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12.24.2007

Depression and Women

We hear a lot about depression in general, but there's a reason most of the ads we see for antidepressant medications feature women. Women are twice as likely as men to have major depression and, like men, may experience episodes throughout their lives. Women also attempt suicide much more frequently than men, but are less likely to die from those attempts. Here are some facts about women and depression:

Women may develop depressive episodes at any time during their lives, but the tendency is greatest during their reproductive years. Prior to adolescence, boys and girls become depressed at about the same rate. Some women experience depressive symptoms in relation to their menstrual cycles (most commonly toward the end of the cycle). Depression may also occur during pregnancy, the postpartum months, and during the years just before and after menopause. Despite extensive research, however, no reason for the increased risk for depression in women has been firmly established. Some hypotheses point to hormonal changes; endocrine system alterations such as elevated cortisol levels and subclinical hypothyroidism; the pressures of social and family roles; culturally determined gender expectations; and genetic influences. But we don't know for sure how these factors combine to cause depression. After menopause, the risk for depression in women is closer to that for men because it declines somewhat in women and increases in men in that same age range. As do men, women certainly suffer as a result of their depression. Mood, motivation, concentration, energy, sleep, appetite, and libido all can be affected. In some women, these signs can be overlaid with feelings of worthlessness and guilt, irritability and restlessness, and thoughts of suicide. And because women often play central roles as family caregivers, their depression can have a profound effect on all family members, especially children. This makes effective treatment especially important.
One treatment challenge that only women face is what to do about taking antidepressants and related psychiatric medications during pregnancy. All FDA-approved medications are categorized according to their relative safety during pregnancy.

The system includes ratings of A, B, C, D, and X, with "A" being proven safe during pregnancy and "X" posing a high risk. Some antidepressants apparently carry less risk than others. Women who have had episodes of depression and either are pregnant or are considering becoming pregnant should consult with their health care providers about their treatment options. All women need to recognize their increased risk for depression. If you believe you or someone you know may be depressed, help may come in many forms. Your first step is to talk to someone, such as another family member, a counselor or doctor, or another trusted person.

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