Depression In Women: A Guide

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By Dr. David Woo - March 4, 2024

When it comes to mental health, women face unique challenges that contribute to higher rates of depression compared to men. This gender disparity in mental health outcomes, often referred to as the “gender depression gap,” highlights the need for greater understanding and support for women’s mental health. On a more positive note, there are innovative therapies for depression that work especially well for women. Let’s examine the gender depression gap, the signs and symptoms of depression in women, and treatment options.

Recognizing Signs Of Depression In Women

Signs of depression in women can vary. Although common symptoms of depression can be experienced by any gender, studies have shown that societal gender roles influence how depression is expressed: men are more likely to express anger and engage in risky behavior, whereas women are more likely to express traditional signs of sadness, such as crying, or experience disrupted eating patterns (1).

Common symptoms of depression in women include:

A persistent sense of emptiness or lingering sadness.
Diminished interest in activities you used to enjoy.
Fluctuations in appetite or weight.
Struggling with sleep, whether it’s insomnia or oversleeping.
Fatigue and low energy levels.
Excessive feelings of low self-worth and guilt.
Finding it challenging to concentrate or make decisions.
Irritability or restlessness.
Thoughts of death or suicide.
Chronic pain, headaches, or digestive issues.

If you are experiencing several of the symptoms above for an extended period, it’s essential to recognize the signs and seek professional help as early as possible. Depression is a treatable condition, and many people find relief through medical intervention. Depression treatment methods include talk therapy and antidepressant medications as well as newer techniques such as transcranial magnetic stimulation (TMS).

Depression In Women

Studies consistently show that women are twice as likely as men to experience depression. This disparity is believed to be influenced by a combination of biological, psychological, and socio-cultural factors. Hormonal fluctuations, such as those experienced during menstruation, pregnancy, and menopause, can contribute to mood disturbances in women (2).

However, biological sex differences do not tell the whole story. Societal expectations, restrictive gender roles, and experiences of discrimination and gender-based violence can contribute to feelings of stress, low self-esteem, and depression in women (3, 4).

Some types of depression are more commonly experienced by women due to the hormonal changes that women experience throughout puberty, menstruation, pregnancy, and childbirth. These include the following:

Premenstrual Dysphoric Disorder (PMDD) is a severe form of premenstrual syndrome (PMS) characterized by significant mood disturbances, such as extreme sadness, irritability, or mood swings, in the week or two before menstruation.
Perinatal Depression includes depression during pregnancy (antenatal depression) and after childbirth (postpartum depression). Hormonal fluctuations, changes in sleep patterns, and the challenges of adjusting to motherhood contribute to perinatal depression.
Perimenopausal Depression occurs during the transitional phase leading up to menopause. Fluctuating hormone levels during perimenopause can affect mood and contribute to depressive symptoms.

TMS Therapy For Depression In Women

If you have tried antidepressants and still experience your symptoms, then TMS may be a good option for you. TMS is a non-invasive treatment that uses tiny magnetic pulses to stimulate specific areas of the brain, offering a drug-free alternative for depression patients who have not found relief with traditional medications. TMS may be an especially effective depression treatment for women as:

Research indicates that women are more likely than men to respond to TMS therapy and achieve remission (5).
Other studies have shown that it does not pose any additional risks to pregnant women (6).

TMS therapy costs can be covered by insurance, and its long-term success rate can make it more affordable than antidepressants over time. See our article on TMS reviews for some real-life experiences from patients.

Discrimination In Mental Health Treatment

Despite the higher prevalence of depression in women, they often face barriers to accessing appropriate mental health care. Women may encounter discrimination or dismissive attitudes from healthcare providers, leading to underdiagnosis and undertreatment of mental health conditions. Additionally, the stigma surrounding mental illness in many cultures can prevent women from seeking help or disclosing their symptoms, further exacerbating their suffering (7).

Empowering Women’s Mental Health

To address the gender depression gap and improve mental health outcomes for women, it is crucial to raise awareness, challenge stereotypes, and promote gender-sensitive approaches to mental health care. This includes providing education and resources tailored to women’s unique needs, advocating for policies that support women’s mental health, and ensuring equal access to quality mental health services. We encourage everyone to openly discuss their mental health issues with their support network and seek treatment as early as possible—nothing is more important than your health.

Seeking Help With Madison Avenue TMS & Psychiatry

If you or a loved one is struggling with depression, anxiety, or other mental health concerns, know that you’re not alone, and help is available. Madison Avenue TMS & Psychiatry offers compassionate therapy and TMS for depression and other mental health conditions. We take women’s mental health issues seriously and believe that no one in need of care should be left behind or ignored.

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.

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:

Mental Health Disorder	Men	Women
Depression	More likely to present irritability, anger, substance abuse, risk-taking behavior, and physical pain (e.g., back pain, headaches).	More likely to experience sadness, excessive crying, fatigue, sleep disturbances, and rumination.
Anxiety	Externalizing symptoms like irritability, anger, restlessness; may self-medicate with alcohol or drugs.	Internalizing symptoms such as excessive worry, fear, avoidance, and physical symptoms (e.g., headaches, muscle tension).
Bipolar Disorder	More prone to manic episodes characterized by irritability, aggression, and impulsive behavior; higher risk of substance abuse.	More prone to depressive episodes; rapid cycling is more common, along with mixed states of mania and depression.
Borderline Personality Disorder (BPD)	Often underdiagnosed; may show aggression, substance abuse, or reckless behavior; stigma around “masculine” emotional expression.	More likely to exhibit mood swings, intense emotional reactions, fear of abandonment, and self-harm behaviors.
Obsessive-Compulsive Disorder (OCD)	More likely to have obsessions related to symmetry, checking, and contamination; less likely to seek treatment.	More likely to have obsessions related to cleanliness, contamination, and compulsive cleaning; higher rates of comorbid anxiety.
Attention-Deficit/Hyperactivity Disorder (ADHD)	Often presents with externalizing behaviors like impulsivity, hyperactivity, and risk-taking; more diagnosed in childhood.	Often presents with inattentiveness, forgetfulness, and disorganization; underdiagnosed and often identified in adulthood.
Post-Traumatic Stress Disorder (PTSD)	More likely to experience irritability, anger, emotional numbing, and substance abuse; symptoms linked to combat or accidents.	More likely to experience hypervigilance, flashbacks, avoidance, and emotional distress; symptoms often linked to sexual trauma or abuse.

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:

Sources

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.
Albert, P. R. Why is depression more prevalent in women? Journal of Psychiatry & Neuroscience.. 2015;40(4), 219-221. Link. Accessed September 16, 2024.
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.
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.
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.
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.
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.
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.
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.
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.

Don’t let depression or stigma hold you back from living a fulfilling life. Our experienced team of professionals is committed to providing compassionate care and support to help you overcome obstacles and reclaim your mental well-being.

Contact Madison Avenue TMS & Psychiatry today via our website or call (212) 731-2033 to schedule a consultation and take the first step toward healing and empowerment. Together, we can bridge the gender-depression gap and promote mental health equity for people of all genders, everywhere.

Resources:

Macdonald JA, Greenwood CJ, Francis LM, Harrison TR, Graeme LG, Youssef GJ, Di Manno L, Skouteris H, Fletcher R, Knight T, Williams J, Milgrom J and Olsson CA. Profiles of Depressive Symptoms and Anger in Men: Associations With Postpartum Family Functioning. Front. Psychiatry. 2020;11:578114. Link. Accessed February 20, 2024.
Kropp, D. R., & Hodes, G. E. Sex differences in depression: An immunological perspective. Brain Research Bulletin. 2023;196, 34-45. Link. Accessed February 20, 2024.
Hyde, Janet S. PhD; Mezulis, Amy H. PhD. Gender Differences in Depression: Biological, Affective, Cognitive, and Sociocultural Factors. Harvard Review of Psychiatry. 2020;28(1):p 4-13. Link. Accessed February 20, 2024.
Fatima Batool. Gender Discrimination At Workplace And Mental Health Of Women: A Systematic Literature Review. PalArch’s Journal of Archaeology of Egypt / Egyptology. 2020;17(8), 622-633. Link. Accessed February 20, 2024.
Hanlon CA and McCalley DM. Sex/Gender as a Factor That Influences Transcranial Magnetic Stimulation Treatment Outcome: Three Potential Biological Explanations. Front. Psychiatry. 2022;13:869070. Link. Accessed February 20, 2024.
Kim, DR. Wang, E., McGeehan, B., Snell, J., Ewing, G., Iannelli, C., O’Reardon, JP., Sammel, C., Epperson, N. Randomized controlled trial of transcranial magnetic stimulation in pregnant women with major depressive disorder. Brain Stimulation. 2019;12 (1), 96-102. Link. Accessed February 20, 2024.
Mizock, L., & Brubaker, M. Treatment experiences with gender and discrimination among women with serious mental illness. Psychological Services. 2021;18(1), 64–72. Link. Accessed February 20, 2024.

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.

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