Depression in women is quite common, yet only about one-fifth of those who suffer will seek treatment. Statistics tell us that between 20-25% of women will experience some type of depression in their lifetime. In fact, it is considered to be the number one cause of disability in women, with “disability” being defined as difficulty performing normal tasks or actions, and an inability to participate in everyday life situations.
Depression is painful, not only for the sufferer, but for her family and friends as well. It can effect every aspect of daily life and make doing her job or taking care of her children seem like overwhelming tasks. Yet, many women believe that feeling “sad” or “down” is normal during hormonal changes or periods of stress, and so they don’t seek help right away. A lot of women are taught to be patient and the feelings will eventually pass. Unfortunately, this isn’t always the case and too may people suffer in silence because they are ashamed to admit that they are struggling. But, the truth is – depression is a highly treatable condition and the sooner you seek treatment, the quicker your recovery can begin.
Causes of Women’s Depression:
Women are twice as likely as men to experience depression; and although the doctors aren’t quite sure why this is the case, many believe that it is due to a number of physiological, psychological, and social factors that are unique to women.
Prior to adolescence, the rate of depression is about the same for both boys and girls; however, with the onset of puberty, these statistics change dramatically. Doctors and researchers believe that this widening gap can be explained by the many hormonal and chemical changes a women will experience throughout her lifetime – puberty, pregnancy and delivery, perimenopause, menopause, etc. Combine this with the fact that women respond much differently to stressful or emotional situations than men, and you can see why depression may look far different in females than in their male counterparts.
Some of the common reasons for depression in women include:
Menstruation: Hormones will fluctuate during a normal menstrual cycle and many women may experience typical symptoms of PMS; however, sometimes these symptoms can be so severe that a condition known as Premenstrual Dysphoric Disorder is diagnosed (PMDD). Extreme fatigue, irritability, mood swings (including depression), and anxiety can often be debilitating and will usually require treatment. Premenstrual Dysphoric Disorder affects about 3-5% of menstruating women and comes and goes in a cyclical pattern, similar to PMS.
Pregnancy: Pregnancy brings with it many hormonal changes, not to mention the physical stress and demands on a woman’s body. These rapid changes can contribute to depression, particularly in those who are already at high risk or have a history of depressive episodes. In addition, the physiological and emotional challenges associated with such things as miscarriage, infertility, or fertility treatments can also cause the onset of depression.
Postpartum Depression (PPD): While many new mothers expect to experience some form of the “baby blues”, some people will have very severe and longer lasting symptoms that often require treatment. Most doctors believe that PPD is caused primarily by hormonal fluctuations; however, they do not disregard other factors that may play a role in the development of the disorder such as feelings of stress and insecurity about caring for a newborn, an inability to lose “baby weight”, or the added fatigue of childbirth.
Perimenopause and Menopause: Research has shown that some women are at increased risk for depression during perimenopause, the period just prior to menopause. As women approach menopause, their ovaries begin producing much less estrogen and progesterone. This drop in hormone levels can cause both physical and emotional responses, often leading to depression, even in women who have had no previous history of depressive episodes. Dramatic hormonal changes can also affect other systems within the body, including a drop in the production of a neurotransmitter known as Serotonin, which plays an important role in such things as mood, sleep, appetite, and anxiety. Depression and menopause often go hand-in-hand, but treatments are usually quite simple and effective.
Aside from specific life events that cause chemical or hormonal changes in the body, there are also other risk factors that have been found to contribute to depression in women. These include:
• Stress: Some studies have indicated that women seem to develop depression at a much lower level of stress than men. In other words, it takes less stress for a woman to become depressed than a man. Some researchers believe that this is because women respond differently to stressful events and they often struggle more with overcoming things such as trauma, loss of a job, difficult relationships, or divorce/separation. Single parenting and the difficulty balancing the desire or need for a career with the responsibility of raising children can also contribute to depression.
Furthermore, some studies have shown that women tend to dwell on their stressful situations longer, thereby prolonging their feelings and magnifying the problem rather than looking for solutions. This can create a sense of hopelessness, which may eventually lead to feelings of depression.
• Body Image: Studies have shown that, from puberty on, women are very conscious of their physical appearance and that a dissatisfaction with the way they look can often trigger depression. In many cases, the media has created unrealistic expectations and feelings of inadequacy when it comes to body image, resulting in a significant connection between eating disorders and depression.
• Family History or Previous History of Mood Disorders: A women with a family history of depression is at a higher risk of developing the disorder herself. Also, someone who struggled with depression as a teen is more likely to experience a recurrence during pregnancy than someone who has no previous history of depression. Although prior episodes are not always indicators of future occurrence, if you have dealt with depressive episodes in the past, then you should be aware of the possibility that depression can re-occur at other times, such as before/during/after pregnancy or during menopause.
• Childhood Abuse: Women who were physically or sexually abused as children seem to be at a higher risk for depression in adolescence and adulthood. Similarly, women in abusive marriages or relationships are also more likely to suffer from the disorder than those in healthy relationships.
• Oral Contraceptives: The hormones in oral contraceptives can contribute to the onset of depression.
• Infertility Drugs: Since many fertility treatments require the use of hormones, these chemical changes within the body, particularly sudden ones, can often trigger depression.
• Lack/Loss of Support System: Women who feel they are alone and have no support system to lean on may be at a greater risk of developing depression. This is particularly true for women who have had to move away from family or friends, especially if they had a close social network and suddenly find themselves without this support.
• Medications: Certain medications can cause depression, particularly those that effect hormonal or chemical levels.
• Loss of Parent in Childhood: Research has shown that women who lost a parent before the age of 10 seem to be at a higher risk for depression.
Signs and Symptoms:
The criteria for diagnosing depression is the same for both men and women; however, women will often experience certain symptoms more or less frequently than men.
Feelings of guilt, anxiety, and self-blame are also more prevalent among women, whereas men more often become angry and blame others for their feelings. Where men create conflicts, women will withdraw and avoid confrontation at any cost. Women feel fatigued and apathetic, while men become restless and agitated.For example, women are much more likely to have Seasonal Affective Disorder, a form of depression that appears during the winter months due to lack of sunlight. Atypical depression is also more common in women than men. In this case, rather than the “typical” symptoms of sleeping less, eating less, and weight loss, they will experience the opposite or “atypical” signs of excessive sleep, overeating, and weight gain.
The rate of suicide attempts is much higher among depressed women, although men are more often successful. However, any suicidal words or actions are a cry for help and should not be ignored. Since depression in women is often cyclical, feelings of suicide can “come and go”, causing many people to assume that any talk about death is simply “drama” or a “false alarm”. Just because a woman is not in a depressive episode does not mean that suicide is no longer a risk. If you, or someone you know, has ever had any suicidal tendencies, then proper treatment should be sought immediately, even if the feeling passes.
Treatment of Depression in Women:
Since problems associated with the thyroid can often mimic the signs of major depression, any women experiencing symptoms should have tests done to eliminate this medical condition.
Once a woman has been diagnosed with depression, treatment often depends on the reason for the problem. Your doctor is likely to ask you a series of questions such as:
Does your depression increase around the time of menstruation?
Are you pregnant, or have you struggled with depression during previous pregnancies?
Have you recently given birth? Postpartum depression can appear six months, and sometimes even up to a year after childbirth.
Are you approaching menopause? Blood tests can be done to determine if you are perimenopausal.
Have you recently experienced any stressful or traumatic situations? Are you under a great deal of stress?
Do you have a family history of mood disorders? Have you been experiencing any physical/medical symptoms?
Have your sleeping or eating habits changed? Have you experienced any dramatic weight loss or gain?
Do you have a support system, or family and friends in the area that can offer help?
Although this is not an exhaustive list, the questions are designed to help your doctor find the cause of your depression – whether hormonal, social, psychological, etc. Once this is determined, then a form of treatment can be given. Sometimes hormone replacement therapy is effective, whereas other women may require antidepressants. Some people have also found success with counselling, talk therapy, or support groups. Women, more than men, find it helpful to talk about their feelings with other people who are experiencing similar symptoms and understand what they are going through. Treatments may also vary depending on your age or stage of life. For example, a different treatment may be used for a women who is pregnant or breastfeeding than for someone who is going through menopause.
Depression is very common, and if you are struggling with any of the signs or symptoms, you are definitely not alone! Women experience a lot of hormonal changes throughout their lives, have to battle guilt over conflicting roles (mother, career), and deal with the stress of being the primary child caregiver while also handling the responsibilities of the workplace. In addition, aging parents, health struggles, or family difficulties can also be a factor. With all this in mind, it is not surprising that one in every four women will experience depression at some point in time. But, help is available, and there are many treatment options that can aid in recovery so you can feel good again and begin living life to the fullest!
Go to the top of this page Depression in Women