Women and Depression

MENTAL HEALTH SERVICES IN SOUTHERN CALIFORNIA

Both men and women can experience depression; however, they may experience it for different reasons. Women are more likely than men to develop depression and have risk factors that men do not have, including various hormonal changes they experience in their lifetime. With the right treatment, women can recover from their depression and cultivate a better life.

Table of Contents

What is Depression

Depression is a common but severe mood disorder characterized by symptoms that can affect someone’s ability to work, sleep, study, eat, and engage in once enjoyable activities. Depression is generally caused by a combination of genetic, biological, environmental, and psychological factors. 1
Almost 12 million American women experience clinical depression each year, and about one out of every eight women will experience it at some point in their life.2

Additionally, one out of every eight women experiences postpartum depression symptoms. The number of women who experience postpartum depression differs by age and race/ethnicity.3
Clinical depression occurs most often in women between the ages of 24 and 44.2

It isn’t possible for someone suffering from depression to “snap out of it,” as getting better usually requires treatment. If a woman you love is experiencing depression, it is vital to offer support, patience, and encouragement. It is crucial to remind her that she can feel better over time and with the right treatment.1

If you believe you are suffering from depression, a good first step is making an appointment with your primary doctor or a psychiatrist. Some medications, viruses, and a thyroid disorder can produce the same symptoms as depression. A medical professional can properly examine you and rule out any other possibilities. If you are diagnosed with depression, they will present you with treatment options and guide you along the way.1

Signs and Symptoms of Depression in Women

Women can experience a variety of signs and symptoms of depression, and they can be different for each individual.

They are likely to experience some combination of the following signs and symptoms: 4

Why Depression is More Common in Women

Depression is rare before adolescence and occurs at the same rate in girls and boys during this phase of development. After puberty, girls become twice as likely as boys to develop depression. 5

Women may become more likely to develop depression than men because of the hormonal changes women experience during puberty, pregnancy, and menopause. Women also experience monthly hormonal changes during menstrual cycles. 5

Depression can also occur due to the following: 6

Causes of Depression in Women

Women are almost two times more likely than men to be diagnosed with depression. Mood changes and feelings of depression can occur with a woman’s regular hormonal changes; however, hormonal changes on their own cannot cause clinical depression. Biological factors, genetics, and life experiences create a higher risk of depression. 7

Hormonal Causes

Hormonal changes that contribute to depression in women include puberty, premenstrual problems, pregnancy, postpartum, and perimenopause, and menopause. 7

Puberty

Puberty creates hormonal changes in girls that can increase their risk of developing depression. Normal responses during puberty include mood swings related to changing hormones. These mood swings alone do not equate to depression. Puberty is related to other life experiences that can contribute to the onset of depression, including:  7
  • Sexuality and issues with sexual identity
  • Conflicts with family members
  • Pressure from guardians and peers to perform well in school, sports, and other areas of life
Once a female experiences puberty, she is more likely to experience depression than her male counterpart. Girls generally go through puberty before boys do, which means that they are more likely to develop depression at a younger age than boys.  7

Premenstrual Syndrome

Premenstrual syndrome (PMS) is usually characterized by the following short-lived symptoms:  7

  • Abdominal bloating 
  • Tender breasts
  • Headaches
  • Anxiety
  • Irritability 
  • Sadness
Some women experience more severe and disabling symptoms that affect their ability to work, study, and engage in relationships. Symptoms this extreme are usually characteristic of premenstrual dysphoric disorder (PMDD), which is a type of depression that can require treatment.  7 PMS and PMDD cause cyclical changes in estrogen, progesterone, and other hormones. These changes can alter brain chemicals like serotonin that control someone’s mood. This alteration of brain chemicals may play a role in the link between PMS and PMDD and depression.  7

Pregnancy

There are dramatic hormonal changes that occur during pregnancy that can alter a woman’s mood. Other issues associated with pregnancy and attempting to become pregnant can occur and might increase the risk of developing depression, including: 7

  • Lifestyle changes
  • Relationship issues
  • Previous depression episodes
  • Lack of support
  • Unwanted or unintended pregnancy
  • Miscarriage
  • Infertility
  • Stoppingantidepressant medication

 

Postpartum

New mothers may experience bouts of sadness, anger, and irritability. These feelings are normal after giving birth and usually go away after one or two weeks. Postpartum depression is characterized by more severe and longer-lasting symptoms, including:  7

  • Crying more often than usual 
  • Low self-esteem
  • Anxiety
  • Numbness
  • Sleeping problems
  • Issues functioning 
  • Inability to care for the newborn 
  • Thoughts of harming the newborn 
  • Thoughts of suicide

 

Postpartum depression occurs in about 10% to 15% of women and is a serious condition that requires treatment. It may be caused by significant hormonal changes, a predisposition to mood disorders, complications during pregnancy or birth, breastfeeding issues, or a lack of social support.  7

Perimenopause and Menopause

Perimenopause is the transitional stage into menopause when a woman’s hormone levels can erratically fluctuate. During this stage, the risk of depression may increase. Estrogen levels are significantly low in early menopause and after menopause, which can also increase the risk of depression. 7

The likelihood of developing depression due to menopausal symptoms is relatively low but increases if the following risk factors are present: 7

  • Sleep issues 
  • Anxiety 
  • History of depression 
  • Stress 
  • Weight gain 
  • Menopause at a younger age
  • Menopause caused by ovary removal  

Genetic Causes

Depression is genetic, which means that some genetic makeups are more prone to depression than others. However, environmental factors may also influence whether someone develops depression. Someone who is genetically predisposed to depression, but has healthy family and social relationships, may never develop depression. And someone who is more genetically resistant to depression may find themselves depressed due to environmental factors. 4

Psychological Causes

Depression is genetic, which means that some genetic makeups are more prone to depression than others. However, environmental factors may also influence whether someone develops depression. Someone who is genetically predisposed to depression, but has healthy family and social relationships, may never develop depression. And someone who is more genetically resistant to depression may find themselves depressed due to environmental factors. 4

Women are also more likely than men to experience stress-induced depression. Women have increased levels of progesterone, which can prevent the leveling out of stress hormones. Women also experience negative body image issues more often than men, which can also cause depression. 4

Social Causes

Women experience depression as a result of social causes more often than men do. They are more likely to experience depression due to relationship issues, problems with work-life balance, financial issues, loss of a loved one, and other stressful life events.  4

Other Causes

Additional risk factors for depression in women include:  4

Different Types of Depression

Many different types of depression can affect both men and women alike. However, some forms of depression only affect women. 

Types of Depression That Affect Men and Women

There are different types of depression that both men and women experience.  These include:  8

Types of Depression That Affect Women

Some types of depression are only experienced by women and occur because of drastic physical and hormonal changes during different stages in a woman’s life.

These types of depression include:  1

Treatment for Depression

If you are suffering from depression, remember, there is hope. Counseling and the right medication can help treat depression. These methods can be effective independently; however, most treatment involves some combination of medication and psychotherapy. It is best to approach your healthcare provider regarding the right treatment option for you.  9

Treatment for depression is often the same for women as it is for men and is usually divided into the following three phases:  10

1.

The acute phase lasts 6 to 12 weeks. The goal during this phase is to relieve symptoms.  10

2.

The continuation phase can last for several months. The goal during this phase is to maximize improvements, and a doctor may adjust medication dosage.  10

3.

The maintenance phase focuses on preventing future depressive episodes. During this phase, a doctor helps lower medication dosage, and psychotherapy becomes the main treatment method.  10

Medication

Depression medication, called antidepressants, can be used to treat depression effectively. Over 10% of women currently take antidepressants, and about 65% to 85% of people who take antidepressants experience some relief. Antidepressants are equally useful for men and women; however, some individuals respond differently to the same medication, so the choice in antidepressant is individualized.  10

When someone first begins taking antidepressants, they usually start with a selective serotonin reuptake inhibitor (SSRI). This type of antidepressant medication includes fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). SSRIs influence the serotonin system that affects mood, arousal, anxiety, impulses, and aggression.  10

Other antidepressants work to treat depression in different ways. Bupropion (Wellbutrin) affects norepinephrine and dopamine, mirtazapine (Remeron) affects norepinephrine and serotonin, and venlafaxine (Effexor) and duloxetine (Cymbalta) inhibit the reuptake of serotonin and norepinephrine.  10

All medications produce side effects. If side effects become extreme, it is essential to discuss them with your doctor. They may suggest trying a different medication or reducing the dosage of the current medication.  10

Psychotherapy

Psychotherapy is equally useful for men and women and includes three major types: cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Group therapy, family therapy, and couples therapy can also be effective. Most often, some combination of these types of therapy works best for patients.  10

Cognitive Behavioral Therapy

The main goal of CBT is to change negative thought patterns and behaviors into more positive ones. CBT therapists work with the patient to correct distorted and self-critical thoughts that the patient has identified. They work together to evaluate the truth behind these thoughts and transform them. 10

Interpersonal Psychotherapy 

This kind of therapy involves weekly sessions and lasts for several months. Patients learn to identify and cope with conflicts that reoccur in their relationships. This kind of therapy generally focuses on grief of a recent loss, disputes regarding social expectations, significant life changes, and social isolation.  10

Psychodynamic Therapy 

Psychodynamic Therapy involves exploring how life events, desires, and relationships affect the patient’s feelings and behaviors. A therapist helps the patient identify the unconscious defenses they have used to avoid painful thoughts and emotions. This awareness can help patients to overcome these issues.  10

Group Therapy 

This type of therapy involves a group of patients struggling with similar issues. Within each session, patients support each other with the group leader’s help. Group therapy can help individuals to recognize they are not alone.  10

Family and Group Therapy 

This type of therapy identifies destructive patterns within a family system and works to replace them with healthier ones. Family therapy can foster better communication and help in situations where one family member’s issues affect the rest of the family.  10

Sources

  1. Depression in Women: 5 Things You Should Know. (n.d.). Retrieved from https://www.nimh.nih.gov/health/publications/depression-in-women/index.shtml
  2. Depression In Women. (n.d.). Retrieved from https://www.mhanational.org/depression-women
  3. Depression Among Women. (2020, May 14). Retrieved from https://www.cdc.gov/reproductivehealth/depression/index.htm
  4. Article by: Christina Gregory. (2020, September 25). Depression in Women: Types, Causes, Symptoms, and Treatments. Retrieved from https://www.psycom.net/depression.central.women.html
  5. Johnson, T. C. (2019, March 22). Depression Effects on Women: Causes, Symptoms, and Treatments. Retrieved from https://www.webmd.com/depression/guide/depression-women#1
  6. Miguel, M., Aseni, & Rachel. (n.d.). Women and Depression. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/women-and-depression
  7. Women’s increased risk of depression. (2019, January 29). Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725
  8. Depression. (2019, May 14). Retrieved from https://www.womenshealth.gov/mental-health/mental-health-conditions/depression
  9. Commissioner, O. O. (n.d.). Women and Depression. Retrieved from https://www.fda.gov/consumers/women/women-and-depression
  10. Publishing, H. H. (n.d.). Women and depression. Retrieved from https://www.health.harvard.edu/womens-health/women-and-depression