Women and Depression

Sad to say, one in eight individuals may require treatment for depression during their lifetime. But for some reason, recent studies has shown, that rate is twice as high among women. What is going on? Women also seem more at risk to forms of depression somewhat less serious than major depressive episodes, and also to seasonal affective disorder (SAD), a mood disorder related to natural variations in the length of the day throughout the year.

The question is why?

Researcher's at NIMH, the National Institute of Mental Health, have recently looked at the differences in melatonin and estrogen production in women. They found that melatonin secretions, a natural hormone that affects the so-called circadian rhythm (our wake/sleep cycle), seem not to change in men from summer through winter, while women seem to produce more melatonin in winter and less in summer. Sleep disturbances, too little or too much sleep, are one of the symptoms associated with depression.

Estrogen production may be another factor. Researchers noted that prior to puberty, boys and girls experience equal rates of depression. But the rate for women doubles shortly after puberty. Menopause may also play a role. Little is known about the varying effects of menstruation and menopause on the variety of physical processes that are involved with the biochemistry of depression.

The American Psychological Association has taken a different tact. The APA's task force on women and depression recently pointed to social and psychological factors also affecting women. For instance, the task force

pointed out that men and women have different coping styles, noting that men often employ "action and mastery" strategies, while women may brood and dwell on their problems. It was also noted that women who function in multiple roles--job, mothering, marriage, volunteering--may have better support networks and more outlets for feelings of competence, thus less vulnerable to depression.

The task force noted a number of social, personality, and situation factors that also weigh more upon women than men:

Reproductive issues: Menstruation and pregnancy generally do not lead to depression. Infertility, however, can be a source of depression for women who want children. Miscarriages and surgical menopause can also cause depressive symptoms.

Personality styles: Women who are more passive, dependent, pessimistic, or negative in their attitudes are more likely to become depressed, particularly if they dwell on their bad feelings.

Sexual and Physical abuse: At least 37% of women have had a significant experience of sexual or physical abuse by the age of 21; some experts actually believe that the rate may be closer to 50%. Violent episodes such as battering and rape may leave women with Post-Traumatic Stress Disorder (PTSD). Also, undiagnosed head trauma from battering can cause depressive symptoms.

Marriage and children: Marriage protects men against depression much more than it does women. Mothers of young children are very vulnerable to depression, and the more children a woman has, the more likely it is that she'll be depressed.

Poverty and minority status: Poverty is a pathway to depression. 75% of people living in poverty in the U.S. are women and children.

Women who are minorities experience great stress from discrimination. In addition, poor women or minority women often do not have access to basic mental health care.

Other high-risk groups: lesbians, adolescents, and women who are alcoholics or drug abusers are all at high risk for depression.

The term "depression" has been variably used to describe either a symptom, a syndrome, or a disease. Depression is used in the broad sense to describe a syndrome that includes a constellation of physiological, affective, and cognitive manifestations. As listed in the current American Psychiatric Association Diagnostic and Statistical Manual (DSM-IV), criteria for the diagnosis of depression include:

1. changes in appetite and weight;

2. disturbed sleep;

3. motor agitation or retardation;

4. fatigue and loss of energy;

5. depressed or irritable mood;

6. loss of interest or pleasure in usual activities;

7. feelings of worthlessness, self-reproach, excessive guilt;

8. suicidal thinking or attempts; and

9. difficulty with thinking or concentration.

If you or someone you know is experiencing depression, please contact us at the JFS of MetroWest.

Click here If you would like to contact Jewish Family Service with a question or to make an appointment.
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