Depression in Women – Signs, Possible Causes and Treatment

Women suffer from depression twice as often as men but not all seek help. Many of the causes of depression are same as those in men but certain gender-related and biologic factors make women more vulnerable to the effects of depression. Depression is a significant risk factor for suicide. Counseling and medication can be effective in treating depression.

What is Depression?

Mood variations and feeling sad on occasions are normal phenomenon but when low mood becomes persistent without moments of happiness and the person loses the ability to feel pleasure under any circumstances, depression should be suspected. It is often accompanied by guilt, inadequacy, low self-esteem, sleeping difficulty, change in appetite, along with thoughts of self-harm or suicide. Women are more likely than men to suffer from feelings of inappropriate guilt, excessive self-blame, low self-esteem, and worthlessness.

Signs of Major Depression

A person is diagnosed as suffering from major depression when she loses all interest or pleasure in daily life (anhedonia) and suffers from mood variations, along with 4 or more of the following symptoms, which should be present nearly every day for at least 2 weeks.

  • Change in appetite – usually poor appetite with weight loss. Rarely, there may be increased appetite.
  • Sleep difficulty, usually early waking. Also, mood variation during the day, which may be worse in the mornings.
  • Slowness in spontaneous movement or thought process (psychomotor retardation), or psychomotor agitation.
  • Loss of interest in sex.
  • Poor concentration.
  • Feelings of guilt or worthlessness.
  • Ideas of self-harm or suicide attempts.

Causes and Risk Factors of Depression in Women

Various factors may be responsible for increased risk of depression in women. These may include :

  • Genetic factors – a family history of mood disorders or depression.
  • Biochemistry – excess of 5-hydroxytryptamine receptors in the brain may be responsible.
  • Hormonal factors – changes in female hormones affect mood during different stages of a woman’s life, such as puberty, before periods, during pregnancy, after childbirth, and around menopause.
  • Premenstrual dysphoric disorder – this is a severe form of premenstrual syndrome where depression is a significant symptom. It may not be associated with abnormal hormonal changes but may occur as a result of aggravated response to the usual hormonal changes before the onset of menstruation.
  • Depression during pregnancy, particularly in the third trimester.
  • Postpartum depression – many women go through a phase of depression following childbirth. Postpartum blues is the mildest form and may present as temporary mood disturbance following delivery. Postpartum depression is a more severe form and may develop weeks or months following delivery. Postpartum psychosis is an extremely severe form of depression which may develop within a few days to a few weeks of delivery. Such patients may try to harm themselves or the baby.
  • Depression associated with infertility, miscarriage, stillbirth, or death of a child.
  • Depression is more common in women around menopause.
  • Stressful life events such as job loss, breaking up of a relationship, divorce, or death of a loved one.
  • Physical or sexual abuse as a child.
  • Loss of a parent or significant caregiver in early childhood.
  • Illnesses such as cancer, HIV/AIDS, heart disease, stroke, or Parkinson’s disease.
  • Depression may coexist with eating disorders such as anorexia nervosa and bulimia nervosa.

Treatment of Depression

Counseling and medication is the mainstay of treatment. Special precautions are necessary while prescribing for pregnant women and those who are breastfeeding.

  • Psychological treatment such as cognitive therapy.
  • Antidepressants.
  • Alternative therapy may include herbal therapy with St John’s wort but this should be overseen by a doctor in conjunction with the psychotherapist.
  • Associated symptoms such as delusions and hallucinations may be treated with antidepressant and antipsychotic drugs.
  • Electroconvulsive therapy (ECT) may become necessary in certain cases.

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