up period. The Journal of Clinical Psychiatry. 2014;75(12):1394-401. Link. Accessed July 17, 2023.

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.