Mood Swings: For Women
Major depression
and Mood Disorder affect twice as many women as
men. This two-to-one ratio exists regardless of racial and ethnic
background or economic status. The same ratio has been reported in ten
other countries all over the world. Men and women have about the same
rate of bipolar disorder (manic-depression), though its course in women
typically has more depressive and fewer manic episodes.
A variety of factors unique to
women's lives are suspected to play a role in developing depression.
Much research has focused on understanding these factors, including:
reproductive, hormonal, genetic or other biological factors; abuse and
oppression; interpersonal factors; and certain psychological and
personality characteristics. And yet, the specific causes of depression
in women remain unclear; many women exposed to these factors do not
develop depression. What is clear is that regardless of the contributing
factors, depression is a highly treatable illness.
Stress Factors in relationships
and work roles
Stress in general can
contribute to depression in persons biologically vulnerable to the
illness. 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. In fact, rates of depression were shown to be highest among
unhappily married women.
Reproductive Events
Women's reproductive events include the menstrual cycle, pregnancy, the
postpregnancy period, infertility, menopause, and sometimes, the
decision not to have children. These events bring fluctuations in mood
that for some women include depression. Researchers have confirmed that
hormones have an effect on the brain chemistry that controls emotions
and mood. Many women experience certain behavioral and physical changes
associated with phases of their menstrual cycles. In some women, these
changes are severe, occur regularly, and include depressed feelings,
irritability, and other emotional and physical changes. Called
premenstrual syndrome (PMS) or premenstrual dysphoric disorder
(PMDD), the changes typically begin after ovulation and become gradually
worse until menstruation starts.
Postpartum mood changes
These 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. For more information, please visit our Post
Partum Depression page.
Pregnancy
Pregnancy seldom contributes to depression,
and having an abortion does not appear to lead to a higher incidence
of depression. Women with infertility problems may be subject to
extreme anxiety or sadness, though it is unclear if this contributes
to a higher rate of depressive illness. In addition, motherhood may be
a time of heightened risk for depression because of the stress and
demands it imposes.
Menopause
Menopause,
in general, is not associated with an
increased risk of depression. In fact, while once considered a unique
disorder, research has shown that depressive illness at menopause is
no different than at other ages. The women more vulnerable to
change-of-life depression are those with a history of past depressive
episodes.
Even severe depression and mood
disorder can be highly responsive to treatment. Indeed, believing one's
condition is "incurable" is often part of the hopelessness that
accompanies serious depression. Such individuals should be provided with
the information about the effectiveness of modern treatments for
depression in a way that acknowledges their likely skepticism about
whether treatment will work for them. As with many illnesses, the
earlier treatment begins, the more effective and the greater the
likelihood of preventing serious recurrences. Of course, treatment will
not eliminate life's inevitable stresses and ups and downs. But it can
greatly enhance the ability to manage such challenges and lead to
greater enjoyment of life.