Understanding depression in women
Depression is a serious condition that can impact every area of your life. It can affect your social life, your family relationships, your career, and your sense of self-worth and purpose. And for women in particular, depression is common.
If you’re feeling sad, guilty, tired, and just generally “down in the dumps,” you may be suffering from major depression. But the good news is that depression is treatable, and the more you understand about depression’s particular implications for and impact on women, the more equipped you will be to tackle the condition head on.
According to the National Mental Health Association:
- Approximately 12 million women in the United States experience clinical depression each year.
- About one in every eight women can expect to develop clinical depression during their lifetime.
Signs and symptoms of depression in women
The symptoms of depression in women are the same as those for major depression. Common complaints include: Depressed mood Loss of interest or pleasure in activities you used to enjoy
- Feelings of guilt, hopelessness and worthlessness
- Suicidal thoughts or recurrent thoughts of death
- Sleep disturbance (sleeping more or sleeping less)
- Appetite and weight changes
- Difficulty concentrating
- Lack of energy and fatigue
Differences between male and female depression
Although the signs and symptoms of depression are the same for both men and women, women tend to experience certain symptoms more often than men. For example, seasonal affective disorder—depression in the winter months due to lower levels of sunlight—is more common in women. Also, women are more likely to experience the symptoms of atypical depression.
In atypical depression, rather than sleeping less, eating less, and losing weight, the opposite is seen: sleeping excessively, eating more (especially carbohydrates), and gaining weight. Feelings of guilt associated with depression are also more prevalent and pronounced in women. Women also have a higher incidence of thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician in women who are depressed.
Causes of depression in women
Women are about twice as likely as men to suffer from depression. This two-to-one difference persists across racial, ethnic, and economic divides. In fact, this gender difference in rates of depression is found in most countries around the world. There are a number of theories which attempt to explain the higher incidence of depression in women. Many factors have been implicated, including biological, psychological, and social factors.
Biological causes of depression in women
Premenstrual problems - Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For many women, PMS is mild. But for some women, symptoms are severe enough to disrupt their lives and a diagnosis of premenstrual dysphonic disorder (PMDD) is made.
Pregnancy and infertility - The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.
Postpartum depression - Many new mothers experience the “baby blues.” This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is known as postpartum depression. Postpartum depression is believed to be influenced, at least in part, by hormonal fluctuations.
To learn more, see Postpartum Depression: Signs, Symptoms, and Help for New Moms.
Perimenopause and menopause - Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.
Social and cultural causes of depression in women
- Role strain - Women often suffer from role strain over conflicting and overwhelming responsibilities in their life. The more roles a woman is expected to play (mother, wife, working woman), the more vulnerable she is to role strain and subsequent stress and depression. Depression is more common in women who receive little help with housework and child care. Single mothers are particularly at risk. Research indicates that single mothers are three times more likely than married mothers to experience an episode of major depression.
- Unequal power and status - Women’s relative lack of power and status in our society may lead to feelings of helplessness. This sense of helplessness puts women at greater risk for depression. These feelings may be provoked by discrimination in the workplace leading to underemployment or unemployment. Low socioeconomic status is a risk factor for major depression. Another contributing factor is society’s emphasis on youth, beauty, and thinness in women, traits which to a large extent are out of their control.
- Sexual and physical abuse - Sexual and physical abuse may play a role in depression in women. Girls are much more likely to be sexually abused than boys, and researchers have found that sexual abuse in childhood puts one at increased risk for depression in adulthood. Higher rates of depression are also found among victims of rape, a crime almost exclusively committed against women. Other common forms of abuse, including physical abuse and sexual harassment, may also contribute to depression.
- Relationship dissatisfaction - While rates of depression are lower for the married than for the single and divorced, the benefits of marriage and its general contribution to well-being are greater for men than for women. Furthermore, the benefits disappear entirely for women whose marital satisfaction is low. Lack of intimacy and marital strife are linked to depression in women.
- Poverty - Poverty is more common among women than men. Single mothers have the highest rates of poverty across all demographic groups. Poverty is a severe, chronic stressor than can lead to depression.
Psychological causes of depression in women
- Coping mechanisms - Women are more likely to ruminate when they are depressed. This includes crying to relieve emotional tension, trying to figure out why you’re depressed, and talking to your friends about your depression. However, rumination has been found to maintain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
- Stress response - According to Psychology Today, women are more likely than men to develop depression under lower levels of stress. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men.
- Puberty and body image - The gender difference in depression begins in adolescence. The emergence of sex differences during puberty likely plays a role. Some researchers point to body dissatisfaction, which increases in girls during the sexual development of puberty. Body image is closely linked to self-esteem in women, and low self-esteem is a risk factor for depression.
Risk factors for depression in women
There are a number of different, yet interrelated, risk factors for depression in women. Women of lower socioeconomic status are more likely to develop depression. This makes sense considering that the more sources of stress in a woman’s life, the more likely she is to develop depression. Women of low socioeconomic status are likely to struggle with financial problems, issues of unemployment or underemployment, discrimination, lack of education, and single parenthood. Additional risk factors include marital conflict and dissatisfaction, past sexual or physical abuse, and role strain.
Risk Factors for Depression in Women
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