October 5, 2007

Women’s Health

Depression in Women

By Kenneth L. Noller, MD

Depression is a common mental illness that affects one in 10 Americans each year. Women are twice as likely to develop depression over the course of their lifetime than men are.

Depression is often misunderstood—its symptoms can be overlooked or attributed to a passing case of “the blues” or another medical problem, such as a thyroid disorder. Nearly two-thirds of sufferers do not get the help they need. But being depressed goes beyond feeling sad for a short time or grieving after a loss.

In some women, depression may be triggered or worsen around the time of certain reproductive events, such as menstruation, pregnancy, loss of a baby, after the birth of a baby, mastectomy, hysterectomy, and menopause. Extreme stress or grief, feeling overwhelmed by responsibility at work and home, having a stressful job, money problems, drug and alcohol use, a history of abuse, divorce, or the death of a partner are also causes.

Women who are depressed usually have several symptoms on a near daily basis, all day, for at least two weeks. Symptoms can include:

• Lack of interest in things that used to be enjoyable

• Feeling sad or “down in the dumps”

• Restlessness, the inability to sit still, or feeling very sluggish

• Feelings of worthlessness or guilt

• A change in appetite or weight

• Thoughts of death or suicide or attempts at suicide

• Problems concentrating, thinking, remembering, or making decisions

• Sleeping too much or having problems falling or staying asleep

• Lack of energy or always feeling tired

If you have at least five of these symptoms (including one of the first two) you may be depressed. Additionally, some women may suffer from headaches or other aches and pains, digestive problems, sexual problems, hopelessness and negative feelings, worry, or fear. Talk to your doctor if you have any of these symptoms.

Depression is a treatable condition that can improve with the proper care. If you are diagnosed with depression, it is important that you work with your doctor to tailor the best treatment plan for you.

Your doctor may prescribe anti-depressants to treat mild to moderate depression. Take antidepressants according to your doctor’s instructions, and quickly report any side effects—nausea, dizziness, constipation, skin rashes, weight gain or loss, restlessness, insomnia, or sexual problems. Additionally, your doctor may refer you to a therapist.

Women with long-term depression, those who have symptoms between severe episodes, or those who don’t respond to therapy alone, may be prescribed both antidepressants and psychotherapy.

For more information, the Patient Education Pamphlet “Depression” is available at www.acog.org/publications/patient_education.

Dr. Noller is President of the American College of Obstetricians and Gynecologists

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