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We often think of posture as a physical habit - but it’s also a mirror of your inner world. The connection between posture and mental health runs deeper than you might expect, subtly influencing mood, focus, and emotional regulation.

This article unpacks what science says about posture’s psychological effects - and how small physical shifts might support bigger emotional change. It’s not a fix-all. But it’s a place to start noticing.

Why Your Posture Says More Than You Think

How are you sitting right now? Shoulders slumped? Head forward? Spine curved? These small physical habits may seem minor, but your posture affects more than just how you look - it’s deeply connected to how you feel and think.

What we often consider simply "bad sitting habits" can become silent signals of emotional strain. Over time, the body’s default position (especially one of collapse or tension) begins to shape the way we process stress, respond to challenges, and regulate our emotions.

Poor posture can influence:

• Breathing patterns and oxygen flow
• Muscle tension and chronic pain
• Fatigue and low energy
• Confidence and self-perception
• Emotional states like anxiety or sadness

In contrast, sitting up straight with good posture helps improve focus, circulation, and overall mood. The relationship between posture and mental health isn’t just behavioral - it’s biological. As we’ll explore in the next sections, better posture isn’t only about avoiding back pain; it’s a foundation for better emotional balance and long-term mental health.

The Science Behind Posture and Mental Health

In one study published in Health Psychology, participants who sat upright during a stressful task reported feeling more alert, confident, and in control compared to those in a slouched position. Their body language didn’t just reflect their emotional state - it shaped it. This offers a clearer picture of the relationship between posture and anxiety, showing that how we sit and move can influence both short-term reactions and long-term emotional patterns.

Below, we explore how posture connects with mood, anxiety, and symptoms of depression - and why these physical cues matter more than we often realize.

How Body Position Shapes Your Mood

Maintaining an upright posture supports a more open, engaged state - both physically and emotionally. In the study, participants who sat up straight while delivering a stressful speech reported greater self-esteem and used more balanced, confident language. This highlights how posture can shape our internal state, not just reflect it.

Researchers have also found similar effects in "power pose" research, suggesting that expansive postures can influence hormonal activity and emotional readiness.

• Key takeaway: Upright posture can reinforce emotional stability and support a more confident mindset.

Posture, Anxiety, and Cognitive Bias

Anxiety often starts in the body. A slouched, compressed posture can restrict breathing and heighten physical tension - sending the brain a subtle message that danger is near. This connection between posture and anxiety is part of a self-reinforcing loop, where the body shapes thought patterns and vice versa.

While posture alone doesn’t treat anxiety, improving it can interrupt this feedback loop and support other tools like mental health counseling.

• Key takeaway: Correcting posture helps reduce the body’s stress signals that fuel anxious thinking.

Depression, Slouching, and Learned Helplessness

Depression is often expressed through the body - in reduced movement, slumped shoulders, and a lowered gaze. Participants assigned to slouched posture in the study reported more negative thoughts and used language tied to sadness and helplessness.

Though good posture won’t reverse depression on its own, it can help shift physical cues that reinforce low mood, especially when paired with supportive care or treatment.

• Key takeaway: Collapsed posture may sustain depressive patterns, while upright posture can gently support emotional engagement.

How Poor Posture Affects Your Physical Health

The Silent Strain on Your Spine and Organs

Poor posture leads to subtle yet consistent pressure on your musculoskeletal system. Muscles must overcompensate to hold you upright, while organs become compressed - reducing efficiency and function.

Here’s how posture affects different systems:

When we talk about the connection between posture and anxiety, these physical consequences are a central part of the story.

Energy, Focus, and Breathing

The way you sit and move also affects cognitive and physical performance. Slouching limits lung capacity, restricts oxygen intake, and increases muscle fatigue - all of which can reduce your ability to stay alert and focused.

Poor posture can lead to:

• Shallow breathing, which lowers oxygen delivery to the brain
• Neck and jaw tension, contributing to headaches and distraction
• Increased fatigue, as muscles work harder to stabilize the body
• Reduced circulation, which affects energy and temperature regulation
• Mental fog, often related to poor alignment and decreased airflow

Improving posture is one of the simplest ways to support clearer thinking, better energy, and overall posture and health outcomes - without requiring a major lifestyle overhaul.

What Good Posture Does for Your Brain and Body

Boosts Confidence and Emotional Stability

How we hold our bodies influences how we feel about ourselves. Standing or sitting tall helps create a sense of groundedness - a message your body sends to your brain. This physical alignment promotes greater confidence, improved self-regulation, and more balanced emotional reactions.

In social or professional settings, an upright posture also communicates calm and engagement. Over time, practicing better posture can shift self-perception, reinforcing a stronger internal narrative. This link between posture and health isn’t abstract - it’s something your nervous system registers with every movement.

Improves Physical Efficiency and Reduces Fatigue

Proper alignment reduces strain on the muscles that support your spine, letting your body do more with less effort. Here’s how posture influences performance:

When your posture works with your body you conserve energy and stay sharper throughout the day. That’s how posture and health stay connected long-term.

Supports Long-Term Mental Clarity

Better posture supports brain function by improving how the body breathes and moves. Here’s why alignment matters for your focus:

• More oxygen to the brain improves alertness and reduces brain fog during the day.
• Fewer physical distractions help minimize cognitive overload and support sustained attention.
• Reduced muscle fatigue allows you to maintain focus for longer periods without discomfort.
• Better nervous system balance promotes a calmer emotional baseline and greater mental flexibility.

When your body feels stable and open, your mind has more bandwidth. While posture won’t replace rest or therapy, it helps create the conditions for clearer thinking and more consistent mental performance.

Posture Habits That Actually Work

Posture Checkpoints in Real Life

Forget posture tips that only work in ideal conditions. Instead, build awareness where it counts:

• In the car: Adjust your seat and mirrors so you’re prompted to sit tall without leaning forward.
• On video calls: Keep your screen at eye level, feet grounded - your back slumps when you're half-engaged.
• During scrolling breaks: Whether on the couch or in bed, notice if your head is jutting forward or your spine is collapsing.
• At the desk: Set a reminder to uncross your legs, pull your shoulders back, and realign every hour.
• While cooking or doing chores: Check if you're locking your knees or leaning your weight onto one hip.
• When feeling overwhelmed: Anxiety often starts with your breath and chest. Open the ribcage, exhale slowly - posture and anxiety are more linked here than you think.
• Before sleep: Place a pillow under your knees (back sleepers) or between them (side sleepers) to reduce spinal tension overnight.

These posture "checkpoints" help bring your attention back - not to perfection, but to presence. That’s where posture and health start to shift in real life.

Building Core Strength Without a Gym

Improving posture isn’t about planks or fancy routines. It’s about waking up underused muscles - especially when you’re sitting.

Try these:

• Gently engage your lower abdomen when waiting in line or brushing your teeth.
• Lift through the crown of your head during slow walks or breaks.
• Check in with your breath: Are your ribs moving freely, or is your chest collapsed?

These small actions retrain the core muscles that hold your spine - no gym required. Over time, they support better posture, reduce strain, and improve both mental health and stamina.

Ergonomics That Make a Real Difference

Not all posture gear delivers. Some tools help, others just clutter your desk and most often simple adjustments to your setup tend to have the biggest impact on posture and health. Here’s a quick breakdown:

Beyond Posture: Dealing With Deeper Mental Health Issues

There’s a point where posture correction meets its limits. If anxiety, low mood, or exhaustion persist - even with better habits - the cause may lie deeper. It’s not just about how you sit, but what sits underneath. Conditions like depression, anxiety disorders, or trauma responses can shape posture from within, not the other way around.

That’s where therapy comes in. For many, the loop between posture and anxiety becomes automatic - slouching triggers stress, which deepens emotional discomfort. Somatic approaches, CBT, and trauma-informed care help reconnect the mind and body - especially in people with co-occurring disorders and dual diagnosis, where emotional and physical symptoms are deeply linked.

Final Thought: Straighten Your Spine, Shift Your Mind

Your posture reflects more than muscle memory - it mirrors your emotional state. Sitting upright won’t resolve chronic anxiety or low mood, but it can be the first clue that something deeper is asking for attention.

If emotional strain keeps pulling you down, physically or mentally, it might be time to address what’s underneath. At Amae Health, we support people facing anxiety, depression, and burnout with care that treats the root, not just the surface.

You deserve support that honors both mind and body. Contact our specialists when you’re ready.

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Last updated: November 2026.

ADHD in women vs. men is the same condition. What differs is how visible the symptoms are, especially in childhood, and how quickly people get diagnosed. Boys are around three times more likely to be diagnosed with ADHD in childhood, according to the Duke Center for Girls and Women with ADHD. By adulthood, the same source notes, rates are equal. So the gap is less about who has ADHD and more about who gets noticed, and when.

ADHD in Women vs. Men at a Glance

These are tendencies, not rules. Plenty of girls are hyperactive, and plenty of men mostly struggle with focus. The sections below explain where each row comes from.

The Three ADHD Presentations Apply to Everyone

The National Institute of Mental Health describes ADHD as a neurodevelopmental disorder marked by inattention, hyperactivity, and impulsivity that are frequent, show up across settings, and interfere with daily life. The CDC uses the term "presentations" and names three:

• Predominantly Inattentive Presentation: trouble organizing, finishing tasks, following details, or keeping track of things.
• Predominantly Hyperactive-Impulsive Presentation: fidgeting, talking a lot, trouble waiting, acting before thinking.
• Combined Presentation: symptoms of both are present.

Any of the three can occur in anyone, of any sex. Because symptoms can change over time, the CDC notes, a person's presentation can change too. ADHD symptoms can continue into adulthood but may look different in adults. If attention problems overlap with reading or math difficulties, our guide to learning disabilities vs. ADHD explains how the two differ.

ADHD Symptoms in Women vs. Men

When people compare ADHD symptoms in women vs. men, they're usually comparing tendencies within the same three presentations. Here's how those tendencies often look.

How ADHD Often Shows Up in Boys and Men

In boys, ADHD more often shows up in outward behavior that other people can see. In a 2025 study of adults with ADHD, men were more likely than women to recall leaving their seat as children (45.97% vs 34.96%). Common examples:

• Leaving a seat in class, fidgeting, or seeming always "on the go"
• Blurting out answers and interrupting
• Making quick, impulsive decisions

Because these behaviors disrupt a classroom or a household, adults tend to notice them early.

How ADHD Often Shows Up in Girls and Women

In girls and women, ADHD more often turns inward. Inattention is common: losing the thread of a conversation, misplacing things, drifting off during long tasks.

Some women describe compensating: making lists, redoing work late at night, putting in extra effort. That effort can make symptoms harder for others to see. It also wears people down.

For the full picture of how this looks in daily life, including masking, see our guide to high-functioning ADHD in women.

ADHD in Girls vs. Boys: Why the Diagnosis Gap Starts in Childhood

The difference between ADHD in girls vs. boys starts with who gets referred. Disruptive behavior gets attention fast. A child who is quietly lost in thought doesn't.

The bias has deep roots. In 1902, the pediatrician George Still published some of the earliest clinical descriptions of what we now call ADHD. Of his 20 cases, 15 were boys. For much of the following century, the textbook picture of the condition looked like those boys.

Girls' symptoms still don't fit that picture well. The Duke Center notes that ADHD in girls and women is often missed completely or misinterpreted as other conditions, and that co-occurring anxiety and mood disorders can make it harder to identify. A girl who can't focus may be told she's anxious. A girl who is anxious because she can't keep up may only get treated for the anxiety.

None of this means girls have milder ADHD. It means their ADHD is easier to overlook.

Do Women and Men With ADHD Look More Alike in Adulthood?

Largely, yes. This is the part of the comparison most articles skip.

The Duke Center reports that adult rates of ADHD are equal in men and women, and that women are more likely than men to be first diagnosed as adults. Many of those women went through childhood without anyone naming what was going on.

A 2025 study in Frontiers in Global Women's Health looked at 2,257 adults diagnosed with ADHD at clinics in the Netherlands. The researchers concluded that ADHD shows up in a remarkably similar way in men and women. Where differences existed, they were small. In several adult symptoms, women reported higher rates: 80.38% of women said they lose things, compared with 71.40% of men. Looking back on childhood, men more often recalled classroom hyperactivity, with 45.97% reporting leaving their seat, compared with 34.96% of women.

The study has limits. It included only people who had already been diagnosed, it came from one country, and the authors call it exploratory. Still, it fits the larger pattern. The sharpest differences between ADHD in males vs. females appear in childhood, when outward behavior drives who gets seen. By adulthood, the symptoms themselves look much the same.

Hormones and ADHD Symptoms Across the Lifespan

Hormones come up often in this comparison. The science is early. The Duke Center describes emerging research into how hormone changes, such as those across the menstrual cycle and in menopause, may affect ADHD symptoms and treatment. It also states plainly that more research is needed.

Some women do notice that their focus or mood shifts at certain points in their cycle or around menopause. Keeping track of those patterns gives a clinician who knows your history something concrete to work with. But the research doesn't yet support firm conclusions about why it happens or what to change. Any decision about medication belongs in that clinical conversation, not in an article.

When ADHD Comes With Depression, Anxiety, or Bipolar Disorder

ADHD rarely travels alone. The Duke Center notes that girls and women with ADHD often also have anxiety and mood disorders.

That overlap makes diagnosis harder for everyone. Poor concentration, restlessness, sleep problems, and mood changes can come from ADHD, depression, anxiety, or bipolar disorder. They can also come from more than one at once. Sorting out which is which takes a careful psychiatric evaluation that looks at your full history, not a quick checklist.

This is where we can help. ADHD on its own isn't an Amae specialty. But our psychiatry-led teams work with adults whose ADHD occurs alongside depression, anxiety, or bipolar disorder, where the mood or anxiety symptoms are a large part of what's making life hard. You can read about bipolar disorder treatment at Amae or learn more about our care model.

Conclusion

ADHD in women vs. men is one condition with two common patterns of visibility. Boys are more often noticed early because their symptoms are louder, while girls are more often missed and diagnosed later, sometimes as adults. In adulthood, the symptoms look much more alike. If ADHD is showing up alongside depression, anxiety, or bipolar disorder, you can contact us to talk with our team about whether our care fits what you need.

Frequently Asked Questions

Is ADHD more common in men or women?

It depends on whether you mean diagnosis or occurrence. Boys are around three times more likely than girls to be diagnosed in childhood. In adulthood, rates are equal, according to the Duke Center for Girls and Women with ADHD. Much of the childhood gap reflects who gets noticed, not who has ADHD.

Why is ADHD underdiagnosed in girls?

Girls' symptoms are often less disruptive, so they're less likely to prompt a referral. When symptoms are noticed, they're often missed or misread as other conditions, and co-occurring anxiety or mood disorders can make ADHD harder to spot. Our guide to high-functioning ADHD in women covers how this plays out in adult life.

What are the main differences in ADHD symptoms in women vs. men?

In childhood, boys more often show outward symptoms like leaving their seat, while girls more often show inattention. In adults with ADHD, a 2025 study of 2,257 diagnosed patients found the symptoms remarkably similar between men and women, with only small differences.

Can women be diagnosed with ADHD as adults?

Yes. Women are more likely than men to be first diagnosed with ADHD as adults. An evaluation by a psychiatrist or another qualified clinician usually looks at current symptoms and at how things were in childhood.

Do hormones affect ADHD symptoms in women?

Researchers are beginning to study how hormone changes, such as the menstrual cycle and menopause, may affect ADHD symptoms and treatment. More research is needed before firm conclusions can be drawn.

Can ADHD be mistaken for depression or anxiety?

Yes. Trouble concentrating, restlessness, and low mood can appear in all three conditions, and they often occur together. A thorough psychiatric evaluation helps tell them apart. If you're having thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline.

Finishing a course of TMS and feeling like yourself again brings a new worry: will it hold? How long do TMS results last, and what happens if the depression comes back? The research is more encouraging than many people expect. Among people who respond to a course, roughly half to nearly two-thirds are still responding a year later, and when symptoms do return, restarting TMS brought back the improvement for most people in the research.

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None of that predicts any one person's course. It does show what tends to help results last, and why the months after treatment deserve a plan of their own.

What "Lasting" Means: Response vs. Remission

Two terms do most of the work in durability research. A person has responded when their depression scores fall by at least half on a standard rating scale. They're in remission when scores drop low enough that the depression is largely gone.

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Durability studies then ask a narrower question than the original trials did: of the people who responded or reached remission by the end of a course, how many were still doing well months later? That framing matters when you read the numbers. A result such as 62.5% of people keeping their response for a year describes people who had already responded, not everyone who started TMS. Those follow-up checks happen at set points, typically three, six, and 12 months after a course, so durability is reported as the share of people still responding at each checkpoint.

What the Research Shows About Durability

The most direct data come from a 2014 study in The Journal of Clinical Psychiatry that followed people with medication-resistant major depression for a year after they finished TMS at 42 U.S. clinical practices. Of the 257 people who completed a course and agreed to follow-up, 120 had responded or reached remission by the end of treatment. Of those 120, 75 (62.5%) kept meeting response criteria through the full 12 months.

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Two details shape that result. The study used a practical approach after the course: continued antidepressant medication, plus access to more TMS if symptoms returned. And over the year, 93 participants (36.2%) had TMS reintroduced at some point, averaging about 16 treatment days. So the 62.5% reflects TMS inside ongoing care, not a single course left to stand on its own.

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A 2019 meta-analysis in Brain Stimulation pooled 19 studies of people who had responded to a TMS course. About two-thirds were still responding at three months, about 53% at six months, and about 46% at one year. The authors' summary: roughly half of responders keep their response for up to a year after a successful course.

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Read together, the two studies give a realistic range of around half to nearly two-thirds of responders still doing well a year out. The other side of those numbers matters just as much. A meaningful share of people see symptoms return within the first year, and planning for that possibility is part of good care, not a sign that treatment failed.

Factors That Influence How Long Results Last

The research has identified a few patterns, mostly at the level of groups rather than individuals:

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• Maintenance treatment. In the 2019 meta-analysis, studies that included maintenance treatment showed higher sustained response at some time points.
• The mix of people studied. Studies with a higher proportion of women also showed higher sustained response, a group-level pattern that says nothing reliable about any one person.
• Continued medication. The best-known durability results come from people who stayed on antidepressants after TMS, so those numbers describe that combination.
• A completed course. Durability figures come from people who finished a full acute course. They don't describe what happens after a partial one.

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Clinicians also weigh a person's history when planning follow-up, such as how many depressive episodes they've had and how many treatments failed before TMS. The findings above don't establish how much those factors change the odds, so they inform a clinician's judgment rather than supply a number.

Maintenance TMS: What It Is and Who May Need It

TMS maintenance treatment means periodic sessions after the main course, scheduled to protect a response rather than to answer a relapse. Schedules vary between providers and between people, and no single schedule has become standard.

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The evidence supports the idea without settling the details. The 2019 meta-analysis found maintenance associated with more durable response, and its authors suggested maintenance be considered in practice and tested in future trials. That's a promising signal, not a proven protocol. Maintenance TMS is also separate from staying on medication: in both the year-long and six-month studies, people continued antidepressants whether or not they received more TMS.

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Not everyone needs it. Some people stay well for long stretches without it. Whether maintenance makes sense for a particular person is a judgment a psychiatrist makes from their history and how they're doing in the months after the course.

Can TMS Be Repeated If Symptoms Return?

Yes, and the research on restarting TMS is among the most reassuring parts of this topic. In a six-month study in Brain Stimulation, people whose depression had improved by at least a quarter with TMS stopped treatment gradually over three weeks while starting maintenance antidepressant medication. In that study, worsening had a specific meaning: a clinician-rated decline that held for two consecutive weeks, which triggered restarting TMS. Over the next 24 weeks, 38% had symptoms worsen enough to restart TMS, and 32 of those 38 people (84%) regained their improvement. Only 10% of the 99 people whose results were reported met the study's definition of relapse.

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A repeat course is different from maintenance. Maintenance is planned in advance to hold a response; a repeat course starts because symptoms have come back. In the year-long study described above, about a third of participants had TMS reintroduced at some point. Whether and when to restart is a decision made with a psychiatrist, based on how symptoms are changing.

What Helps Results Last Longer

Beyond maintenance and continued medication, two more things help, though neither promises that results will last for a particular person:

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• Catching changes early. In the six-month study, regular assessments flagged worsening symptoms, and most people who restarted TMS at that point regained their improvement.
• Staying connected to care. Therapy and regular psychiatric visits mean someone is watching for early changes between treatments.

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Knowing what returning depression tends to look like makes early changes easier to catch: shifts in sleep or appetite, lower energy, less interest in usual activities, and a low mood that lingers instead of lifting after a few days. When those signs show up, reaching out sooner gives a care team more options, and our guide on how to ask for help when depressed covers how to start that conversation.

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These describe what research associates with better long-term results in groups of patients. They aren't instructions for any one person's treatment plan; that's a psychiatrist's call, made with the whole history in view.

Talking to a Psychiatrist About a Long-Term Plan

A TMS course is the start of a plan, not the end of one. The months afterward are when follow-up, medication decisions, and a clear plan for what happens if symptoms return matter most.

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At Amae, TMS sits inside our integrated care model, where psychiatric care, therapy, primary care, and peer support stay linked after the course ends. We provide TMS therapy for major depressive disorder at our Los Angeles clinic and at our Bay Area clinics in Los Altos and San Mateo. Commercial insurance plans and cash pay are both accepted, and our intake team handles prior authorization. To map out what comes after a course, talk with an Amae psychiatrist about a long-term plan. Anyone in crisis can reach the 988 Suicide and Crisis Lifeline by call or text.

Frequently Asked Questions

How long do TMS results typically last?

For many people, months to a year or longer, though it varies. In a year-long study of people who responded to TMS, 62.5% kept meeting response criteria for the full 12 months. A 2019 meta-analysis found that about half of responders were still responding at one year.

What percentage of people relapse after TMS?

Some return of symptoms within a year is common. In the 2019 meta-analysis, roughly half of responders were no longer responding at one year. That isn't always a full relapse: in a six-month study, 38% had symptoms worsen enough to restart TMS, while 10% met the study's definition of relapse.

Can TMS be repeated if depression comes back?

Yes. In a six-month study, 84% of people whose symptoms worsened regained their improvement when TMS was restarted. A repeat course is different from ongoing maintenance sessions, and the decision is made with a psychiatrist based on individual history.

Do I need maintenance TMS sessions after my initial course?

Not necessarily. Some people stay well without them, and there is no standard maintenance schedule across providers. Research links maintenance with longer-lasting response, so whether it fits is a decision a psychiatrist makes based on your response and how closely symptoms are being monitored.

What can help TMS results last longer?

The research points to planned follow-up, continued medication when it's part of the plan, and catching symptom changes early. These are general findings from groups of patients, not instructions for any one person's treatment.

Is maintenance TMS covered by insurance?

It depends on the insurer and on whether sessions are billed as maintenance or as a new course for returning symptoms, since coverage can differ between the two. Ask the provider to verify benefits with your insurer before sessions begin.

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Citations

1. 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. Journal of Clinical Psychiatry. 2014;75(12):1394-1401. https://pubmed.ncbi.nlm.nih.gov/25271871/
2. Senova S, Cotovio G, Pascual-Leone A, Oliveira-Maia AJ. Durability of antidepressant response to repetitive transcranial magnetic stimulation: systematic review and meta-analysis. Brain Stimulation. 2019;12(1):119-128. https://pubmed.ncbi.nlm.nih.gov/30344109/
3. Janicak PG, Nahas Z, Lisanby SH, et al. Durability of clinical benefit with transcranial magnetic stimulation (TMS) in the treatment of pharmacoresistant major depression: assessment of relapse during a 6-month, multisite, open-label study. Brain Stimulation. 2010;3(4):187-199. https://pubmed.ncbi.nlm.nih.gov/20965447/
4. 988 Suicide and Crisis Lifeline. https://988lifeline.org

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