Women and Depression MENTAL HEALTH SERVICES IN SOUTHERN CALIFORNIA

01/11/2021

[ Article was originally posted on https://socalempowered.com ]

What is Depression

Depression is a common but severe mood disorder characterized by symptoms that can affect someone’s ability to work, sleep, study, eat, and engage in once enjoyable activities. Depression is generally caused by a combination of genetic, biological, environmental, and psychological factors. ¹
Almost 12 million American women experience clinical depression each year, and about one out of every eight women will experience it at some point in their life.²

Additionally, one out of every eight women experiences postpartum depression symptoms. The number of women who experience postpartum depression differs by age and race/ethnicity.³
Clinical depression occurs most often in women between the ages of 24 and 44.²

It isn’t possible for someone suffering from depression to “snap out of it,” as getting better usually requires treatment. If a woman you love is experiencing depression, it is vital to offer support, patience, and encouragement. It is crucial to remind her that she can feel better over time and with the right treatment.¹

If you believe you are suffering from depression, a good first step is making an appointment with your primary doctor or a psychiatrist. Some medications, viruses, and a thyroid disorder can produce the same symptoms as depression. A medical professional can properly examine you and rule out any other possibilities. If you are diagnosed with depression, they will present you with treatment options and guide you along the way.¹

Signs and Symptoms of Depression in Women

Women can experience a variety of signs and symptoms of depression, and they can be different for each individual.

They are likely to experience some combination of the following signs and symptoms: ⁴

Feeling empty, hopeless, and sad
Irritability, anxiety, and guilt
Exhaustion or extreme fatigue
Lack of interest in once pleasurable activities
Inability to concentrate or remember details
Thoughts or attempts of suicide
Insomnia, too much or too little sleep
Appetite, eating too much or too little
Aches, pains, cramps, headaches
Lack of energy
Feeling out of control
Changes in mood
Panic attacks
Disinterest in relationships and regular activities

Why Depression is More Common in Women

Depression is rare before adolescence and occurs at the same rate in girls and boys during this phase of development. After puberty, girls become twice as likely as boys to develop depression.⁵

Women may become more likely to develop depression than men because of the hormonal changes women experience during puberty, pregnancy, and menopause. Women also experience monthly hormonal changes during menstrual cycles.⁵

Depression can also occur due to the following:⁶

Causes of Depression in Women

Women are almost two times more likely than men to be diagnosed with depression. Mood changes and feelings of depression can occur with a woman’s regular hormonal changes; however, hormonal changes on their own cannot cause clinical depression. Biological factors, genetics, and life experiences create a higher risk of depression.⁷

Hormonal Causes

Hormonal changes that contribute to depression in women include puberty, premenstrual problems, pregnancy, postpartum, and perimenopause, and menopause.⁷

Puberty

Puberty creates hormonal changes in girls that can increase their risk of developing depression. Normal responses during puberty include mood swings related to changing hormones. These mood swings alone do not equate to depression. Puberty is related to other life experiences that can contribute to the onset of depression, including: ⁷

Sexuality and issues with sexual identity
Conflicts with family members
Pressure from guardians and peers to perform well in school, sports, and other areas of life

Once a female experiences puberty, she is more likely to experience depression than her male counterpart. Girls generally go through puberty before boys do, which means that they are more likely to develop depression at a younger age than boys. ⁷

Premenstrual Syndrome

Premenstrual syndrome (PMS) is usually characterized by the following short-lived symptoms: ⁷

Abdominal bloating
Tender breasts
Headaches
Anxiety
Irritability
Sadness

Some women experience more severe and disabling symptoms that affect their ability to work, study, and engage in relationships. Symptoms this extreme are usually characteristic of premenstrual dysphoric disorder (PMDD), which is a type of depression that can require treatment. ⁷ PMS and PMDD cause cyclical changes in estrogen, progesterone, and other hormones. These changes can alter brain chemicals like serotonin that control someone’s mood. This alteration of brain chemicals may play a role in the link between PMS and PMDD and depression. ⁷

Pregnancy

There are dramatic hormonal changes that occur during pregnancy that can alter a woman’s mood. Other issues associated with pregnancy and attempting to become pregnant can occur and might increase the risk of developing depression, including:⁷

Lifestyle changes
Relationship issues
Previous depression episodes
Lack of support
Unwanted or unintended pregnancy
Miscarriage
Infertility
Stoppingantidepressant medication

Postpartum

New mothers may experience bouts of sadness, anger, and irritability. These feelings are normal after giving birth and usually go away after one or two weeks. Postpartum depression is characterized by more severe and longer-lasting symptoms, including: ⁷

Crying more often than usual
Low self-esteem
Anxiety
Numbness
Sleeping problems
Issues functioning
Inability to care for the newborn
Thoughts of harming the newborn
Thoughts of suicide

Postpartum depression occurs in about 10% to 15% of women and is a serious condition that requires treatment. It may be caused by significant hormonal changes, a predisposition to mood disorders, complications during pregnancy or birth, breastfeeding issues, or a lack of social support. ⁷

Perimenopause and Menopause

Perimenopause is the transitional stage into menopause when a woman’s hormone levels can erratically fluctuate. During this stage, the risk of depression may increase. Estrogen levels are significantly low in early menopause and after menopause, which can also increase the risk of depression.⁷

The likelihood of developing depression due to menopausal symptoms is relatively low but increases if the following risk factors are present:⁷

Sleep issues
Anxiety
History of depression
Stress
Weight gain
Menopause at a younger age
Menopause caused by ovary removal

Genetic Causes

Depression is genetic, which means that some genetic makeups are more prone to depression than others. However, environmental factors may also influence whether someone develops depression. Someone who is genetically predisposed to depression, but has healthy family and social relationships, may never develop depression. And someone who is more genetically resistant to depression may find themselves depressed due to environmental factors.⁴

Psychological Causes

Women are also more likely than men to experience stress-induced depression. Women have increased levels of progesterone, which can prevent the leveling out of stress hormones. Women also experience negative body image issues more often than men, which can also cause depression.⁴

Social Causes

Women experience depression as a result of social causes more often than men do. They are more likely to experience depression due to relationship issues, problems with work-life balance, financial issues, loss of a loved one, and other stressful life events. ⁴

Other Causes

Additional risk factors for depression in women include: ⁴

Different Types of Depression

Many different types of depression can affect both men and women alike. However, some forms of depression only affect women.

Types of Depression That Affect Men and Women

There are different types of depression that both men and women experience. These include: ⁸

Major Depressive Disorder - A combination of symptoms that interfere with someone's ability to sleep, study, work, eat, complete daily tasks, and enjoy once pleasurable activities. ⁸
Dysthymic Disorder - Symptoms are less severe than those associated with major depression but last for two or more years. These symptoms can still prevent someone from living a normal life. ⁸
Psychotic Disorder - A severe depressive illness that includes some form of psychosis, including a break with reality, hallucinations, and delusions. ⁸
Seasonal Affective Disorder - A depressive episode that occurs each year during the winter months, when there is less natural sunlight. ⁸
Bipolar Depression - The depressive phase of bipolar disorder. Depression associated with bipolar disorder requires different treatment than that of major depression. ⁸

Types of Depression That Affect Women

Some types of depression are only experienced by women and occur because of drastic physical and hormonal changes during different stages in a woman’s life.

These types of depression include: ¹

Premenstrual Dysphoric Disorder (PMDD) - A more severe form of PMS with intense and disabling symptoms including irritability, anger, depressed mood, sadness, suicidal thoughts, changes in appetite, bloating, breast tenderness, and physical pain. ¹
Parental Depression - A mood disorder that occurs during pregnancy (prenatal depression) or after childbirth (postpartum depression). This kind of depression includes symptoms such as extreme sadness, anxiety, fatigue, and difficulty completing daily tasks and caring for the newborn. ¹
Perimenopausal Depression - A type of depression that occurs during the transition into menopause. Abnormal periods, sleeping problems, mood swings, and hot flashes are normal during perimenopause, but depression is not. This type of depression includes symptoms such as irritability, anxiety, sadness, and loss of enjoyment. ¹

Treatment for Depression

If you are suffering from depression, remember, there is hope. Counseling and the right medication can help treat depression. These methods can be effective independently; however, most treatment involves some combination of medication and psychotherapy. It is best to approach your healthcare provider regarding the right treatment option for you. ⁹

Treatment for depression is often the same for women as it is for men and is usually divided into the following three phases: ¹⁰

The acute phase lasts 6 to 12 weeks. The goal during this phase is to relieve symptoms. ¹⁰

The continuation phase can last for several months. The goal during this phase is to maximize improvements, and a doctor may adjust medication dosage. ¹⁰

The maintenance phase focuses on preventing future depressive episodes. During this phase, a doctor helps lower medication dosage, and psychotherapy becomes the main treatment method. ¹⁰

Medication

Depression medication, called antidepressants, can be used to treat depression effectively. Over 10% of women currently take antidepressants, and about 65% to 85% of people who take antidepressants experience some relief. Antidepressants are equally useful for men and women; however, some individuals respond differently to the same medication, so the choice in antidepressant is individualized. ¹⁰

When someone first begins taking antidepressants, they usually start with a selective serotonin reuptake inhibitor (SSRI). This type of antidepressant medication includes fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). SSRIs influence the serotonin system that affects mood, arousal, anxiety, impulses, and aggression. ¹⁰

Other antidepressants work to treat depression in different ways. Bupropion (Wellbutrin) affects norepinephrine and dopamine, mirtazapine (Remeron) affects norepinephrine and serotonin, and venlafaxine (Effexor) and duloxetine (Cymbalta) inhibit the reuptake of serotonin and norepinephrine. ¹⁰

All medications produce side effects. If side effects become extreme, it is essential to discuss them with your doctor. They may suggest trying a different medication or reducing the dosage of the current medication. ¹⁰

Psychotherapy

Psychotherapy is equally useful for men and women and includes three major types: cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Group therapy, family therapy, and couples therapy can also be effective. Most often, some combination of these types of therapy works best for patients. ¹⁰

Cognitive Behavioral Therapy

The main goal of CBT is to change negative thought patterns and behaviors into more positive ones. CBT therapists work with the patient to correct distorted and self-critical thoughts that the patient has identified. They work together to evaluate the truth behind these thoughts and transform them.¹⁰

Interpersonal Psychotherapy

This kind of therapy involves weekly sessions and lasts for several months. Patients learn to identify and cope with conflicts that reoccur in their relationships. This kind of therapy generally focuses on grief of a recent loss, disputes regarding social expectations, significant life changes, and social isolation. ¹⁰

Psychodynamic Therapy

Psychodynamic Therapy involves exploring how life events, desires, and relationships affect the patient’s feelings and behaviors. A therapist helps the patient identify the unconscious defenses they have used to avoid painful thoughts and emotions. This awareness can help patients to overcome these issues. ¹⁰

Group Therapy

This type of therapy involves a group of patients struggling with similar issues. Within each session, patients support each other with the group leader’s help. Group therapy can help individuals to recognize they are not alone. ¹⁰

Family and Group Therapy

This type of therapy identifies destructive patterns within a family system and works to replace them with healthier ones. Family therapy can foster better communication and help in situations where one family member’s issues affect the rest of the family. ¹⁰

Sources

Depression in Women: 5 Things You Should Know. (n.d.). Retrieved from https://www.nimh.nih.gov/health/publications/depression-in-women/index.shtml
Depression In Women. (n.d.). Retrieved from https://www.mhanational.org/depression-women
Depression Among Women. (2020, May 14). Retrieved from https://www.cdc.gov/reproductivehealth/depression/index.htm
Article by: Christina Gregory. (2020, September 25). Depression in Women: Types, Causes, Symptoms, and Treatments. Retrieved from https://www.psycom.net/depression.central.women.html
Johnson, T. C. (2019, March 22). Depression Effects on Women: Causes, Symptoms, and Treatments. Retrieved from https://www.webmd.com/depression/guide/depression-women#1
Miguel, M., Aseni, & Rachel. (n.d.). Women and Depression. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/women-and-depression
Women’s increased risk of depression. (2019, January 29). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725
Depression. (2019, May 14). Retrieved from https://www.womenshealth.gov/mental-health/mental-health-conditions/depression
Commissioner, O. O. (n.d.). Women and Depression. Retrieved from https://www.fda.gov/consumers/women/women-and-depression
Publishing, H. H. (n.d.). Women and depression. Retrieved from https://www.health.harvard.edu/womens-health/women-and-depression

SOURCE: https://socalempowered.com/women-and-depression/

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