Depression in Women

 

What is depression?

Clinical depression is a serious and pervasive mood disorder. It causes feelings of sadness, hopelessness, helplessness, and worthlessness. Depression can be mild to moderate with symptoms of apathy, little appetite, difficulty sleeping, low self-esteem, and low-grade fatigue. Or it can be more severe.

How stress affects the body

Stress can be defined as an automatic physical response to any stimulus that requires you to adjust to change. Every real or perceived threat to your body triggers a cascade of stress hormones that produces physiological changes. We all know the sensations: your heart pounds, muscles tense, breathing quickens, and beads of sweat appear. This is known as the stress response.

The stress response starts with a signal from the part of your brain known as the hypothalamus. The hypothalamus joins the pituitary gland and the adrenal glands to form a trio known as the hypothalamic-pituitary-adrenal (HPA) axis, which governs a multitude of hormonal activities in the body and may play a role in depression as well.

When a physical or emotional threat looms, the hypothalamus secretes corticotropin-releasing hormone (CRH), which has the job of rousing your body. Hormones are complex chemicals that carry messages to organs or groups of cells throughout the body and trigger certain responses. CRH follows a pathway to your pituitary gland, where it stimulates the secretion of adrenocorticotropic hormone (ACTH), which pulses into your bloodstream. When ACTH reaches your adrenal glands, it prompts the release of cortisol.

The boost in cortisol readies your body to fight or flee. Your heart beats faster — up to five times as quickly as normal — and your blood pressure rises. Your breath quickens as your body takes in extra oxygen. Sharpened senses, such as sight and hearing, make you more alert.

CRH also affects the cerebral cortex, part of the amygdala, and the brainstem. It is thought to play a major role in coordinating your thoughts and behaviors, emotional reactions, and involuntary responses. Working along a variety of neural pathways, it influences the concentration of neurotransmitters throughout the brain. Disturbances in hormonal systems, therefore, may well affect neurotransmitters, and vice versa.

Normally, a feedback loop allows the body to turn off "fight-or-flight" defenses when the threat passes. In some cases, though, the floodgates never close properly, and cortisol levels rise too often or simply stay high. This can contribute to problems such as high blood pressure, immune suppression, asthma, and possibly depression.

Studies have shown that people who are depressed or have dysthymia typically have increased levels of CRH. Antidepressants and electroconvulsive therapy are both known to reduce these high CRH levels. As CRH levels return to normal, depressive symptoms recede. Research also suggests that trauma during childhood can negatively affect the functioning of CRH and the HPA axis throughout life.

What are the symptoms of depression in women?

Symptoms of depression in women include:

• Persistent sad, anxious, or "empty" mood
• Loss of interest or pleasure in activities, including sex
• Restlessness, irritability, or excessive crying
• Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
• Sleeping too much or too little, early-morning waking
• Appetite and/or weight loss or overeating and weight gain
• Decreased energy, fatigue, feeling "slowed down"
• Thoughts of death or suicide, or suicide attempts
• Difficulty concentrating, remembering, or making decisions
• Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain.

• What are the symptoms of mania in women?

  Mania is a highly energized state with elevated mood that can occur in bipolar disorder. Moods in bipolar disorder swing over the course of days or weeks or months from the lows of depression to the highs of mania. Even though mania is an elevated mood, it is serious and needs medical assessment and treatment.

  The symptoms of mania include:

  • Abnormally elevated mood
  • Irritability
  • Decreased need for sleep
  • Grandiose ideas
  • Greatly increased talking
  • Racing thoughts
  • Increased activity, including sexual activity
  • Markedly increased energy
  • Poor judgment that can lead to risk-taking behavior
  • Inappropriate social behavior

   

  Why is depression in women more common than depression in men?

  Before adolescence, depression is rare and occurs at about the same rate in girls and boys. However, with the onset of puberty, a girl's risk of developing depression increases dramatically to twice that of boys.

  Some experts believe that the increased chance of depression in women may be related to changes in hormone levels that occur throughout a woman's life. These changes are evident during puberty, pregnancy, and menopause, as well as after giving birth or experiencing a miscarriage. In addition, the hormone fluctuations that occur with each month's menstrual cycle probably contribute to premenstrual syndrome, or PMS, and premenstrual dysphoric disorder, or PMDD -- a severe syndrome marked especially by depression, anxiety, and mood swings that occurs the week before menstruation and interferes with normal functioning of daily life.

  What increases the chances of depression in women?

  According to the National Institutes of Health, factors that increase the risk of depression in women include reproductive, genetic, or other biological factors; interpersonal factors; and certain psychological and personality characteristics. In addition, women juggling work with raising kids and women who are single parents suffer more stress that may trigger symptoms of depression. Other factors that could increase risk include:

  • Family history of mood disorders
  • History of mood disorders in early reproductive years
  • Loss of a parent before age 10
  • Loss of social support system or the threat of such a loss
  • Ongoing psychological and social stress, such as loss of a job, relationship stress, separation or divorce
  • Physical or sexual abuse as a child
  • Use of certain medications

  Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder.

  Is depression hereditary?

  Depression can run in families. When it does, it generally starts between ages 15 and 30. A family link to depression is much more common in women. However, there is not always an apparent genetic or hereditary link to explain why someone may develop clinical depression.