Depression in women is twice as common as in men. Women also have higher rates of seasonal affective depression and dysthymia (persistent depressive disorder) than men.
In addition, depression in women can take on other forms, present exclusively in women:
- postpartum depression;
- premenstrual dysphoric disorder;
- perimenopausal depression.
This gender difference in the prevalence of depression has not been fully explained by the researchers. However, it is very important to be aware of women’s vulnerability to depression, in order to prevent it, recognize it as early as possible and treat it effectively.
Conflicting theories regarding the increased incidence of depression in women
Depression in women has extremely numerous and very well-documented cases for several decades. However, there are experts who claim that the gender difference exists only in the number of diagnoses, not in the number of illnesses.
In other words, they believe that the discrepancy is caused by the reluctance of many men to go to the doctor for their mental problems. Men usually refuse to discuss their feelings or admit that they have health problems in order not to appear weak. This is especially true in conservative countries with outdated beliefs about masculinity. It is possible that depression is masked in men by maladaptive behaviors, such as: verbal or physical violence, which they resort to in order to “treat” their suffering themselves.
This theory makes valid arguments, and can certainly contribute to the significant gender difference in the diagnosis of depression. However, there are a number of other biological, genetic, social explanations that can justify this imbalance.
How do we explain the natural predisposition to depression in women?
1. Genetics
Studies of identical twins (who share the same genes) show that
about 40% of the risk for depression is inherited.
Certain genetic mutations associated with depression develop only in women. This means that if we have a close relative who suffers from depression and we are women, we are more likely to develop depression than men in the family.
2. Hormones
Gender differences in the incidence of depression appear at puberty. From the age of 11, there are more girls with depression than boys. This suggests that the hormonal changes that girls go through influence their susceptibility to depression. In support of this theory comes the fact that the monthly hormonal changes that accompany menstruation affect the general mood in a similar way to depression. In addition, women are more vulnerable to developing depression after they give birth or when they enter menopause. These are two major hormonal events. However, the exact mechanism by which the fluctuation of female hormones increases the predisposition to depression is not known.
3. Stress
Studies show that women and men have a different response to stress. Depression in women is more likely to develop following a stressful event. Also, studies suggest that women have higher levels of stress than men.
Last but not least, women are unfortunately more often the victims of major stressful and traumatic events, such as childhood sexual abuse; rape; domestic violence. They have a long-term harmful effect on the brain. It changes its structure and chemical balance, leading to the development of several conditions. Stress, especially chronic stress, erodes mental health and can be a major factor in depression.
4. Social factors
Depression in women occurs as a result of the interaction between genetic and environmental factors. Thus, a healthy environment has a protective effect against depression. Its vulnerability decreases, while a toxic environment has a precipitating effect. In most of the world, women continue to be discriminated against and have worse living conditions than men. For example: women are more likely to live in poverty. – according to the World Health Organization.
Financial instability can cause excessive worry about the future; lack of access to medical services and low self-esteem. Women also assume multiple roles that require a lot of time and energy on their part: mother; employee; wife; daughter; sister; girlfriend. All this leads to exhaustion and neglect of one’s own needs.
Depression in women – Symptoms
Depression is more than just a state of sadness.
- It can take the pleasure out of all the aspects of life that brought us joy in the past
- It robs us of hope and optimism about the future.
- It causes changes in our sleep rhythm (insomnia or excessive sleeping)
- Changes in eating habits (eating too little or too much).
- It can cause physical symptoms such as fatigue, pain or gastrointestinal problems.
There is certainly a variety of specific manifestations in different people, however, and some of these differences in symptoms occur by gender. The symptoms of depression in women are largely the same as in men. Recent research suggests that there are certain characteristics of depression in women.
Here are the signs of depression in women:
Rumination:
The tendency to overthink negative events and replay problems over and over in the mind is more common in women. This can cause:
- a negative inner speech;
- excessive self-blame and self-criticism;
- bursting into tears for no apparent reason;
- a permanent feeling of guilt.
Changes in eating habits
If you eat more or less than usual, you may be suffering from depression. In the case of women, depression is more often accompanied by eating disorders, such as anorexia or compulsive eating. Additionally, weight gain can exacerbate depression by lowering self-esteem and increasing inflammation in the body.
Sleeping disorders
Sleep plays an essential role in our physical and mental well-being. Sleep-deprived people are more likely to develop depression. Women are more prone to sleep deprivation due to the fact that most of them are the primary caregivers of children. Thus, if they have a baby or child who wakes up during the night or who has an illness that requires near-constant supervision, they most likely have a chaotic sleep schedule. Also, insomnia or hypersomnia (excessive sleeping) can be signs of depression. Therefore, it is important to prioritize sleep and pay attention to any changes that may occur.
Low libido
Some mental health experts believe that changes in women’s sexual appetite are essential factors in the diagnosis of major depression. There are several reasons that can cause a decrease in libido:
- decreased interest in pleasurable activities, such as sex;
- fatigue and lack of energy;
- low self-esteem.
Physical symptoms
- pains;
- cramps;
- migraines;
- breast tenderness;
- bloating.
Particular variations
1. Premenstrual dysphoric disorder (PMD)
Most of us have heard of PMS, which causes irritability and mood swings before our menstrual cycle. However, its symptoms are moderate and most women learn to live with them. Less well known is premenstrual dysphoric disorder. It is a severe and rarer form of PMS. PDD is a serious disorder, affecting approximately 5% of sexually mature women. It is characterized by:
- anger;
- irritability;
- numerous interpersonal conflicts;
- depressed state;
- feeling of hopelessness;
- anxiety;
- emotional lability (sudden mood swings, increased sensitivity to rejection).
Symptoms are present during most menstrual cycles over the past year, being most intense at the onset of menstruation.
Postpartum depression in women
Birth is a major event. It brings a lot of changes, both in a woman’s body and in her life. Many new mothers feel unhappy, exhausted, worried after giving birth. This phenomenon is called “baby blues“. These symptoms are moderate and disappear after 1 week or 2. If they persist, we are already talking about postpartum depression. It has the same symptoms as the baby blues, but of greater intensity, which do not go away, and affect the mother’s ability to care for herself and the newborn.
Other symptoms are:
- crying fits out of the blue;
- excessive sleeping;
- uncontrollable anger;
- difficulty establishing a connection with the newborn;
- persistent doubts about the ability to care for the little one;
- thoughts of harming oneself or harming the child.
This type of depression is quite common. Most gynecologists and pediatricians are alert to the signs that a new mother is suffering from it. Surprisingly, recent studies indicate that even dads can suffer from postpartum depression. About 10% of fathers may suffer from postpartum depression, with symptoms similar to those present in mothers.
Perimenopausal depression
Perimenopause is women’s transition to menopause. This can cause abnormal menstrual cycles; fluctuations in hormone levels; insomnia. It is also closely related to the onset of depression or worsening of existing depressive symptoms. Women in this transition have a 4 times higher rate of depression than other women.
In addition to the classic symptoms of depression, perimenopausal depression can have the following signs:
- increased anxiety;
- intense feeling of hopelessness;
- crying for no reason;
- sudden changes in mood.
What do women say about depression?
Women’s attitudes toward major depression, according to a study by the American Mental Health Association:
- more than 50% of participants believe that it is “normal” for a woman to be depressed during menopause and that treatment is not necessary.
- more than 50% of women believe that depression is a “normal” stage in the aging process;
- more than 50% of women think it’s normal for a new mother to feel depressed for at least two weeks after giving birth;
- more than 50% of women stated that denial is a barrier to depression treatment, while 41% of them cited shame or guilt as barriers to treatment;
- more than 50% of female participants said they believed they knew more about depression than men.
Depression in women – Treatment
Whatever the reasons for the increased incidence of depression among women, the most important thing is that they get professional help. Fortunately, studies consistently show that women seek mental health services more often and follow recommended treatment.
Treatment options are the same for men and women. Studies show that the chances of success are the same for both sexes.
Antidepressants
are drugs designed specifically to treat depression. According to some studies, more than 10% of women in the US take antidepressants. Between 65% and 85% of them feel a change for the better. There are several classes of antidepressants, each with advantages and disadvantages. With the help of the right doctor, we can find the medicine with the most benefits for us.
Psychotherapy
Therapy through talking has benefits for both men and women. The main types of psychotherapy used to treat depression are cognitive-behavioral therapy; interpersonal therapy; psychodynamic therapy. And in this case, it is about the compatibility between each of these and the different people suffering from depression. A form that works for one person will not produce the same results for a vastly different person. So everyone has to find what works for them.