Women's Health Matters

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Depression in women

While depression affects each individual uniquely, women tend to experience it differently than men. First off, depression is much more common in women than in men. Depression also looks different in women and is experienced differently by women. Specifically unique to women are the reproductive life stages related depression, such as premenstrual dysphoric disorder, postpartum depression and depression during menopause.

Premenstrual dysphoric disorder – is a condition characterized by severe depression, irritability and other mood disturbances. This typically occurs in the two weeks before a woman’s menstrual period and subsides in the first day or two of her cycle. 

Postpartum depression – is depression that occurs within one month of delivering a baby.

Perinatal depression – is a more inclusive term and refers to depression that occurs either in pregnancy and/or in the six to 12 weeks following delivery.

Menopausal depression – is depression that occurs during the transition from premenopause to menopause.

Higher rates of depression in women | Depression in women looks different than in men |
Risk factors for women


Higher rates of depression in women

Depression affects both men and women, but throughout most of their lifetime, more women are diagnosed with depression than men. These differences are most apparent starting in puberty and last until women are post-menopausal.

  • women are approximately twice as likely to experience a depressive episode
  • one in eight women will develop depression at some point in their lives
  • depression can occur at any time in a woman’s life, but is most common between the ages of 25 and 44
  • the age of onset for depression is younger for girls than for boys
  • women experience more frequent depressive episodes over their lifetime

Depression in women looks different than in men

While the diagnostic description of depression is the same for both men and women, women not only subjectively experience their depression differently, but it also objectively looks different than men’s depression. Women tend to report a greater number of symptoms and greater severity of symptoms.

Women’s symptoms tend to be classified as “atypical depression.” Atypical symptoms include:

  • reactive mood, which improves in response to positive events
  • overeating or weight gain
  • oversleeping
  • excessive physical fatigue
  • feelings of sensitivity to rejection from others

In addition, women report more somatic (body-related) symptoms related to their depression (such as headaches or body pains), and have more negative thinking patterns and are more prone to excessive guilt. They are also more likely to report a loss of interest in sexual activity, and report more crying than men. Research has found that women’s subjective experience of distress is higher than men’s.

The reasons for these differences are not well understood, but different theories regarding the biological, socio-cultural and psychological reasons for how and why depression affects women differently will be discussed in this section.

Suicide
Women who are depressed are at an increased risk of suicide. While more men complete suicide, more women attempt suicide. If you are feeling suicidal it is important to get help immediately.

  • call your doctor
  • call 911
  • go to the nearest emergency room
  • call a suicide crisis support hotline

Depression and the reproductive cycle
The hormonal fluctuations associated with women’s reproductive cycles have been associated with depression.

Risk factors for women

While it is important to remember that none of these risk factors on their own is likely to cause a woman to become depressed, they are important and unique factors that impact women’s mental health.

  • Biological factors
    • Genetics – Women with a family history of depression are at an increased risk for developing depression. It is likely an interaction of multiple genes and environment that places a woman at risk for developing depression. For example, a genetic predisposition to depression combined with a stressful event (such as the early loss of a parent) would likely increase one’s risk for depression.
    • Chemicals and hormones – Modern brain imaging shows that the brains of those who are depressed are different from those who are not depressed. In addition, there are differences in the way neurotransmitters act in the brain. The unique impact of female hormones on the brain and mood are of interest given the increased rates of depression in puberty, before menstruation (premenstrual), during the perinatal period, and in the transition from premenopause to menopause.
    • Illness – Individuals who are experiencing certain medical illnesses may be at an increased risk for depression. Depression can co-exist with various medical conditions, including heart disease, diabetes, stroke, cancer, Parkinson’s disease, HIV/AIDS and multiple sclerosis, and can even make the symptoms worse. In fact, both men and women with depression and a serious medical illness tend to suffer from more severe symptoms. It is important to note that treating the depression along with the medical illness can have positive effects on both.
  • Socio-cultural factors
    • Trauma –A review of the literature shows that childhood abuse, and specifically childhood sexual abuse, increases both men’s and women’s risk for depression in adulthood. Given that women experience higher rates of childhood sexual abuse, they may be at an increased risk for depression.
    • Multiple roles – Women often have multiple important roles in their lives (mother, worker, partner, caretaker, etc.). While these roles can be a source of great satisfaction, they can also cause significant strain and stress. Research has shown how role conflicts (such as work-family conflict) are related to depression in women.
    • Social oppression – In addition to the unequal power experienced by women in our society, those who experience additional forms of social oppression are at an even more increased risk for depression. Women of colour, women of lower socio-economic status, unemployed women, and lesbian women all experience higher rates of depression.
  • Psychological factors
    • We know that psychological factors, such as our thoughts, emotions and how we respond to events in life, are shaped by our genetics, socialization and past experiences. It would make sense then that women will have varied psychological risk factors (for example, a tendency towards pessimistic thinking or feelings of guilt) as well as varied psychological strengths (such as supportive relationships with others and the capacity for deep emotions), depending on their unique situation.

These risk factors for depression are important because they highlight some of the differences between men and women. It is unlikely any one of these risk factors is solely responsible for a woman’s depression, but rather a combination of factors would increase one’s risk.

 

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  • A publication of:
  • Women's College Hospital