Women and Depression Overview

Approximately 21 million (or 1 in 7) adults in the United States suffer from some form of depression each year - more than cancer and heart disease combined. Depression is a very common, though often under-diagnosed and under-treated, illness of the brain. It affects people of every age, race and socioeconomic status – but women are nearly twice as likely to suffer from major depression then men.

Women and Depression

During times of reproductive transition, hormonal factors may contribute to the increased rate of depression in women – particularly such factors as menstrual cycle changes, premenstrual syndrome (PMS), pregnancy, miscarriage, postpartum period, perimenopause, and menopause. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and aging parents.

Many women are also particularly vulnerable after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. While transient “blues” are common in new mothers, a full-blown depressive episode is not a normal occurrence and requires active intervention.

Different Types of Depression

Depressive disorders come in different forms. Three of the most prevalent types of depressive disorders include the following:

• Major depression. A combination of symptoms (see symptom list below) that interfere with the ability to work, sleep, eat, and enjoy previously pleasurable activities. These disabling episodes of depression can occur once, twice, or several times in a lifetime.
• Dysthymia. Long-term, chronically depressed mood and other symptoms that are not as severe or extensive as those in major depression, but keep people from fully functioning or from feeling good. Sometimes, people with dysthymia also experience major depressive episodes.
• Bipolar disorder (manic-depression). A chronic, recurring condition that includes cycles of depression and hypomania or mania.

Within these types, there are variations in the number of symptoms, severity, and persistence.

Women and Depression Symptoms

The following are the most common symptoms of depression. However, each individual may experience symptoms differently. In general, nearly everyone suffering from depression has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable. If you have four or more of the following symptoms for longer than two weeks, it is recommended that you see a health care professional for help.

Symptoms of depression include:

• Noticeable change of appetite, with either significant weight loss not attributable to dieting or weight gain
• Noticeable change in sleeping patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
• Loss of interest and pleasure in activities formerly enjoyed
• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, pessimism
• Restlessness, irritability
• Decreased energy and fatigue
• Feelings of worthlessness
• Persistent feelings of hopelessness
• Feelings of inappropriate guilt
• Inability to concentrate or think, indecisiveness
• Recurring thoughts of death or suicide, wishing to die, or attempting suicide (Individuals with this symptom should receive treatment immediately)

Treatment for Depression

Specific treatment for depression will be determined by your health care provider based on:

• Your age, overall health, and medical history
• Extent of the depression
• Your tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disorder
• Your opinion or preference

Generally, based on the outcome of evaluations, depressive disorders are treated with medication or either psychotherapy or cognitive behavioral therapy, or a combination of medication and therapy.

You can also help yourself. Depressive disorders can make a person feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime, consider the following:

• Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
• Break large tasks into small ones, set some priorities, and do what you can as you can.
• Try to be with other people and to confide in someone you trust; it is usually better than being alone and secretive.
• Participate in activities that may make you feel better.
• Mild exercise, going to a movie, a ball game, or participating in religious, social, or other activities may help.
• Expect your mood to improve gradually, not immediately. Feeling better takes time.
• It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition - change jobs, get married or divorced--discuss it with others who know you well and have a more objective view of your situation.
• People rarely "snap out of" a depression. But they can feel a little better day-by-day.
• Remember, positive thinking will replace the negative thinking that is part of the depression and will improve as your depression responds to treatment.
• Let your family and friends help you.
• Limit use of alcohol and drugs. While some people feel that these can help in the moment, they can worsen symptoms of depression in the long run.

Care for Depression in Women at Brigham and Women's Hospital

The Depression Center within the Brigham and Women's Hospital Department of Psychiatry is a charter member of the National Network of Depression Centers. The Center provides complete care for people living with depression.

Working as a team, our psychiatrists, psychologists, and social workers provide a comprehensive assessment and care that is evidence-based and highly collaborative. We work closely with other experts within the Department and in other Brigham and Women's Hospital departments to ensure that depression and other disorders of mood are understood and addressed in the unique contexts in which they present.

The Division of Women's Mental Health is a broad and encompassing clinical division providing clinical services to women with mental health conditions including management of psychiatric disorders - such as depression - during reproductive life transitions. Our services help women experiencing:

• Psychiatric symptoms during pregnancy, as well as those planning pregnancy, and postpartum
• Reactions to infertility or pregnancy loss
• Premenstrual mood symptoms
• Psychiatric symptoms/emotional changes during the transition to menopause (perimenopause)
• Non-hormonal treatment of hot flashes associated with mood symptoms.
• Reactions to breast cancer, uterine cancer, hysterectomy or other gynecologic problems.

Patient- and Family-Centered Care

Brigham and Women's Hospital has long been committed to not only the care of our patients but also the many other needs that they and their families have. This philosophy of patient- and family-centered care involves systems and services that emphasize healing in a comfortable, relaxed environment.

Quality of Patient Care

Brigham and Women's Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our inpatient satisfaction survey, sent to patients' to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the quality of patient carewe provide and how we are measured compared with other hospitals.

Contact Us

If you believe you should have an evaluation and would like to schedule an appointment with one of our experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help connect you to the doctor that best meets the specialized care needs for women and depression, or fill out an online appointment request.