Feeling occasionally sad is normal, but depression involves a pattern of symptoms over time to the detriment of daily life. Hormones, biology, and societal pressure all contribute to women struggling with depression at a significantly higher rate than men. However, with psychotherapy, learning regulation skills, and medication for some, depression can be managed.
While having a good physical exam and assessment is important to rule out organic causes of any mental distress, this is especially true when experiencing symptoms of depression. Common medical conditions such as hypothyroidism affect energy levels, appetite, and sleep patterns—all symptoms that overlap with depression. Consulting with your doctor about these concerns can assure that medical issues are not overlooked.
What Is Depression?
Depression is a mood disorder that affects a person’s thoughts, feelings, and behavior.1 Most people experience depressive symptoms from time to time, but people with depressive disorder experience symptoms for at least two weeks on a near daily basis. Symptoms of depression include sad mood, difficulty experiencing pleasure, low energy and motivation, and changes in sleep, appetite, and weight and interfere with multiple aspects of daily living.
Prevalence of Depression in Women
In 2020, 13,536,000 of women over age 18, or 10.5%, experienced major depression in the past year.2
Most People With Depression Need Treatment to Feel Better
Like many health conditions, depression is treatable. Treatment for depression typically involves therapy and in some cases medication as well. The earlier that a person seeks treatment for depression, the more likely they are to recover.1 Trying to ignore your symptoms or “tough it out” may only lead them to become worse.
Signs of Depression in Women
Depression can feel incredibly isolating and lonely to a person in the middle of it. If you notice someone may be feeling depressed, don’t be afraid to check in with them. If someone shares with you that they are suicidal, contact 911 immediately. Local law enforcement can perform wellness checks on a person if they have concerning behaviors and statements.
Common signs of depression in women include:3
- Significant weight loss or gain
- Social isolation from friends, family, and relationships
- Lethargy or increased fatigue
- Lack of participation or enjoyment in activities that they once enjoyed
- Seeming to move more slowly than is usual
- A change in hygiene and/or appearance
- Negative statements about themself
- Talking about death or dying
What Are the Symptoms of Depression in Women?
Depression symptoms and severity will vary, but many women with depression experience sadness or emptiness, fatigue, and trouble sleeping. Diagnoses are made by psychiatric providers and therapists, but also by primary care providers and women’s health providers (OB/GYNs).
Common symptoms of depression in women include:3
- Persistent feelings of sadness, emptiness, or hopelessness
- Inability to enjoy things
- Significant weight changes and/or appetite changes
- Sleeping too much or not sleeping enough
- Fatigue
- Trouble concentrating
- Feeling worthless or overly guilt-ridden
- Thoughts of death or dying, suicidal thoughts or a suicide attempt
Types of Depression Unique to Women
Hormonal and lifestyle changes occurring during menstruation, pregnancy, and menopause are to thank for specific depressive episodes that only affect women. These types of hormonal change can also exacerbate existing episodes of depression or anxiety. Consulting with a medical specialist (such as an ob/gyn) about symptoms associated only with hormonal changes is suggested in order to get the best possible treatment.
Types of depression unique to women include:
Premenstrual Dysphoric Disorder (PMDD)
Most women experience some form of premenstrual syndrome (PMS) in the days before or during their period. PMDD is marked by significant mood, physical, and behavioral changes that are so severe that daily life is affected. PMDD is also different from depression in that symptoms are minimal or resolved in the week post-menses.3
Postpartum Depression
Pregnancy and the birth of a child cause a massive shift in hormones as well as lifestyle. Most women experience times of sadness or fluctuating mood in the weeks following delivery, often known as “baby blues.” While the baby blues is an expected phenomena, postpartum depression occurs when those symptoms increase or fail to resolve over time.
Perimenopausal Depression
Due to the vast hormonal changes during perimenopause (the time of transition women experience prior to menopause), many women find that their moods become erratic and that episodes and depressive symptoms increase during menopause.
Depression in Women vs Men
Hormonal shifts due to menses, pregnancy, and menopause can all trigger depressive symptoms. Some scholars believe that internalizing/shutting down behaviors were safer for our female Homo sapien ancestors than acting out behaviors and therefore became coded into the human genotype over centuries.4
Is Depression More Common in Males or Females?
Women are consistently shown to have higher incidences of depression than men. A CDC survey of adult Americans stated “Overall, women (10.4%) were almost twice as likely to have depression as men (5.5%).”5
Causes of Depression in Women
While the causes of depression are still being actively researched and debated, there are some issues that are known to increase the risk of developing symptoms of depression.
Hormones
Hormonal changes associated with menstruation, pregnancy, childbirth, and menopause cause changes in brain chemistry that can be associated with depressive episodes.6 One study showed that 12.4% of women studied had a Major Depressive Episode during pregnancy.7 13-18% of women of reproductive age may have premenstrual dysphoric symptoms severe enough to induce impairment and distress.8
Family History of Depression
Genetics may also be a factor. One study showed that major depression is likely to be inherited in the 31%–42% range, though they noted that this was likely to be on the low end of the spectrum.9
Childhood Trauma
Research demonstrates that exposure to adverse experiences in childhood increases the risk of depressive disorders even decades after the events occur.10 Trauma, loss, violence, and other life crises can trigger the onset of depression. Depressive symptoms that present only after a stressful event may also be signs of PTSD, acute stress disorder, or adjustment disorder.
What Raises the Chances of Depression in Women?
There are several factors that can influence why women become depressed. Other than genetic and biological causes, here are some common factors that can raise a
woman’s chances of developing depression:
Overwhelm
Women who choose to work and have families often serve as both a primary caregiver to children and aging parents while also working to advance a profession and/or provide financial security. Carrying the load of family and career can be overwhelming and lead to feelings of resentment or shutting down.
Guilt
While women are more educated than ever, they still often find themselves being expected to fulfill traditional expectations. Social media leaves women feeling judged for every decision they make regarding their parenting and life choices. Guilt and shame for not being able to be at every school event or organize the perfect themed birthday party can lead to other symptoms of depression.
Abuse
Women are also more likely to be victims of violence and abuse, which are factors that contribute to depression.
Gaps in Resources
Additionally, there remains a gender gap regarding wealth and power, meaning that women continue to earn less money than men and are far less likely to be in a position of power. The emotional and financial burdens of this can lead to emotional distress and depression.
Recognizing Depression and Seeking Treatment
Choosing to get help with depression is not easy. Often, people do not admit how badly they are feeling until things get unbearable. The sooner a person can begin to admit their symptoms to a professional, the sooner an accurate medical and psychological assessment can be made, and then treatment can begin. Ruling out medical causes of depression like a thyroid imbalance is incredibly important, especially for women, who experience significantly more thyroid problems than men.
Reaching out to a primary care physician or OB-GYN can be the first step in seeking treatment. Likewise, finding a therapist can also begin the healing process. Your medical provider can often refer to a therapist they are familiar with, and likewise asking trusted friends can lead to therapist referrals. Also, if you would like to find a therapist who accepts your insurance, you can call the number on your insurance card to get a list of mental health providers who are contracted with your insurance. Using an online therapist directory can help you find therapy for depression as well.
OB-GYNs Often Detect Signs of Depression & Recommend Therapy
Choosing Therapy conducted a survey of 135 OB-GYNs on Sermo, a global data collecting platform of over 800,000 anonymous, verified physicians, about the mental health of their patients. The OB-GYNs reported that about 31% of their patients present with depression. Of those surveyed, 73% say that they’d ideally like the patients they recommend speak with a therapist have their first session within a week. However, the majority say that of the patients they recommend speak to a therapist, 30% or less actually make it to a first therapy session.
How Depression Is Treated
Treatment for depression is best often achieved through a combination of therapy and medication, if medication is needed. Medication is necessary for many people in order to provide enough energy, motivation and hope to engage in the therapeutic process. Some people find that medication needs to remain a constant in their lives, while others are able to work with their doctor to decrease their medication needs as their ability to cope and manage their depression increases.
Therapy
A number of therapy models effectively address depression, including interpersonal therapy, psychodynamic therapy, and cognitive behavioral therapy (CBT). Many therapists will utilize a blended approach of talk therapy with regulation skill building to allow the client to develop strategies to manage symptoms of depression.
Medication
Antidepressant medications such as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin–norepinephrine reuptake inhibitors) are often prescribed to treat symptoms of depression in women. These medications allow for an increase in certain chemicals in the brain that facilitate healthy mood stabilization.
Self-Help for Depression in Women
Depression can feel miserable, but change can feel completely overwhelming. However, even small steps can help you start to feel better, along with professional help.
Here are five ways to help yourself feel better when dealing with depression:
1. Connect With Others
Connection with others is incredibly difficult when in a depressive episode, but it is vital to mental health. Finding a way to catch up with a friend or intentionally spend time with a family member can help.
2. Get Outside
Getting even a few minutes of fresh air can help your body and brain experience different sensations (wind, hot or cold, sun or rain) that can help decrease depressive feelings.
3. Get Moving With Exercise You Enjoy
Walking, yoga, or any kind of exercise that gets your body moving can help adjust your brain chemistry and alleviate symptoms.
4. Develop (and Stick to) a Routine
Having a solid routine can build a habit of engaging in healthy behaviors, like exercise and eating at regular intervals, that combat depression.
5. Take Care of Your Body
Try to notice when you are hungry or full. Eat at regular intervals and attempt to listen to your body for cues around food. Try to eat food that is healthy and avoid excessive alcohol and sugar.
6. Get Enough Sleep
Sleep is important for maintaining good mental health. Sleeping too much or too little is associated with depression. Aim for 8 hours of uninterrupted sleep per night. If you’re struggling to sleep, try a mindfulness activity at night to help promote relaxation. If you continue to have trouble, speak to your doctor.
7. Try a New Hobby
Engaging in positive activities that are enjoyable is another way to manage depression. When people become depressed, they often give up hobbies and activities that they once enjoyed. Consider taking up an old hobby or trying something new, like joining a club, team sport, or taking a class.
8. Practice Gratitude
Gratitude can help foster a positive mindset and help reduce negative thoughts that are common with depression. Writing down just three to five things a day that you are grateful for can encourage positive feelings that may help fight depression.
What NOT to Do
Here are some coping mechanisms to avoid if you’re trying to overcome depression:
- Self-diagnose: It is almost impossible to objectively see yourself and your behaviors.
- Blame yourself for feeling down or sad: We have very little control over what we feel, we can only work to change how we respond to those feelings.
- Isolate: Isolation feeds feelings of depression and continues a negative cycle.
- Self-Medicate: Yes, that glass of wine or new sweater may make you feel better for a moment, and there is nothing wrong with treating yourself within reason, but if you are using food, alcohol, substances, shopping, sex, or any other compulsive behavior to distract from depression, that strategy will not work in the long term and can often lead to significant future stress or even addiction.
- Ignore thoughts of self-harm: Thoughts do not have to control actions, but if you have thoughts of self-harm or suicide, talk to someone immediately.
Depression in Women Infographics
