Can women with depression use TMS or Ketamine?

Question

Hello doctor,

I am a 37-year-old woman diagnosed with major depressive disorder. I often feel very tired, have little interest in daily activities, and find it hard to sleep. Antidepressants have helped somewhat, but I am worried about side effects such as weight gain and sexual problems.

Are there newer treatment options, like TMS (transcranial magnetic stimulation) or Ketamine therapy, that are safe for women? I also wonder if depression can worsen during hormonal changes, such as before my periods or after pregnancy.

Lastly, I would like to know how to best balance medication with therapy and lifestyle changes, since my main goal is to manage my health while caring for my children effectively. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Major depressive disorder (MDD, a serious form of sadness that lasts a long time, makes you lose interest in things, and affects daily life), also called clinical depression, can be tough to manage, especially when symptoms like tiredness, poor sleep, and loss of interest in daily life continue even with medication. It is also normal to worry about side effects such as weight gain or sexual health changes, which some antidepressants can cause.

There are newer treatment options for women:

Transcranial magnetic stimulation (TMS): A non-invasive treatment that uses gentle magnetic pulses on specific brain areas linked to mood. It does not affect the whole body, so side effects are usually fewer.
Ketamine or Esketamine therapy: These medicines, given in a clinic under close supervision, can bring quick relief for people whose depression does not respond to standard treatments. However, they need careful monitoring for safety.

Hormonal changes can also play a role. Shifts before your period (premenstrual), after childbirth (postpartum), or during the transition to menopause (perimenopause) can sometimes make depression worse. Keeping track of your mood in relation to your cycle may help your doctor personalize treatment better.

The best results often come from combining approaches:

Medication: Adjusting doses or changing drugs to reduce side effects.
Therapy: Talking treatments like cognitive behavioral therapy (CBT), which helps challenge negative thought patterns, or interpersonal therapy (IPT), which focuses on relationships and support.
Lifestyle steps: Regular exercise, healthy food, good sleep routines, stress management, and leaning on supportive friends or family.

Since your goal is to stay well and care for your children, a plan that balances medication with therapy and lifestyle strategies can help you achieve more stable mood control and a better quality of life.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.