Depression and Women: Getting the Help You Need

By Myrna Beth Haskell–

A huge number of our mothers, sisters, and female friends are silently suffering from depression. That’s because depression is hard to talk about. Frequently, women who suffer from depression perceive their plight as something to be endured alone. After all, mood swings and transient “blues” are a typical part of almost every woman’s monthly cycle. Women might conceal their depression from family and friends for fear of being ridiculed or perceived as unstable. Some women may not realize the warning signs of severe depression. Consequently, they may not seek professional advice or support from family and friends, which only allows them to sink deeper and deeper into a despondent state. 

Women need to know that they are not alone. According to the National Institute of Mental Health (NIMH), “Each year about 6.7% of U.S. adults experience major depressive disorder. Women are 70% more likely than men to experience depression during their lifetime. The NIMH also reports, “Many people with a depressive illness never seek treatment.” These statistics are daunting.

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Deborah Serani, Psy.D., author of the award-winning book Living with Depression: Why Biology and Biography Matter Along the Path to Hope and Healing (Rowman & Littlefield Publishers, 2011) and technical advisor for the NBC television show Law & Order: Special Victims Unit, is a psychologist who specializes in depression and trauma. However, there is something unique about Serani. She treats patients with depression, but she has also had experience battling her own illness. Her journey began as a teenager who descended into a debilitating, depressive state.

“With talk therapy, I realized that genetics and biology greatly affected me. We traced two generations of relatives that were depressed in both my mother’s and father’s lineage. I began writing about being a psychologist who experiences depression and takes medication to help take the stigma out of depression. Experiencing depression personally has given me tremendous insight into my professional work,” Serani explains.

Serani stresses that women should seek help, talk about their feelings, and become active participants in their diagnosis and treatment. The first step, however, is to recognize the warning signs.  

Depression Has Many Faces

Depression is thought to be caused by a combination of physical, emotional, biochemical, psychological, genetic, and social factors. Depression is not something you can “snap out of,” so women should understand that pursuing outside help is imperative. There are many different types of depression – some considered severe and some moderate or mild.

Major Depression This is the most serious type of depression in terms of number of symptoms and the severity of symptoms. People with severe depression have a hard time coping with daily activities and responsibilities.

Dysthymic Disorder This refers to a moderate level of depression that persists for at least two years, and sometimes longer (malaise). While the symptoms are not as severe as a major depression, they are more enduring and resistant to treatment.

Unspecified Depression This includes people with a serious depression, but not quite severe enough to have a diagnosis of a major depression. It also includes people with chronic, moderate depression, which has not been present long enough for a diagnosis of a dysthymic disorder.

Adjustment Disorder and Situational DepressionDepression occurs in response to a major life stressor or crisis (such as death, divorce, or other major life changes and adjustments). What we consider to be “Mid-Life Crisis” depression would fall under this category.  It is a myth that mid-life crisis only affects men.   

Bipolar DepressionThis includes both high and low mood swings.

The Female Factor

Researchers have explored the issues which are unique to women (both biological and psychosocial), but there is no simple answer as to why women are twice as likely to experience depression as men.

For women, hormonal changes during and after pregnancy, perimenopause, or menopause can be catalysts. Women often face stressors such as simultaneously caring for children as well as elderly parents. Many also feel the pressure of being both a perfect caregiver and a bread winner. They also tend to absorb and internalize the problems of their children and other family members as their own.

A 2011 article published by Harvard Health Publications (Harvard Medical School) titled “Women and Depression,” discusses how severe hormonal changes may be an underlying factor to a female vulnerability to depression. However, the reader is cautioned not to jump to conclusions. “While multiple studies have examined this question, they have not been able to prove that these hormonal fluctuations significantly affect mood in large groups of women. The consensus now is that hormonal fluctuations may render individual women more vulnerable to depression at certain times of life — perhaps by interacting with other factors, such as stress.

The editors point out that everyday experiences can take a toll. Women are more likely than men to be caregivers — taking care of young children, elderly parents, or both. This chronic, low-grade stress may lead to depression. Single mothers with young children have a particularly high rate of depression.

Recognizing the Warning Signs

Women must learn to recognize the signs of depression and the differences between a depressive disorder and a case of transient blues.

Signs of depression vary from person to person. Women should be concerned if their symptoms last for more than a couple of weeks. 

The following is a list of symptoms that may indicate a person is depressed:

  • excessive crying
  • loss of interest in pleasurable activities (including sex)
  • sleep problems such as insomnia (can’t sleep) or hypersomnia (excessive sleeping)
  • loss of interest in normal activities
  • lack of motivation
  • sense of hopelessness
  • lack of self-worth
  • thoughts of suicide
  • weight gain/loss

Serani also considers duration of symptoms to be a key indicator of depression. “Though everyone feels sad from time to time, usually these sad feelings subside as time goes on. However, when sadness and despair linger for a period longer than two weeks and begin to affect daily living, coping and quality of life, depression could be occurring.

Serani emphasizes the importance of a complete medical evaluation. She explains that an examination will determine if depressive symptoms are biologically related (i.e. hormonal, genetic or organic, such as hypothyroidism). She says, “That is the first step whenever I work with a patient. If medical tests indicate that hormones, chemistry and other illnesses are not a factor, then looking at one’s life stressors is key.”

Helping Yourself

Studies have shown that both medication and talk therapy are extremely useful in treating patients with depression. However, there are certain lifestyle choices that one can make which have proved to be helpful as well. Women should not feel helpless.

Patricia A. Farrell, Ph.D., a New Jersey based psychologist and author of How to Be Your Own Therapist: A Step By Step Guide to Taking Your Life Back (McGraw-Hill Education, 2004), says that diet can affect depression. She stresses the importance of a well-balanced diet. She also warns, “One of the most harmful things you can do is to drink a lot of coffee. Coffee is a diuretic and diuretics cause a loss of potassium.” It has been found that potassium deficiency can cause depression, mood changes and fatigue.

Serani agrees that a well-balanced diet and exercise are ways to help fight and ease depression. She also suggests keeping a regular sleeping pattern. She states, “It is also a good idea to reduce refined sugar, and to limit caffeine and alcohol. Vitamin supplements like B-complex have been shown to be helpful as well.”

However, a healthy diet and regular exercise should not be perceived as cure-alls for depression. Although healthy habits can certainly be beneficial, women should seek advice from professionals if their symptoms continue for two weeks or more.

Dr. Farrell stresses the importance of getting help when one’s condition is not improving. She advises that women seek medical advice if “they find that they are becoming dysfunctional and can’t take care of their responsibilities.” She recommends that women become informed consumers and prepare a specific list of questions prior to a consultation with a specialist. 

Experts suggest getting a complete medical work-up to rule out other possible medical conditions.  Serani emphasizes, “It is so important to find a health care provider that is a specialist in depression. The reason to seek out these specialists is to ensure that whomever you work with understands the biopsychosocial aspects of depression.”

Serani also wants to help debunk the myths about depression. “I think the most important thing I can offer women who are experiencing depression is to understand that it is a real illness.  It is not a result of a faulty character, weaknesses, or laziness.”

Seeking Outside Help

Readers can find more information from the following organizations:

National Institute of Mental Health

Website: https://www.nimh.nih.gov

Anxiety and Depression Association of America

http://www.adaa.org/

Mental Health America

http://www.nmha.org

National Suicide Prevention Lifeline (Crisis Hotline): 1-800-273-TALK

 

Myrna Beth Haskell is an award-winning author, columnist, and feature writer. Her work has appeared in national and regional publications across the U.S., as well as in Canada, London, and the Middle East. For more information, please visit her website at: www.myrnahaskell.com.

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Depression and Women: Getting the Help You Need
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