Depression Depression in Women Feeling Depressed: Is It Normal? Everyone goes through periods of feeling sad, lonely, or unhappy. Everyday events, and our reactions to them, sometimes interfere with our peace of mind. That's all part of life. But when such feelings linger for weeks or months, preventing a return to a healthy outlook on life, they could signal depression. Depression is the most common serious psychiatric problem in the U.S., affecting millions of people each year. And, for reasons researchers are trying to understand, some forms of depression appear to be at least twice as common in women as in men. Depression In Women: How Common Is It? One in four women is likely to experience severe depression. Yet of all women who suffer from depression, only about one-fifth will get the treatment they need. The difference in the incidence of depression between women and men begins to appear around the time of adolescence. As we grow older, this difference becomes more pronounced. Women experience more depression than men between the ages of 18 and 44, and especially after 25. For some reason, between 44 and 65 years of age, the gender difference is less pronounced, but after the age of 65, women are again far more likely to be depressed than men. Not only is depression more common in women, but it is often accompanied by other troubling symptoms which occur more frequently in women, including anxiety, sleep disorders, panic attacks, and eating disorders. One reason that men may suffer less from depression has to do with different coping styles. Men are more likely to employ action and mastery strategies, that is, involve themselves in activities (work, sports, going out with friends) that both distracts them from their worries and, perhaps more importantly, give them a sense of power and control. Women, on the other hand, tend to "brood" and dwell on their problems, often with other women. This is one reason why many therapists prescribe exercise (especially aerobic exercise) as a partial antidote for depression; it gives women an increased sense of self-discipline, control, and mastery. Recognizing The Signs And Symptoms Of Depression The symptoms of depression can vary greatly. Some of the most common signs of depression include feelings of hopelessness and helplessness, persistent sadness, negative thinking or worrying, low self-esteem, loss of pleasure in usual activities, irritability, and problems with concentration, memory, and decision-making. Other symptoms can include low energy, decreased or increased appetite, changes in sleep patterns (either increased or decreased sleep time), and a diminished interest in sex. If several of these symptoms are present and persist for weeks or months, there is a greater likelihood that the individual is suffering from depression. Depression In Women The origins and symptoms of depression in women are varied and complex, and can result from a wide range of physical and emotional causes. Some experts feel that women generally tend to place greater value that men do on interpersonal connection and relationships with other people. This can be a powerful and positive characteristic. It may be, however, that this emphasis on relationships leaves some women more vulnerable to depression. It is interesting to note that positive as well as negative experiences can sometimes trigger depression. In other words, depression can be triggered by the anxiety that can accompany a significant change, even one that's for the better. Whatever the cause, it is important that women learn to recognize the signs of depression and seek medical help if depression persists. A doctor’s guidance and medical expertise are crucial for understanding the appropriate actions to take toward recovery. Most often, depression can be treated effectively through the benefits of counseling or therapy and/or with prescribed antidepressant medications. In addition, health problems and depression sometimes go hand in hand. In some cases, physical symptoms (such as headaches, stomach pain or nausea, constant back or neck aches, breathing problems) for which doctors cannot find a physical cause, may sometimes be signs of an underlying depression. On the other hand, the reverse may also be true. Depression can hide other health problems that sometimes go unnoticed and untreated in depressed persons. Unexplained troubles sleeping, trembling hands, dizzy spells, digestive upsets, and migraine headaches are all common signals that something may be wrong, and that it's time to talk about these symptoms with your doctor. The Role Of Genetics In many cases there appears to be a genetic component to depression. Studies have found that there is a higher percentage of depression and other mental disorders in the families of people diagnosed with depression than is found in the general population. Hormonal Factors Hormones have also received attention in the search for causes of depression in women. Researchers have suggested that changes in levels of hormones such as estrogen and progesterone appear to have strong effect on women's moods. The differences in the rates at which women and men develop depression begin to show up during puberty, a time at which many hormonal changes occur. In addition, hormone levels change during a number of events in women's lives that are often associated with depression, including menstrual cycles and the time following giving birth, the use of birth control pills, which work by altering levels of hormones, has also been associated with depression. Although all of the answers are not yet in, hormones appear to be worth investigating as a possible cause of depression. Depression After Childbirth Nearly everyone has heard of the "baby blues", in which a new mother experiences strong, fluctuating emotions and depression in the first days and weeks following the birth of the baby. Although researchers have not yet confirmed this is the cause of the accompanying depression, the plummeting levels of the hormones estrogen and progesterone may play a role. this depression mood occurs with such frequency that is considered normal, and it usually resolves quickly without treatment. But for some women, depressive feelings may linger and become more severe, and prescription medication and/or counseling may be helpful. Women and their physicians should discuss the implications of taking antidepressant medications while breast-feeding. Women are more likely to experience depression after childbirth if they have experienced depression before. On the positive side, however, pregnant women often have the lowest incidence of depression. Other Possible Causes Of Depression Depression in both men and women can also be influenced by nutrition and diet, medical problems, medicines and other drugs, psycho-social influences, and other factors. Some of these are discussed below.   Medical Problems Medical problems, such as thyroid disease, can cause depression, which is why a physical evaluation and medical work up should be conducted before a diagnosis of depression can be confirmed. Depression can also be influenced by nutritional factors, such as low levels of vitamin B12, or by iron-deficiency anemia, which can result from poor diet or from menstruation.   Medicines, Alcohol, and Other Drugs All medicines have side effects, and some medicines, such as certain hormones and certain drugs used to control high blood pressure, may have depression as a side effect in both women and men. Alcohol consumption has been linked to depression both as a possible cause and as a symptom. Alcohol is itself a depressant, especially when taken in combination with certain drugs. Street drugs, such as cocaine can also cause depression.   Seasonal Affective Disorder (SAD) People with seasonal affective disorder (SAD) may become depressed as winter sets in and daylight hours decrease. Researchers theorize that the reduction in the amount of sunlight affects the balance of certain brain chemicals, leading to symptoms of depression.   Psycho-Social Influences On Depression Psycho-social influences, which include life stresses, coping strategies, and the ways in which women have learned to view themselves in society, are topics of current investigation in women's depression. Some psycho-social factors appear to affect men and women equally, while some apply more specifically to women. Although clear-cut answers have not yet emerged, it seems that some of these psycho-social factors may help to explain why some women are more likely to experience depression than others.   Negative Life Events Negative life events, such as the death of a loved one, divorce, unemployment, or poverty, have been known to lead to depression in both men and women. Some traumatic events, such as rape and other forms of sexual abuse, happen more frequently to women and may contribute to the increased incidence of depression in women.   Relationships, Marriage, and Children The state of our relationships often has much to do with our own emotional state. There is evidence that, in general, married women experience more depression that do single women. In addition, depression is common among young women who stay at home full-time with their small children. Divorce or breakup can also bring on a depressive episode, especially when it involves children and custody battles.   Self-Esteem Because of a number of complex familial and societal factors, many women may experience feelings of low self-esteem and self-worth. These women may feel that they are not taken seriously, that the contributions they make are not valued, or that they do not have an important role in society or in their family. Effective Treatment Programs Are Available Today there are a number of very effective treatments for depression. Some currently available treatments are antidepressant medicines, psychotherapy, and electroconvulsive-convulsive therapy. Choosing the right treatment for you is an individual process that will depend not only on the severity of your depression, but on your preferences and those of your doctor. Antidepressant Medications For people who are so depressed that they cannot function, or are suicidal, antidepressant drugs can literally be a lifesaver. It is extremely important that the prescribing doctor be very well trained in psychopharmacology and fully understand the proper dosages, possible side effects, and interaction with other drugs, and that he or she explain all of this very clearly to you. Getting Beyond Depression Depression is a complex disorder; we have seen that is can have as many causes and many manifestations. But there are now effective treatments available that can help control depression. With the proper treatment, women who have suffered from depression can participate fully in all that life has to offer. This fact sheet is generously supported by a grant from the William H. Donner Foundation. Copyright 1997 Return