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MENTAL HEALTH FACT SHEETS
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Depression and Women
Life is Full of emotional ups and downs. But when the "down" times are long lasting or interfere with your ability to function, you may be suffering from a common, serious illness — Depression.
Clinical depression affects mood, mind, body, and behavior.
Treatment can alleviate the symptoms in over 80 percent of the cases.
The Problem
Research has shown that in the United States about 19 million people — one in ten adults — experience depression each year, and nearly two-thirds do not get the help they need. Yet, because it often goes unrecognized, depression continues to cause unnecessary suffering.
Depression is a pervasive and impairing illness that affects both women and men, but women experience depression at roughly twice the rate of men. Researchers continue to explore how special issues unique to women, biological, life cycle and psycho-social, may be associated with women's higher rates of depression.
Symptoms of Depression And Mania
A thorough diagnostic evaluation is needed if three to five or more of the following symptoms persist for more than 2 weeks, or if they interfere with work or family life. An evaluation involves a complete physical checkup and information gathering on family health history .Not everyone with depression experiences each of these symptoms. The severity of the symptoms also varies from person to person.
| Depression |
Mania |
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Persistent sad, anxious, "empty" mood |
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Abnormally elevated mood |
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Feelings of guilt and helplessness |
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Grandiose notions |
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Decreased energy, fatigue |
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Racing thoughts |
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Thoughts of death or suicide |
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Markedly increased energy |
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Difficulty concentrating, remembering |
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Poor judgment |
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Persistent physical symptoms |
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Inappropriate social behavior |
Only when these symptoms persist for an unusually long time is there reason to suspect that grief has become a depressive illness. Similarly, living with the stress of potential layoffs, heavy workloads, or financial or family problems may cause irritability and 'the blues' .Up to a point, such feelings are simply a part of human experience. But when these feelings increase in duration and intensity and an individual is unable to function as usual, what seemed a temporary mood may have become a clinical illness.
Types of Depressive Illness
1. Major Depression affects twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. In major depression, sometimes referred to as unipolar or clinical depression, people have some or all of the symptoms listed for several months or longer. Episodes of the illness can occur once, twice, or several times in a lifetime.
2. Dysthymia has the same symptoms as major depression, although milder and lasting at least 2 years. People with dysthymia are frequently lacking in zest and enthusiasm for life, living a joyless and fatigued existence that seems almost a natural outgrowth of their personalities. They also can experience major depressive episodes.
3. Manic-Depression, or bipolar disorder, is not nearly as common as other forms of depressive illness and involves disruptive cycles of depressive symptoms that alternate with mania. Men and women have about the same rate of manic-depression, although its course in women typically has more depressive and fewer manic episodes. During manic episodes, people may become overly active, talkative, euphoric, irritable, irresponsible about spending money, and involved in sexual misadventures.
Causes Of Depression
Genetic Factors
There is a risk of developing depression when there is a family history of the illness, indicating that a
biological vulnerability may be inherited. Major depression can occur in people who have had no family members with the illness. This suggests that additional factors, possibly biochemistry , environmental stressors, and other psychosocial factors, are involved in the onset of depression.
Biochemical Factors
Evidence indicates that brain biochemistry is a significant factor in depressive disorders. It is known, for example, that individuals with major depressive illness typically have deregulation of certain brain chemicals, called neurotransmitters. Depression can be induced or alleviated with certain medications, and some hormones have mood-altering properties. What is not yet known is whether the "biochemical disturbances" of depression are of genetic origin, or are secondary to stress, trauma, physical illness, or some other environmental condition.
Environmental and Other Stressors
Significant loss, a difficult relationship, financial problems, or a major change in life pattern have all been cited as contributors to depressive illness. Sometimes the onset of depression is associated with acute or chronic physical illness. In addition, some form of substance abuse disorder occurs in about one-third of people with any type of depressive disorder.
Persons with certain characteristics such as pessimistic thinking, low self-esteem, a sense of having little control over life events and a tendency to worry excessively are more likely to develop depression. These attributes may heighten the effect of stressful events or interfere with taking action to cope with them or with getting well. Upbringing or sex role expectations may contribute to the development of these traits. These negative thinking patterns typically develop in childhood or adolescence.
The Many Dimensions of Depression in Women
A variety of factors unique to women's lives are suspected to playa role in developing depression. Research is focused on understanding these, including: reproductive, hormonal, genetic or other biological factors; abuse and oppression; interpersonal factors; and certain psychological and personality characteristics. What is clear is that regardless of the contributing factors, depression is a highly treatable illness. Researchers are focusing on the following areas in their study of depression in women:
The Issues of Adolescence
Before adolescence, there is little difference in the rate of depression in boys and girls. By the age of 15, however, females are twice as likely to have experienced a major depressive episode as males. This comes at a time in adolescence when roles and expectations change dramatically. The stresses of adolescence include forming an identity , emerging sexuality, separating from parents, and making decisions for the first time, along with other physical, intellectual, and hormonal changes. Studies show that female high school students have significantly higher rates of depression, anxiety disorders, eating disorders, and adjustment disorders.
Sexual Abuse
Studies show that women molested as children are more likely to have clinical depression at some time in their lives than those with no such history. In addition, several studies show a higher incidence of depression among women who have been raped as adolescents or adults. Since far more women than men were sexually abused as children, these findings are relevant. Women who experience other commonly occurring forms of abuse, such as physical abuse and sexual harassment on the job, also may experience higher rates of depression. Abuse may lead to depression by fostering low self-esteem, a sense of helplessness, self-blame, and social isolation.
Relationships and Work Roles
Some have theorized that higher incidence of depression in women is not due to greater vulnerability, but to the particular stresses that many women face. These stresses include major responsibilities at home and work, single parenthood, and caring for children and aging parents.
For both women and men, rates of major depression are highest among the separated and divorced, and lowest among the married, while remaining always higher for women than for men. The quality of a marriage, however, may contribute significantly to depression. Lack of an intimate, confiding relationship, as well as overt marital disputes, have been shown to be related to depression in women.
Reproductive Events
Women's reproductive events include the menstrual cycle, pregnancy, the post pregnancy period, infertility, menopause, and sometimes, the decision not to have children. Many women experience certain behavioral and physical changes associated with phases of their menstrual cycles.
Postpartum mood changes can range from transient "blues" immediately following childbirth to an episode of major depression to severe, incapacitating, psychotic depression. Studies suggest that women who experience major depression after childbirth very often have had prior depressive episodes even though they may not have been diagnosed and treated.
Poverty
Women and children represent seventy-five percent of the U.S. population considered poor. Low economic status brings with it many stresses, including isolation, uncertainty, frequent negative events, and poor access to helpful resources. Sadness and low morale are more common among persons with low incomes and those lacking social supports. But research has not yet established whether depressive illnesses are more prevalent among those facing environmental stressors such as these.
Depression in Later Adulthood
As with younger age groups, more elderly women than men suffer from depressive illness. Similarly, for all age groups, being unmarried (which includes widowhood) is also a risk factor for depression. Most important, depression should not be dismissed as a normal consequence of the physical, social, and economic problems of later life. In fact, studies show that most older people feel satisfied with their lives.
Dual Diagnosis
The term "dual diagnosis" refers to the presence of one or more addictions complicated by a psychiatric disorder such as major depression. These patients represent a challenge to treatment professionals. They frequently utilize services from both fields and are often shuttled back and forth between numerous treatment systems. They are more prone to relapse and are often the most difficult clients to treat effectively because of their many problems.
Dual diagnosis patients require the comprehensive, flexible Rimrock Foundation treatment approach that recognizes their special needs and provides integrated treatment for the multiple disorders. Essential in the process is the close collaboration among our multidisciplinary team of professionals including a psychiatrist, psychologist, psychiatric social workers, and certified chemical dependency counselors.
Depression Is A Treatable Illness
As with many illnesses, the earlier treatment begins, the more effective and the greater the likelihood of preventing serious recurrences. Gaining the benefits of treatment begins by recognizing the signs of depression. The next step is to be evaluated by a qualified professional. Although depression can be diagnosed and treated by primary care physicians, often the physician will refer the patient to a psychiatrist, psychologist, clinical social worker, or other mental health professional.
Treatment is a partnership between the patient and the health care provider. An informed consumer should know all their treatment options and discuss any concerns with the provider as they arise. The most commonly used treatments for depression are antidepressant medication, psychotherapy, or a combination of the two. Which of these is the right treatment for anyone individual depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, one or both of these treatments may be useful, while in severe or incapacitating depression, medication is generally recommended as a first step in the treatment. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows the opportunity to learn more effective ways of handling problems.
Medications
There are several types of antidepressant medications used to treat depressive disorders. Antidepressant medications are not habit-forming. To be effective and to prevent a relapse of the depression, medications must be taken for about 6 to 12 months, carefully following the doctor's instructions. Medications must be monitored to ensure the most effective dosage and to minimize side effects. Other prescribed and over-the-counter medications or dietary supplements being used should be reviewed because some can interact negatively with antidepressant medication. There may be restrictions during pregnancy. For those who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing recurring episodes.
Psychotherapy
In mild to moderate cases of depression, psychotherapy is also a treatment option. Some short-term (10 to 20 week) therapies have been very effective in several types of depression. "Talking" therapies help patients gain insight into and resolve their problems through verbal give-and-take with the therapist. "Behavioral" therapies help patients learn new behaviors that lead to more satisfaction in life and "unlearn" counterproductive behaviors.
Even when treatment is successful, depression may recur. Studies indicate that certain treatment strategies are very useful in this instance. Continuation of antidepressant medication at the same dose that successfully treated the acute episode can often prevent recurrence. Monthly interpersonal psychotherapy can lengthen the time between episodes in patients not taking medication.
Rimrock Foundation has four newly licensed Crisis Stabilization beds available for patients who may need a short-term stay for the purpose of stabilizing them on prescribed medications or who may need a safe place with medical monitoring and evaluation but who do not require the full services of an acute psychiatric facility. These beds serve as an alternative to hospitalization and may be accessed by referral from the patient's physician, case manager or therapist.
For further information on Rimrock Foundation's treatment of Depression, call Althea Bartlett, Admissions Supervisor at 1-800-227-3953 or 1-406-248-3175, or visit our website at rimrock.org. For more educational information on Depression, contact the Rimrock Foundation Library at 1-800-227-3953 or 1-406-248-3175.
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