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Women and Depression

Clinical depression (unipolar or major) and chronic depression (dysthymia) affect more than twice as many women as men. Women also have higher rates of seasonal affective disorder (SAD). The manic depression (bipolar disorder) rates are similar in women and men, however, women suffer higher rates of the depressed phase of manic depression and rapid-cycling bipolar disorder. Some experts consider depression the #1 mental health problem for women, especially younger women during their childbearing years. It has been characterized as an epidemic on the rise.

The statistics are blunt. One study states that one out of every seven (14%) women will experience some form of serious depression in their lifetime. Another study claims that this figure is 20% to 25%. Other western and European countries are reporting similar depression statistics for women.

The improper diagnosis of depression in women is an area of concern also. Some experts claim that depression in women is misdiagnosed 30% to 50% of the time. These authors also note that approximately 70% of the prescriptions for antidepressants are written for women. Their concern is that the combination of misdiagnosis with prescription drugs, along with frequent improper monitoring, presents a significant danger to women.

Why are Women at Greater Risk for Depression ?

There are numerous explanations for the causes of depression in women. However, researchers are still unclear about the specific causes of depression. Many women exposed to these risk factors do NOT develop depression. Below, we will discuss those that are considered most important and most unique to women.

Biological factors

Women do seem to have additional risk factors in addition to the biological risk factors that they share in common with men. It is known that thyroid function can differ between men and women and it is a known risk factor (hypothyroidism). Hypothyroidism is any state in which thyroid hormone production is below normal. Another biological risk factor that differs with women is the circadian rhythm pattern - the system that regulates sleep and activity. Women tend to exhibit more hypersomnia or excessive sleeping than men when depressed. A third biological risk factor is reproductive events which is discussed in a separate category below. Please click the following link to read about the biological risk factors that are common to both women and men.

Genetic factors

The genetic risk factors for women seem to parallel those of men. Rather than repeating these factors, please click on the following link, genetic causes, to read more.

Psychological factors

The most prominent psychological risk factors for women include pessimistic thinking, low self-esteem, sense of "lack of control" in life and excessive worrying. Women with one or more of these risk factors are more likely to develop depression.

Usually women with one or more of these factors present finds it difficult to deal and cope with life's problems and challenges. It creates great internal stress within them. Some researchers have theorized that the traditional upbringing of girls might contribute to the development of these traits.

Social

Researchers have shown that boys and girls have equal rates of depression until the adolescent years. At this time, the rate of depression for girls begins to outpace the rate for boys. There are numerous stresses that girls face during this time period, among them are: changing roles, changing expectations, forming an identity, sexuality and parental separation. Researchers feel that these adolescent stresses are different for girls and boys and that they have differing reactions to the stresses. When boys have difficulty coping with these stresses they tend to have behavioral and substance abuse problems. When girls have difficulty coping with these stresses they tend to become depressed.

Adult women also face numerous social stresses. Some of these social stresses are children, household responsibilities, career responsibilities and single parenthood.

Married women have higher rates of depression than unmarried women. However, married men have lower rates of depression than unmarried men. When the marriage is characterized as "unhappy" then women are three times more likely to be depressed than men. It is speculated that marriage offers greater social advantages to men than to women.

Reproductive Events

Reproductive events for women include pregnancy, post pregnancy, the menstrual cycle, menopause, and infertility. Changes in hormone levels are part of all of these events (see hormone information below). Recent studies have shown that 10% to 15% of women suffer from depression during pregnancy. In addition, 10% to 15% of women suffer from postpartum depression within three months of childbirth.

Generally, a desired pregnancy rarely leads to depression.

Hormones

Fluctuating hormone levels do have an effect on brain chemistry. The result is that women often have changes in moods and emotions. However, it is not fully understood how changing hormone levels might contribute to depression in women. There are several conditions that are related to changing hormone levels.

• Premenstrual Syndrome (PMS) - some women find this condition leads to irritability, mood swings, tension, and anxiety. Less than 10% of women in their reproductive years experience PMS but it is considered a risk factor for depression. However, its relation to depression is not fully understood.
• Pregnancy - usually this condition of fluctuating hormones appears after the pregnancy and is temporary. However, these hormone changes, in combination with the responsibility of a new life, can trigger a form of depression known as Postpartum Depression.
• Menopause - hormonal fluctuations can cause mood swings, fatigue, tension and depression. Some women find relief with hormone replacement therapy.

Abuse - Physical / Sexual

Many researchers are now of the opinion that the actual level of physical and sexual abuse of women is much higher than previously estimated. They also feel that it is a significant factor in the increase in depression in women.

One recent study found that three out of five women who had depression had experienced abuse. In another study, the researchers found that 100% of the women who had experienced severe childhood sexual abuse would develop depression later in their lives.

Adult women are also subject to other forms of abuse such as sexual harassment in the workplace. In general, abuse can lead to lower self-esteem, helplessness, hopelessness and social isolation - and contributing to depression.

Economic Level

Women with economic problems and women from lower socioeconomic levels have exhibited higher levels of depression. These women tend to be found in lower status and higher stress jobs. Other characteristics are lower educational levels, poor health, more children and single parenthood. These women have expressed a "lack of control" and "lack of support" in their lives.

More research is needed to understand the complex nature of depression in women. More information is needed about how women respond to the stresses and emotions associated with depression. And more information is needed to help them find the appropriate treatment.

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