Women and Depression: Causes, Symptoms, and Treatments

Introduction

Depression is among the most studied psychiatric disorders in the world. While it is known that every person will go through periods of mild, short-term depression — following a death, divorce, or similar loss — there is a growing number of individuals who are experiencing depression on a much more serious scale. Among the research findings is the notable observation that women suffer the condition at a much greater rate than men. Specifically, women suffer clinical depression at a significantly higher rate than men. Research has attempted to determine the causes, symptoms, and treatments for the condition, and there has been some success in this endeavor. In this paper, depression's causes, symptoms, and treatment modalities are examined as they apply to women as a group.

Throughout the world, depression is one of the leading disorders linked to healthcare visits according to the World Health Organization (Stoppard, 1999). The WHO projected that depression would become the second most expensive and prominent reason for healthcare visits by 2020 (Stoppard, 1999). This data is consistent with the increased prevalence of the disorder in many countries that have been treating the condition for decades. The incidence of depression appears to have increased substantially since the introduction of psychotropic medications designed to treat it. "The number of antidepressant prescriptions in Canada increased exponentially, from 3.2 million in 1981 to 14.5 million in 2000, and the percentage of persons treated for depression with antidepressants in the U.S. jumped from 37.3% in 1987 to 74.5% in 1997" (Hagen, Wong-Wylie & Pijl-Zieber, 2010). Those numbers have grown even larger in the decade since this data was collected.

Researchers tend to define depression in different ways depending on their specific research needs, which has led to some confusion when examining what the body of research actually says. "Depression can be considered as a state, trait, or a symptom that is secondary to a physical or physiological disorder. Second, it refers to a well-defined mood disorder that has behavioral, cognitive, and emotional symptoms" (Cirakoglu, Kokdemir & Demirutku, 2003). Which description the researcher uses is an important distinction when it comes to the variables that present themselves during a study.

One of these variables is gender. It is acknowledged that more women than men suffer from the condition, though the debate about the validity of this claim grows as more men seek treatment. In general, "major depressive disorder occurs in about 15% of the general population, with a lifetime prevalence of about 10%–25% in women" (Craig, 2009). This indicates that women are more likely to be diagnosed with major depression than men, while also showing that a significant portion of the general population will be diagnosed with major depression at any given time regardless of gender. In the United States, "more than 14 million people reportedly suffer from depression, with the majority of that group being women" (Hurt, 2007). Women may present a greater number of clinical symptoms, but this may be due to circumstances rather than a greater biological predisposition for the disorder.

Causes of Depression in Women

It may seem logical to discuss symptoms before causes, since symptoms are easier to delineate than the wide array of contributing causes. However, research has identified patterns in the causation of depression that are worth examining first. A closer look reveals that relatively few distinct causes apply across different circumstances, and that the underlying causation is often similar even when surface-level factors appear different.

The data collected regarding the causation of depression among women reflects the broader social roles women occupy. Women around the world bear greater responsibility for childcare and domestic duties than men, and this disparity has been studied as a contributing cause of depression. One group of researchers found that "gender differences surrounding problems like depression may be due in part to the fact that women generally carry a heavier burden of parental and domestic responsibilities, which can create a great deal of tension" (Hernandez, Aranda & Ramirez, 2009). This study was conducted with women in Mexico, but its findings can be extrapolated to the broader world population. In areas where women have not entered the workforce to any great extent, this cause of depression may appear more prominent; however, in industrialized countries where women both work outside the home and continue to perform the majority of household tasks, the incidence of depression can be even greater (Stoppard, 1999).

Another gender-related cause of depression is motherhood — particularly in relation to marital status. Researchers found that "mothers who are separated or divorced exhibit a higher incidence of depression and general anxiety than those who stay married. On the other hand, widows experience significantly more depressive symptoms than single or married mothers" (Hernandez, Aranda & Ramirez, 2009). These researchers identified that an increased level of stress due to childcare demands and financial difficulties was the primary driver among single mothers. In widowed women, this finding holds true as well: a widowed woman is more likely to be depressed due to financial worries than due to the death of her spouse alone (Hernandez, Aranda & Ramirez, 2009).

Financial difficulty is actually more prominent as a trigger in male sufferers, but stress as an overall underlying cause is greater among women. "A considerable body of research over the past several decades has found a consistent association between exposure to stressful life events and chronic stressors on the one hand and depressed mood or major depression on the other" (Grote, Bledsoe, Larkin, Lemay & Brown, 2007). Stress manifests in many forms, and while it is not the only cause of depression in women, women face stressors that men generally do not encounter. Nevertheless, some stressful life events that trigger major depression occur for both men and women.

For example, individuals who face chronic financial difficulties — those considered poor or low on the socioeconomic scale — are more likely to experience depression than those who are financially secure. This risk also appears to be tied to minority status. Researchers found that "poverty by itself, or the interaction of poverty and racial minority status, as well as exposure to acute and chronic stressors, constitute risk factors for depression. Poverty is predictive of increases in exposure to acute and chronic stressors and is related to a twofold risk of major depressive disorder" (Grote et al., 2007). Because people with little income face greater stressors in everyday life, they are more likely to exhibit symptoms consistent with major depression. That stress is compounded when a person does not belong to the dominant culture.

Body image is another issue for women that can generate significant stress and thereby contribute to depressive episodes. Research indicates that while this concern affects both men and women, it is considerably more pronounced in women. "Depression is an important contributing factor to the development of body image and shape dissatisfaction. It is well-known that overweight women are significantly more likely to experience depression than controls with a normal BMI" (Sides-Moore & Tochkov, 2011). A substantial body of research has examined this issue in response to the increased incidence of body-image-related disorders among adolescents and young women. Depression is a significant contributor to a young woman's preoccupation with appearing thinner, meaning that the development of bulimia or anorexia nervosa is substantially linked to depression (Sides-Moore & Tochkov, 2011).

Conclusion

The many causes of depression are less a direct guide to treatment selection than a person's symptoms, but causation remains a very important factor. A person cannot be said to be experiencing the disorder if it is entirely event-dictated and time-limited. The therapist or physician must carefully assess the cause before arriving at a diagnosis. In women especially, over-prescription of medications can be a significant problem. Other therapeutic approaches should be given serious consideration, given that depression is widely recognized as a major health issue for women.

References

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