Depression affects both men and women, but more women are diagnosed every year. Here are 7 common reasons why – from genetics, hormones, stress, other illnesses and more. Plus, get expert tips for spotting depression signs, where to go for help and natural ways to ease symptoms...
Everyone occasionally feels blue or sad, but these feelings are usually fleeting and pass within a couple of days. But when a woman has a depressive disorder, it interferes with daily life and normal functioning. It causes pain for her and those who care about her.
Depression is a common but serious illness, and most women who have it need treatment. The majority – even those with the most severe cases – can get better.
Signs You May Have Depression
Women with depressive illnesses don’t all have the same signs. What’s more, the severity and frequency of symptoms, and how long they last, will vary depending on the individual and her particular illness.
They include:
Persistent sad, anxious or “empty” feelings
Feelings of hopelessness and/or pessimism
Irritability, restlessness or anxiety
Feelings of guilt, worthlessness and/or helplessness
Loss of interest in activities or hobbies that once were pleasurable, including sex
Fatigue and decreased energy
Difficulty concentrating, remembering details and making decisions
Insomnia, waking up during the night, or excessive sleeping
Overeating or loss of appetite
Thoughts of suicide or suicide attempts
Persistent aches or pains, headaches, cramps or digestive problems that don’t get better even with treatment
Why Women Get Depressed
Scientists are examining many potential causes for and contributing factors to women’s increased risk for depression. The following are the most likely reasons a woman may get depressed:
1. Genetics
Research indicates that the risk for developing depression likely involves a combination of multiple genes with environmental or other factors.
As a result, if a woman has a family history of depression, she may be more at risk of developing the illness. But this isn’t a hard-and-fast rule – it can occur in women from families with no history of it, and women with depressed relatives may not develop it.
2. Chemicals and hormones
Brain chemistry appears to be a significant factor in depressive disorders.
Modern brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people suffering from depression look different than those of people without it. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior don't appear to be functioning normally. In addition, important neurotransmitters – chemicals that brain cells use to communicate – appear to be out of balance.
Unfortunately, these images don’t reveal why the depression has occurred.
Scientists are also studying the influence of female hormones, which change throughout life. Researchers have shown that hormones directly affect the brain chemistry that controls emotions and mood. Specific times during a woman's life are of particular interest, including puberty; the times before menstrual periods; before, during and just after pregnancy; and just prior to and during menopause.
3. Premenstrual dysphoric disorder
Some women are susceptible to a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD). Women affected by PMDD typically experience depression, anxiety, irritability and mood swings the week before menstruation, to a degree that it interferes with their normal functioning.
Women with debilitating PMDD don’t necessarily have unusual hormone changes, but they do have different responses to these changes. They may also have a history of other mood disorders and differences in brain chemistry that cause them to be more sensitive to menstruation-related hormone changes.
Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may affect the brain chemistry associated with depressive illness.
4. Postpartum depression
Women are particularly vulnerable to depression after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming.
Many new mothers experience a brief episode of mild mood changes known as the “baby blues.” But some will suffer from postpartum depression, a much more serious condition that requires active treatment and emotional support for the new mother.
A 2006 study in Denmark found that postpartum women are at an increased risk for several mental disorders, including depression, for several months after childbirth.
Research has also found that women who experience postpartum depression often have had prior depressive episodes. Some experience it during their pregnancies, but it can go undetected.
Doctors often use patient visits as opportunities to screen for depression during pregnancy and in the postpartum period.
5. Menopause
Hormonal changes increase in the period between premenopause and menopause. While some women may transition without any mood problems, others experience an increased risk for depression. This seems to occur even among women without a history of the illness.
Depression becomes less common for women during the post-menopause period.
6. Stress
Life events such as trauma, loss of a loved one, a difficult relationship or any stressful situation – whether welcome or unwelcome – often occur before a depressive episode.
Additional work and home responsibilities, caring for children and aging parents, abuse and poverty also may trigger a depressive episode.
Research by the University of Michigan indicates that women respond in a way that prolongs their feelings of stress more than men, increasing the risk for depression. Still, it’s unclear why some women faced with enormous challenges become depressed, while others don’t.
7. Other illnesses
Depression often coexists with other illnesses. Sometimes there’s no cause-and-effect relationship between the two, but in some cases a different health issue may actually set off a depressive incident.
This interplay between depression and other illnesses differs for every person and situation. Regardless, these other coexisting illnesses need to be diagnosed and treated.
Depression often coexists with eating disorders, such as anorexia nervosa, bulimia nervosa and others, especially among women. Anxiety disorders, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia and generalized anxiety disorder, also sometimes accompany depression.
Women are more prone than men to having a coexisting anxiety disorder. And women suffering from PTSD, which can result after a person endures a terrifying ordeal or event, are especially prone to having depression.
Although more common among men than women, alcohol and substance abuse or dependence may also coexist with depression.
Depression often accompanies serious medical illnesses, such as heart disease, stroke, cancer, HIV/AIDS, diabetes, Parkinson’s disease, thyroid problems and multiple sclerosis, and may even make symptoms of the illness worse. In fact, both women and men who have depression in addition to a serious medical illness tend to have more severe symptoms of both. They also have more difficulty adapting to their medical condition, and more medical costs than those who do not have coexisting depression.
Research at the University of Washington in Seattle has shown that treating the depression along with the coexisting illness will help ease both conditions.
Where To Go for Help
If you’re unsure where to go for help, start by asking your family doctor. Others who can help are:
Mental health specialists, such as psychiatrists, psychologists, social workers or mental health counselors
Health maintenance organizations (HMOs)
Community mental health centers
Hospital psychiatry departments and outpatient clinics
Mental health programs at universities or medical schools
State hospital outpatient clinics
Family services, social agencies or clergy
Peer support groups
Private clinics and facilities
Employee assistance programs
Local medical and/or psychiatric societies
You can also check the phone book under “mental health,” “health,” “social services,” “hotlines” or “physicians” for phone numbers and addresses (or do a computer search for those services in your area).
An emergency room doctor also can provide temporary assistance and can tell you where and how to get further help.
Other Ways to Help Yourself
When you’re depressed, and even when you begin treatment, you may feel exhausted, helpless and hopeless. It may be extremely difficult to take any action to help yourself.
But it’s important to realize that these feelings are part of the depression and don’t reflect actual circumstances.
As you recognize your depression and the treatment takes effect, negative thinking will fade.
In the meantime:
Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.
Set realistic goals for yourself.
Break up large tasks into small ones, set some priorities and do what you can as you can.
Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you. Expect your mood to improve gradually, not immediately. Don’t expect to suddenly “snap out of” your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
Be confident that positive thinking will replace negative thoughts as your depression responds to treatment.
Adapted from “Women and Depression: Discovering Hope” by The National Institute of Mental Health.
For more information and expert advice, visit our Depression Health Center.
Could You Be Depressed?
Depression affects 20 million people in any given year and is a serious enough disorder to compromise one's ability to function normally day to day. Find out if you're just blue or if you might be clinically depressed.
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