Women are two times more likely to develop depression than are men. According to the National Comorbidity Survey, 20.2 percent of women will experience an episode of major depression some time in their lives.

Why is depression more common in women than in men?

One reason may be the changes in female hormone levels. These changes occur during pregnancy and menopause, after giving birth, and after a miscarriage or a hysterectomy. Premenstrual syndrome (PMS)—the symptoms that occur one week prior to menstruation— may also contribute to or mask the symptoms of depression. Of those experiencing PMS, 3 to 8 percent develop PMDD, a more serious form of the condition.

According to the National Institutes of Health, several factors unique to women are suspected of contributing to higher rates of depression. These include reproductive, genetic, or other biological aspects. Interpersonal factors and certain psychological and personality characteristics also play a role. Stress increases when women try to balance a home and career. It is important to talk to your doctor about the risk factors of getting depression and the physical or emotional changes you are experiencing.

PREMENSTRUAL SYNDROME (PMS) AND PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

Up to 80 percent of menstruating women experience some symptoms of premenstrual syndrome (PMS). PMS is characterized by emotional and physical symptoms that fluctuate in intensity from one menstrual cycle to the next. It usually affects women in their 20s or 30s.

Premenstrual dysphoric disorder (PMDD) is a severe form of PMS. PMDD is characterized by intense irritability, low mood, apathy, fatigue, and physical symptoms that usually are more severe seven to 10 days prior to the onset of menstruation.

PMS, PMDD, and depression

In the last decade, fluctuations in hormone levels have become recognized as important causes of discomfort and behavioral changes for women. Because symptoms may contribute to or be masked by those of PMS and PMDD, women with severe PMS and PMDD occasionally have undiagnosed depression. Although the precise link between PMS, PMDD, and depression is still unknown, chemical changes in the brain and fluctuating hormone levels are both thought to be contributing factors.

Treating PMS and PMDD

Many women gain relief from their symptoms by seeking education regarding their symptoms, and making lifestyle changes that include adding exercise, vitamins, and a caffeine-free diet to their regimen. For those with severe symptoms, medication, individual and group psychotherapy, stress management, or marital therapy can be helpful in managing some of the stresses and conflicts that women experience.

POSTPARTUM DEPRESSION

Postpartum depression is a complex mix of physical, emotional, and behavioral changes that occur after giving birth. These changes are attributed to the chemical, social, and psychological changes associated with having a baby.

Who is affected by postpartum depression?

Up to 80 percent of new mothers experience the “baby blues” after delivery. About 20 percent of these women will develop more lasting depression after delivery. One in 1,000 women develops the more serious condition, postpartum psychosis.

Types of postpartum disorders include:

  • Postpartum blues
  • Postpartum depression
  • Postpartum obsessive-compulsive disorder (OCD)
  • Postpartum psychosis

What causes postpartum depression?

More research is needed to determine the link between depression and the fast drop in hormones after delivery. The levels of estrogen and progesterone, the female reproductive hormones, increase 10-fold during pregnancy but drop sharply after delivery. In addition to these chemical changes, the social and psychological changes associated with having a baby create an increased risk of postpartum depression.

How is postpartum depression treated?

Postpartum depression is treated differently for each woman depending on the type and severity of symptoms. Treatment options include anti-anxiety or antidepressant medications, psychotherapy, participation in a support group, and education.

When should a new mom seek professional medical treatment?

A new mom should seek professional help when:

  • Symptoms persist beyond two weeks
  • She is unable to function as usual; she can’t cope with everyday situations
  • She has thoughts of harming herself or her baby
  • She is feeling extremely anxious, scared, and panicked most of the day

PERIMENOPAUSE AND MENOPAUSE

What is perimenopause?

Perimenopause is the stage of a woman’s reproductive life that begins eight to 10 years before menopause, when the ovaries gradually produce less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the decrease in estrogen accelerates. At this stage, many women experience menopause symptoms.

What is menopause?

Menopause is the period of time when a woman stops having her monthly period and experiences symptoms related to the lack of estrogen production. By definition, a woman is in menopause after her periods have stopped for one year. It is a normal part of aging and marks the end of a woman’s reproductive years. Menopause typically occurs in a woman’s mid-40s to mid-50s. However, women who have their ovaries surgically removed undergo “sudden” menopause.

The drop in estrogen levels during perimenopause and menopause triggers physical as well as emotional changes within the body. Like any other point in a woman’s life, there is a relationship between hormone levels and physical as well as emotional symptoms. Some physical changes include irregular or skipped periods, heavier or lighter periods, and hot flashes.

Can menopause be a positive time of life?

Most certainly, menopause can be a positive time of life. Too often, myths foster errors about this normal process of aging. Although menopause can cause some noticeable and uncomfortable changes, these can be effectively managed. Menopause also does not harm a woman’s overall mental health. Many times, long-term emotional problems are related to other factors, such as stresses at work or home.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/23/2015…#9308