Depression in Women
What You Need to Know
Depression drains you of energy, hope, and drive, making it difficult to do what you need to feel better. And, for women, depression is complicated by many factors - from reproductive hormones to social pressures to the female response to stress. But while overcoming depression takes work on your part, it’s a real possibility. Though you can’t just will yourself to “snap out of it,” you do have more control than you realize. There are small steps you can begin taking that can and will make a difference. The key is to start small and build steadily from there.
What are the signs, symptoms and coping strategies for depression in women?
It’s the Catch-22 of depression: recovering from depression requires action, but taking action when you’re depressed is hard. You may not have much energy, but you probably have enough to take a short walk around the block or pick up the phone to call a loved one. The information and tips that follow are based on a research grounded comprehensive approach that helps you get support while making positive lifestyle changes. In addition to examining the actions you can take to lift your mood, it’s important to also learn about the factors that describe and cause depression in women. This understanding can help you minimize your risk, tackle the condition head on, and treat your depression effectively.
What are the signs and symptoms of depression in women?
The symptoms of depression vary from mild to severe or major depression and are distinguished by the impact they have on a woman's ability to function. Most depression is mild or moderately disabling and responds well to actions that you can take. Common complaints include:
- Depressed mood
- Loss of interest or pleasure in activities you used to enjoy
- Lack of energy and fatigue
- Feelings of guilt, hopelessness and worthlessness
- Appetite and weight changes
- Sleep changes (Sleeping more or sleeping less)
- Difficulty concentrating
- Suicidal thoughts or recurrent thoughts of death
Differences between male and female depression
Women tend to experience certain symptoms more often than men. These include seasonal affective disorder – depression in the winter months due to lower levels of sunlight. Also, women are more likely to experience the symptoms of atypical depression.
In atypical depression, rather than sleeping less, eating less, and losing weight, the opposite is seen: sleeping excessively, eating more (especially carbohydrates), and gaining weight. Feelings of guilt associated with depression are also more prevalent and pronounced in women. Women also have a higher incidence of thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician in women who are depressed.
|Differences between male and female depression|
|Women tend to:||Men tend to:|
Feel sad, apathetic, and worthless
Feel angry, irritable, and ego inflated
Feel anxious and scared
Feel suspicious and guarded
Avoid conflicts at all costs
Feel slowed down and nervous
Feel restless and agitated
Have trouble setting boundaries
Need to feel in control at all costs
Find it easy to talk about self-doubt and despair
Find it “weak” to admit self-doubt or despair
Use food, friends, and "love" to self-medicate
Use alcohol, TV, sports, and sex to self-medicate
Adapted from: Male Menopause by Jed Diamond
Causes of depression in women
Women are about twice as likely as men to suffer from depression. This two-to-one difference persists across racial, ethnic, and economic divides. In fact, this gender difference in rates of depression is found in most countries around the world. There are a number of theories that attempt to explain the higher incidence of depression in women. Many factors have been implicated, including psychological, social and biological factors.
Psychological causes of depression in women
Focusing on and rehashing negative feelings - Women are more likely to ruminate when they are depressed. This includes crying to relieve emotional tension, trying to figure out why you're depressed, and talking to your friends about your depression. However, rumination has been found to maintain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
Overwhelming stress at work, school, or home - Some studies show that women are more likely than men to develop depression from stress. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men.
Body image issues - The gender difference in depression begins in adolescence. The emergence of sex differences during puberty likely plays a role. Some researchers point to body dissatisfaction, which increases in girls during the sexual development of puberty.
Social causes of depression in women
As with men, social factors can also play a part in causing depression in women, along with lifestyle choices, relationships, and coping skills. These may include:
- Marital or relationship problems; balancing the pressures of career and home life
- Family responsibilities such as caring for children, spouse, or aging parents
- Experiencing discrimination at work or not reaching important goals, losing or changing a job, retirement, or embarking on military service.
- Persistant money problems
- Death of a loved one or other stressful life event that leaves you feeling useless, helpless, alone, or profoundly sad
Biological and hormonal causes of depression in women
Premenstrual problems - Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For many women, PMS is mild but for some women, symptoms are more severe and disabling.
Pregnancy and infertility - The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.
Postpartum depression - It's not uncommon for new mothers to experience the "baby blues." This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is called postpartum depression. Postpartum depression is believed to be influenced, at least in part, by hormonal fluctuations.
Perimenopause and menopause - Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.
Health problems - Chronic illness, injury, or disability can lead to depression in women, as can crash dieting or quitting smoking.
Because biology and hormone fluctuations can play such a prominent role in affecting a women's depression, it may be helpful to make use of more coping strategies at hormonal low points during the month. Try keeping a log of where you are in your menstrual cycle and how you are feeling—physically and emotionally. This way you will be able to better anticipate when you need to compensate for the hormonal lows and reduce or avoid the resulting symptoms.
It is important to remember that depression, at any stage in life—because of any reason, is serious and should be taken seriously. Just because you’ve been told that your symptoms are a “normal” part of being a woman does not mean you have to suffer in silence. There are many things you can do to treat your depression and feel better.
Coping tips for depression in women
You can make a huge dent in your depression with simple lifestyle changes: exercising every day, avoiding the urge to isolate, eating healthy food instead of the junk you crave, and carving out time for rest and relaxation. Feeling better takes time and effort when you don’t feel like making an effort. But you can get there if you act as if you feel like it and make positive choices for yourself each day and draw on the support of others.
Get a little sunlight every day. Sunlight can help boost your mood. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day. If you live somewhere with little winter sunshine, try using a light therapy box.
Talk face-to-face about your feelings to someone who can listen. Share what you're going through with the people you love and trust. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time. If you don't feel that you have anyone to confide in, look to build new friendships. See How to Make Good Friends and Dealing with Loneliness and Shyness
Try to keep up with social activities even if you don't feel like it. When you're depressed, it feels more comfortable to retreat into your shell. But being around other people will make you feel less depressed.
Get up and moving. Studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue. You don't even have to hit the gym. A 30-minute walk each day will give you a much-needed boost. And if you can't manage 30 minutes, three or more small 10-minute bursts of movement throughout the day are just as effective.
Aim for 8 to 9 hours of sleep. Depression typically involves sleep problems. Whether you're sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
Practice relaxation techniques. a daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.
Relationships are affected by your mood
An irritable mood brought on by depression can cause you to be critical of and harsh to your loved ones. It can cause you to lash out over situations that wouldn’t normally bother you. Depression can also cause you to feel empty or apathetic, which can result in neglect of your relationships.
- If you have children, taking care of yourself and regulating your mood during depressive episodes or hormonal lows is especially important. Studies show that being raised by a mother with untreated depression has a significant negative effect on a child’s social, emotional, and cognitive development.
Getting the blues can happen to anyone, but it doesn't mean you have a chronic medical condition like depression. If you're down about something, step away from it for a period and do something else.
Consider these mood boosters, and take the steps to fit them into your life.
Mood booster 1: Exercise
Exercise is healthful right down to the cellular level. It improves circulation and nerve function, it helps to regulate mood, and it makes you feel better about yourself
Action steps: For a quick pick-me-up, try a medium- to high-intensity workout such as a brisk 30-minute walk, an aerobics class, or a game of tennis. For a remedy that will stay with you, go for a daily activity you can sustain, such as a daily lower-intensity walk.
Mood booster 2: Meditate
Meditating produces brain changes that promote positive emotions and reduce negative emotions such as fear and anger. It can lower your heart rate, blood pressure, breathing rate, oxygen consumption, adrenaline levels, and levels of cortisol, a hormone released in response to stress.
Action steps: Many health centers offer meditation classes. Sign up for one, or consider taking yoga, which combines physical and mental practices. If it's hard for you to get to a class, buy a guided meditation book or CD, which can introduce you to meditation practice.
Mood booster 3: Socialize
Being isolated can lead to loneliness, which can make you sad. Spending time with others helps improve mood. We're wired to be social. Focusing on others can move you off a preoccupation with self-defeating thoughts.
Action steps: Avoid isolation. Get together with a friend, family member, or group at least once a month. Visit with friends at home. Get out of your house, go to a movie, or check out an art exhibit. If you don't have someone to spend time with, go to church or take a class.
Mood booster 4: Find purpose
Dedicating time to a meaningful activity improves mood, reduces stress, and keeps you mentally sharp. The activity can be as simple as taking up a new hobby or volunteering your time. You worry less about every little ache and pain in your own life when you move the focus to a new interest.
Action steps: Volunteer for a library, hospital, school, day care center, or charitable group. Tutor neighborhood kids. Babysit. Contact the chamber of commerce to mentor young business people. Take up gardening, painting, dancing, or gourmet cooking.
Adapted with permission from Harvard Health Letter, a newsletter published by Harvard Health Publications.
Additional treatments for depression in women
Some women find relief from dietary modifications, nutritional supplements and herbal remedies. These include:
- Changes to your diet may help reduce symptoms. Cutting back on salt, fatty foods, caffiene, and alcohol is recommended. Eating plenty of complex carbohydrates is also recommended.
- Vitamin B-6, calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit somen suffering from PMDD
- Evening primrose oil and chaste tree berry are herbal supplements that have both been studied and found to be effective in the treatment of PMDD.
More help for depression
Resources and references
General information about depression in women
Depression in women: Understanding the gender gap – Explore the unique biological, psychosocial, and cultural factors that may increase a woman’s risk for depression. (Mayo Clinic)
Mood Disorders and the Reproductive Cycle – Review how changing levels of female reproductive hormones over the life cycle can impact depression. Includes information about estrogen, thyroid impairment, and the effect of oral contraceptives. (HealthyPlace)
More Women Suffer Depression – Article looks into some of the reasons why women around the world are more susceptible to depression than men. (Psychology Today)
Premenstrual dysphoric disorder and perimenopausal depression
PMS & PMDD – Learn about premenstrual mood changes, including the symptoms and treatment of premenstrual dysphoric disorder. (Massachusetts General Hospital, Center for Women’s Health)
Menstrually Related Mood Disorders – A guide to the mood disorders and depression-related symptoms associated with the menstrual cycle. (UNC School of Medicine, Center for Women’s Mood Disorders)
Depression During the Transition to Menopause: A Guide for Patients and Families (PDF) – Explore the symptoms and treatment of perimenopausal depression.
Diagnosis and Treatment of Premenstrual Dysphoric Disorder – Comprehensive article geared towards medical professionals. Learn about treatment options including therapy, medications, lifestyle changes, herbal treatments, and nutritional supplements. (American Academy of Family Physicians)
Pregnancy and depression
Antidepressants: Safe during pregnancy? – Uncover the risks of taking antidepressants during pregnancy. Learn which antidepressants are safer than other and what can happen if you stop taking your medication during pregnancy. (Mayo Clinic)
Psychiatric Disorders During Pregnancy – Covers the risks associated with taking antidepressants and other psychiatric medications during pregnancy. (Massachusetts General Hospital, Center for Women’s Health)
Depression During Pregnancy: Treatment Recommendations – Explore the current treatment recommendations for depression during pregnancy. (American Congress of Obstetricians and Gynecologists)
Depression in adolescent and teenage girls
Mood Disorders and Teenage Girls – Discusses why girls are more vulnerable to mood disorders and what signs and symptoms you should look for in adolescent girls. (Child Mind Institute)
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