Depression in women

Types, Causes, Symptoms, and Treatments

As women, we have many life roles. Mother, wife, employee, friend, healer, caregiver, and the list goes on. The complexity of all of these roles can cause ups and downs throughout life. Some of these mood changes may be due to life events (e.g., getting in an argument with a friend) or may be due to hormones (e.g., pregnancy, menstrual cycle). In general, after a few days, your emotions tend to level out and you don’t feel down in the dumps anymore. But, if you are suffering from depression, your “downs” don’t go away after a few days and may interfere with your daily life activities and relationships. This can be a debilitating cycle and can occur due to a number of causes. Symptoms can last weeks, months, or years and can be intermittent or a one-time occurrence.

Depression is almost twice as likely to affect women than men and tends to have different contributing causes in women than it does in men. Contributing factors include reproductive hormones, a differing female response to stress, and social pressures that are unique to a woman’s life experiences. Listed below are the different forms of depression most common in women.

Major Depression
Major depression is a severe form of depression where a woman loses her ability to find pleasure in activities once considered enjoyable. In addition, it affects a woman’s ability to work, sleep, and eat in normal and effective manners and usually negatively impacts interpersonal and social relationships. With major depression, also known as major depressive disorder, your depressed state may persist for an extended period of time and is often accompanied with low self-esteem.

Postpartum Depression
This is a special form of depression that occurs after the birth of a baby – often referred to as the “baby blues.” Typical symptoms of depression begin in the months following birth, while in some women, they can occur while still pregnant.

Persistent Depressive Disorder
Considered a milder form of depression, this is an extended depressed mood that lasts for two years or more. Major depressive episodes (i.e., more severe forms of depression) may still occur during persistent depressive disorder.

Premenstrual Dysphoric Disorder
Depression that is tied to a woman’s menstrual cycle. In this form of depression, severe mood swings, anxiety, and negative thoughts present themselves in the week prior to the start of menstruation and dissipate once the menstrual period begins. Depressive symptoms are severe enough to negatively impact interpersonal relationships and interfere with daily activities.

Some of the distinguishing factors in how depression differs between women vs. men include:

Women feel anxious and scared; men feel guarded
Women blame themselves for the depression; men blame others
Women commonly feel sad, worthless, and apathetic when depressed; men tend to feel irritable and angry
Women are more likely to avoid conflicts when depressed; men are more likely to create conflicts
Women turn to food and friends to self-medicate; men turn to alcohol, TV, sex, or sports to self-medicate
Women feel lethargic and nervous; men feel agitated and restless
Women easily talk about their feelings of self-doubt and despair; men hide feelings of self-doubt and despair-considering it a sign of weakness

What Causes Depression in Women?

There are a multitude of genetic, hormonal, psychological, and social factors that come into play when citing the cause of depression in women.

Biology and Hormones
Biologically speaking, depression runs in families – with scientific evidence that some genetic makeups are more prone to depression, whereas some genetic makeups are more resistant to it. Though, environmental factors are thought to interact with genetic predispositions. That is, just because you may be more prone to depression because of your genes, healthy family and social relationships can increase resilience.

Other biological and hormonal factors are also likely to increase your chances of suffering from depression. Issues with pregnancy, fertility, perimenopause, menopause, and menstrual cycles increase women’s risk factors of developing depression. Most of these are due to hormonal imbalances and rapid fluctuations in reproductive hormones. Health problems, in general, especially those of chronic illness or disability can prompt depression in women, as can medical life changes – such as frequent dieting and smoking cessation.

Psychological Causes
Women are more prone to psychological causes of depression than men. With a tendency to be more emotional, women are more likely to rehash negative thoughts during bouts of depression. While it is a normal response to cry, talk with friends, and rehash why it is you are in your depressive state, research has shown that ruminating about depression can cause it to last longer and even make it worse. In contrast, men tend to distract themselves from their depressive state – which has been shown to reduce the duration of symptoms. Additional psychological factors that tend to affect women over men are negative body images and stress-induced depression. Women are more prone to stress than men because their increased levels of progesterone have been shown to prevent stress hormones from leveling out. Negative body image issues usually begin in adolescence and seem to be correlated with the onset of puberty in women.

Social Causes
Coping skills, choice of relationships, and lifestyle choices affect women differently than men. As a woman, you are more likely to develop depression from marital or relationship problems, work-life balance issues, financial troubles, and stressful life events, including the loss of a loved one.

In addition to the biological, psychological, and social causes of depression mentioned above, the National Institutes of Health indicate the following are also increased risk factors of depression in women:

Death of a parent before age 10
Job loss, relationship problems, divorce
Physical or sexual abuse during childhood
History of mood disorders
Use of certain medications

Signs and Symptoms

Signs and symptoms of depression vary from woman to woman. Some of the most common signs and symptoms are listed below:

Feelings of emptiness, hopelessness, despair, and sadness
Irritability, anxiousness, and guilt
Feelings of exhaustion, severe tiredness
Loss of interest in previously pleasurable activities
Inability to concentrate or remember details
Suicidal thoughts or attempts of suicide
Sleep disturbances; sleeping too much or too little, insomnia
Changes in appetite – eating too much or too little
Physical symptoms – aches and pains, cramps, headaches, digestive issues, breast tenderness, bloating
Lack of energy
Feeling out of control
Mood swings and feelings of tearfulness
Panic attacks
Feelings of tension
Disinterest in daily activities and relationships

Treatment Options

If you are a woman and suffering from depression, it is best to seek treatment right away to improve your quality of life. Your first course of action should be a visit to your doctor or mental health professional. Your doctor will ask you a series of questions and perform tests to rule out an underlying medical condition causing your depression or determine if certain medications might be to blame for your depressed mental state. Your primary care doctor will also ask you a number of questions about your symptoms – how long they have lasted, when they started, the severity of your symptoms, how persistent they are (re-occurrence rate), and your family history of depression. If your doctor suspects you may be suffering from depression, he or she will refer you to a mental health specialist who can formally diagnose your condition and make recommendations for treatment.

The most common treatment options for women suffering from depression include medications and therapy. It is imperative you tell your doctor if you are pregnant or may become pregnant during treatment as certain medications to treat depression may affect your growing baby. If you are depressed, your doctor may prescribe you antidepressants to help you cope and to lessen the symptoms of your depression. If you do begin taking antidepressants for your depressed mood state, it is important that you monitor your symptoms and note any side effects. Certain side effects of antidepressants can worsen depression in a small percentage of individuals. Specifically, increased risk of suicidal thoughts, suicidal attempts, and irritability have found to be associated with the use of antidepressants in some individuals. Other more common side effects include:

Sleep disturbances
Sexual problems

Though, these problems usually decrease over time.

Therapy has also been shown to be a very effective method of treatment if you are suffering from depression. Cognitive behavioral therapy (CBT) is one of the most common forms of talk therapy, or psychotherapy, in the treatment of depression. This method of therapy focuses on teaching new ways of thinking and coping mechanisms when feelings of depression hit. In addition, therapy is helpful in helping women understand difficult relationships and how to improve them, and how to change habits that might be contributing to their depression. In addition to one-on-one therapy, group therapy or family therapy is a helpful method to treat depression if family stress is a contributing factor to your depressed state.

Unfortunately, depression in women can have misdiagnosis rates as high as 50% and fewer than half of women who experience major depression will ever seek treatment. Fortunately, depression has shown great treatment success rates. More than 80% of women with depression are treated successfully through antidepressants, therapy, or a combination of both.

In addition to medications and therapy, the self-help techniques below can help improve your mood if you are suffering from depression:

Don’t keep your feelings bottled up – find a support group with people you trust
Stay engaged in social activities and social functions
Exercise regularly
Get enough sleep – 8 hours per night is ideal
Meditate, try yoga, or practice other relaxation techniques

If you or a loved one are suffering from depression, you are not alone. Seek help for your depressed mood to elevate your quality of life. If you are unsure who to contact, try the following resources:

Family doctors
Employee assistance programs
Mental health centers
Social agencies
Mental health specialists (psychiatrists, social workers, mental health counselors)
Private clinics
State hospital outpatient clinics
Health maintenance organizations

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