Depression

The term "depression" is sometimes used casually to refer to any "down" mood, but depression, as a clinical diagnosis, is an umbrella term for a group of illnesses that vary in symptoms, degrees of severity and duration.¹ All are serious medical illnesses involving disturbances in mood, concentration, sleep, activity, appetite and social behavior.² At its most extreme, depression can result in suicide and is, in fact, the leading cause of it.³ A 1997 survey of adolescent girls revealed that almost 30% of them reported suicidal thoughts.⁴ Of the 18.8 million American adults who suffer from depression, more than half of them are women.⁵ Nearly twice as many women (12%) as men (6.6%) are affected by a depressive disorder each year. Additionally, women experience higher rates of seasonal affective disorder and dysthymia and have higher rates of the depressive phase of manic depression and rapid-cycling bipolar disorder.⁶ The reason for the gender gap in depression is not clear, but there appear to be important links between mood changes and reproductive health events as is evident in the increase in female depression during the reproductive years.⁷ As many as 10% to 15 % of women experience clinical depression during pregnancy or after the birth of a baby.⁸ Once a woman has experienced a postpartum depression, her risk of having another reaches 70 %.⁹ Also, the first episode of bipolar disorder in women frequently occurs following the birth of a child.¹⁰

Depression can run in families, with a 25% rate of depression in first-degree relatives (mother, father, siblings) of people with depression and an even greater prevalence of the illness in first-degree and second-degree female relatives. But depression also occurs in people who have no family history of the disease.¹¹ The psychosocial factors contributing to women's increased vulnerability to depression include the stress of multiple work and family responsibilities, sexual discrimination, lack of social supports, traumatic life experiences, sexual and physical abuse, and poverty.¹² One study found that three out of five of the women diagnosed with depressive illnesses had been victims of abuse.¹³ Another major study revealed that 100% of women who had experienced severe childhood sexual abuse developed depression later in life.¹⁴

Several studies of depression among college students, and within the Amish community of eastern Pennsylvania, have shown no gender difference in the rates of depression, suggesting that greater social equality may help reduce the higher rates of depression in women.¹⁵ Currently, the standard methods of treating depression are psychotherapy and prescription medications, often in combination.¹⁶ Yet, despite the disproportionate impact of depression on women, few, if any, of the nation's largest managed care organizations have gender-specific guidelines for the treatment of depression.¹⁷ Knowing how to recognize symptoms is, thus, all the more crucial, as early detection can mean a saved life.¹⁸

Actions, Information & Opportunities to Help
Many sites, both comprehensive and single-issue, dedicated to informing, organizing and analyzing. Some interesting theoretical sociological pieces, and cultural studies, lots of published news articles and campaign info.

• Depression in Women: Diagnostic and Treatment Considerations
• Depression in African American Women
• Internet Mental Health Index - click on "D" for depression links
• National Institute of Mental Health (NIMH) - Depression resources
• Free brochure from NIMH - "Depression: What Every Woman Should Know"
• NIMH - Depression in Pregnancy and the Postpartum Period
• National Mental Health Association (NMHA)
• NMHA - Clinical Depression and Women
• NMHA - Depression Screening
• National Foundation for Depressive Illness, Inc.
• The National Alliance for the Mentally Ill - Helpline Fact Sheet: Women and Depression
• Clinical Depression Screening Test
• National Depressive and Manic-Depressive Association
• Intimacy & Depression - the silent epidemic
• About.com's page on Dysthymia
• Why Change the World . . . When You Can Have a Prozac Moment?
• Early Physical or Sexual Abuse and the Course of Bipolar Illness
• Depression in the Elderly
• HelpDepression.com - Common Symptoms of Depression
• Society for Women's Health Research
• Natural Remedies for Depression

¹Descriptions and attributions to depression of various mood disorders and psychological and physiological symptoms may be found in: American Psychiatric Association, 1994, Weissman & Beck, 1978, Sweeny, Anderson & Bailey, 1986, MacLeod and Matthews, 1991.
²"Depression, what you need to know." National Mental Health Association.
³According to the National Center for Health Statistics at the Centers for Disease Control and Prevention, untreated depression is the #1 cause of suicide.
⁴The Commonwealth Fund Survey on the Health of Adolescent Girls. The Commonwealth Fund, September 1997.
^{5"The Numbers Count: Mental Illness in America." National Institute of Mental Health (NIMH), 2001.
6}The National Alliance for the Mentally Ill, Fact Sheet (This fact sheet is based on an article written by Susan J. Blumenthal, M.D., M.P.A., Assistant Surgeon General, U.S. Department of Health and Human Services published in NAMI's The Decade of the Brain (Fall 1996, Volume VII, Issue 3)
⁷Ibid.
⁸Ibid.
⁹Ibid.
¹⁰Ibid.
¹¹Ibid.
¹²Ibid.
¹³Ibid.
¹⁴Ibid.
¹⁵Ibid.
¹⁶NAMI, Fact Sheet.
¹⁷Monica Oss et al. Managed Care Approaches and Models for the Treatment and Management of Depression: Specific Issues for Women. Prepared for presentation at the Jacobs Institute of Women's Health Symposium "Managed Care and Women's Mental Health: A Focus on Depression," December 5, 1997, Washington, DC. Forthcoming in Women's Health Issues 8(5); Sept./Oct. 1998
¹⁸Check out the list of symptoms at http://www.helpdepression.com/#top

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