12 Facts About Women and Depression The Truth About Baby Blues, PMS and More

Depression symptoms in women can be tricky to pinpoint. Maybe it's just the blues... but it could be something more. Can you snap out of it? Do natural remedies really work? We separate fact from fiction with these 12 common depression myths... Depression Myth #1: Women get blue more often than men. True Depression is twice as common in women than men. “Women are a petri dish for mood disturbance,” says Michael E. Silverman, Ph.D., co-director of the Division of Cognitive & Behavioral Neurology at Mount Sinai School of Medicine in New York City. One out of every four women will experience clinical depression during her lifetime, compared to only one out of every eight men, according to the National Institutes of Health. But why? There’s no simple answer, but hormones may be to blame. Monthly hormonal changes may cause a higher incidence and different types of depression in women than men, says Thom E. Lobe, M.D., founder and director of Beneveda Medical Group (Beneveda.com) in Beverly Hills, Calif. Puberty seems to be the dividing line. Before adolescence, depression rates are the same in boys and girls, Silverman says. Afterward, the risk goes up for young women. Depression Myth #2: You can “snap out of” depression. False Depression is much more than just having a bad day, Lobe says. It’s a complex neurobiology that can’t be turned on and off at will in order to stop being depressed. That’s because brain chemistry alters with clinical depression, explains Mark Anderson, M.D., of Executive Medicine of Texas. “Real change takes place when the chemistry can be reversed back to normal.” Depression Myth #3: Men and women behave differently when depressed. True “Women cry more,” says Myrna Weissman, Ph.D., professor of epidemiology and psychiatry at New York’s Columbia University. “Men get angry," she explains. Depressed men are more likely to abuse drugs and alcohol; women suffer more from anxiety disorders. They're also more likely to feel guilty, sleep too much, overeat, gain weight and neglect their appearance. Depression Myth #4: Depression is all your head. False Sometimes you can blame your body for bringing you down. Depression is a side effect of many drugs or a symptom of physical disorders — including multiple sclerosis, rheumatoid arthritis, hypothyroidism, infections and allergies. “When I see a patient with any mood disorder, I make sure they get a physical,” Silverman says, That's because treating the underlying condition might relieve the depression. Medications, including birth control pills or drugs to treat hypertension and insomnia, also can cause the blues. Some birth control pills — particularly progesterone-only contraceptives — may make the depressed feelings even worse “by lowering levels of serotonin or, perhaps, tryptophan,” Lobe says. Other triggers: dehydration, lack of sleep, alcohol, tobacco and drug abuse. Depression Myth #5: It’s PMS, not depression. False If your monthly crankiness feels like PMS on steroids, you may have premenstrual dysphoric disorder (PMDD), a menstruation-linked disorder that triggers severe depression. “PMDD occurs when depressive symptoms, such as crying, tiredness and sadness, occur one week prior to menstruation and disappear afterward,” Lobe says. The severe mood swings resemble clinical depression and interfere with normal day-to-day functioning, Silverman says, but they’re temporary. “It’s not a typical depression.” Fortunately, selective serotonin reuptake inhibitors (SSRIs) — the same drugs used to treat clinical depression — relieve PMDD. But women can take SSRIs as needed to ease symptoms and stop being depressed, without worrying about withdrawal problems. “When PMDD goes away [after a woman’s period], she can stop taking the medication and she’s fine,” Silverman says. Depression Myth #6: Pregnancy-related depression can occur during the nine months. True Thanks to Brooke Shields, even Tom Cruise now knows about postpartum depression. But have you heard of antenatal depression? It occurs in anytime during pregnancy and often precipitates postpartum depression. “Ten percent or more pregnant women suffer from depression,” Lobe says. Pregnancy’s hormonal shifts is one cause, he says. So are personal problems – for example, feeling overwhelmed with responsibility, lack of support or relationship problems could cause depression. Depression Myth #7: Pregnant women should never take antidepressants. False Doctors are split on this issue. Some believe a pregnant woman should never take antidepressants because scientists don’t know how they affect the unborn baby. Others — like the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association — say the medications may help. You and your doctor need to weigh the risk of not treating the depression against the possible dangers of the medication to you and your baby, according to “The Management of Depression During Pregnancy,” published in 2009 in Obstetrics & Gynecology and General Hospital Psychiatry. Until there’s definitive research, “[treatment] depends on the doctor, the patient, the symptoms and the circumstances,” Lobe says. Medications considered an option during pregnancy: Celexa Prozac Sarafem Zoloft Amitriptyline Pamelor Wellbutrin Depression medications to avoid during pregnancy: Paxil Nardil Parnate Behavioral therapies may also help with mild depression. Depression Myth #8: It’s the “baby blues,” not depression. False “Baby blues” are common – 6% of women experience mood fluctuations in the days or weeks after giving birth, primarily due to hormonal changes and sleepless nights, Columbia’s Weissman says. But not all signs of depression should be dismissed as baby blues. About 10% of new mothers have postpartum depression, says ACOG, and many experts think it’s underreported. Depression symptoms in women of clinical postpartum depression include: Difficulty making decisions Intense irritability and anger Overwhelming fatigue Feelings of shame, guilt or inadequacy Severe mood swings Difficulty bonding with your baby Thoughts of harming yourself or your baby When symptoms last more than two weeks and you have trouble caring for your baby and yourself, get help. “Postpartum depression requires intervention,” Silverman says. “Baby blues aren't a less severe” version of it, Silverman explains. Depression Myth #9: Stress can trigger depression symptoms in women. True “Stress and depression run in the same brain circuitry,” Silverman says. Long-term stress can bring on depression. So can “significant life events, like sexual abuse or post-traumatic stress disorder.” Plus, women deal with stress differently than men. Men get angry and blow off steam. Women are more likely to keep those feelings private. “Guilt is anger turned inward, and that starts the whole cycle of depression,” he says. Men also try to “fix” the source of stress, says Executive Medicine’s Anderson. Women, on the other hand, focus on the problem, not the solution. “This adds to the stress and ultimately leads to depression,” he says. So how do you lower your risk? Exercise regularly to keep the body producing natural feel-good endorphin hormones and avoid fatty and fried foods, Anderson advises. Also, keep a journal: It can help manage stress that causes depression by emptying your mind so you can sleep better at night. Depression Myth #10: All natural depression remedies are safe. False St. John’s wort, one of the most popular herbal mood boosters, isn’t safe for everyone. “It interacts with almost every prescription medication that we know of,” says Shawn M. Talbott, Ph.D., nutritional biochemist (ShawnTalbott.com). St. John’s wort may interfere with drugs used to treat heart disease, depression, seizures, some cancers and organ transplant rejection, according to a 2000 FDA advisory. Another worry for women: The herb may also make oral contraceptives less effective. Plus, it may not even work. A 2002 clinical trial by the National Institutes of Health found that St. John’s wort was no better than a placebo in treating major depression. Talbott recommends the following natural supplements, which have no known drug interactions: 5-HTP, eurycoma, theanine and fish oil. But as with any herbal supplement, check with your doctor before taking it. Depression Myth #11: It’s natural to be sad when something bad happens — that’s not depression. True It’s normal to feel grief in life’s challenging moments, whether it's a breakup, death of a loved one, or loss of a job. But with depression, the feelings last longer than a couple of weeks: It’s "an abnormal extended response” to a sad or bad life event,” Silverman says. “Major depression stops someone in their tracks," Silverman explains. So what’s a “normal” reaction? Sadness, crying, anger and confusion when life is at its roughest, Anderson says. Depression Myth #12: All depression symptoms in women are the same. False In fact, the symptoms can vary. Red flags include feelings of hopelessness and thoughts of suicide or wanting to harm yourself or someone else, Anderson says. Other common signs: Persistent sad, anxious or empty feelings Feelings of guilt, worthlessness or helplessness Irritability and restlessness Loss of interest in activities you once enjoyed Loss of libido Fatigue and decreased energy Difficulty concentrating, remembering details and making decisions Insomnia or excessive sleeping Overeating or loss of appetite Persistent aches or pains, headaches or digestive problems that do not ease even with treatment If you think you're depressed, talk to your doctor about getting screened. For more information, visit our Depression Health Center. How Much Do You Know About Seasonal Affective Disorder? Chances are you've felt emotional highs and lows as the weather gets colder and darker. Did you know there’s actually a name for it? It's seasonal affective disorder (SAD).