Depression
Depression is a state of despondency, with symptoms such as fatigue, difficulty sleeping, and a loss of interest in everyday activity. Women are twice as likely as men to suffer from depression; 20 to 25 percent of women will experience a serious depressive episode at least once in their lives. Anxiety and depression seem to go hand in hand; research has shown that people with a major depressive episode are much more likely to suffer from an anxiety disorder, such as GAD.
Fact
In people with major depression, 85 percent also have generalized anxiety disorder, 35 percent have panic disorder, and 60 percent have feelings of anxiety.
Depression has many causes, including biology and external circumstances. For example, a family history or a medical condition may predispose a person to clinical depression, but events such as grief, job loss, divorce, living with chronic pain, and financial problems can also prompt depressive episodes. From a biological perspective, most experts believe depression is caused by low levels of the neurotransmitter serotonin.
Some common depression risk factors in women include:
A family history of mood disorders
Personal past history of mood disorders
Using an oral contraceptive, especially one with high progesterone content
Lower socioeconomic status
Loss of a parent before age ten
Sexual and physical abuse
Using gonadotropin stimulants as part of infertility treatment
Psychosocial stressors, such as job loss
Losing a social support system, or the threat of such a loss
Being a non-Caucasian woman
Having financial problems
Marital status (women in unhappy marriages, or who are separated or divorced)
Having young children
The
Depressed mood
Feelings of hopelessness and worthlessness
Suddenly feeling sad or tearful, with increased sensitivity personal rejection
Decreased interest in usual activities
Lethargy or fatigue
Marked lack of energy
Depression and anxiety exacerbate each other. A person suffers from both depression and anxiety will have more symptoms than if he or she had each of the disorders separately.
Alert
Depression and anxiety are risk factors for high blood pressure. Researchers from the Centers for Disease Control and Prevention followed more than 3,300 adults from the 1970s through 1990s and found that adults (both male and female) with anxiety depression had the highest odds of being treated for hypertension.
Treatments for Depression
Treatment for depression depends on how severe the illness is, ranging from self-help to drug therapy, psychotherapy, and even electroconvulsive therapy.
Drug therapies may include antidepressants such as SSRIs (selective serotonin reuptake inhibitors) or TCAs (tricyclic antidepressants), antipsychotic, and antianxiety medications. Therapy includes psychotherapy, light therapy, or electroconvulsive therapy (electric shock). Other options for people suffering from depression, promoted by alternative medical practitioners, include herbal treatment, exercise, and meditation, even aromatherapy, vitamins, and diet changes. (Chapters 3, 4, and 11 provide more information on depression, its connections to PMS, and treatment.)
Vagal Nerve Stimulation
Vagal nerve stimulation is used to help people whose depression resists other treatments. Doctors implant a small pacemaker in the brain, which sends tiny electrical pulses into the brain. First used on epileptic patients to eliminate seizures, the pacemakers also improved depressive symptoms. In a study of thirty patients conducted by John Rush, MD, at the University of Texas Southwestern Medical Center at Dallas, 40 percent showed a substantial decrease in depressive symptoms and 17 percent went into complete remission. However, this treatment remains controversial and a number of scientists question both the safety and effectiveness of the device used in this treatment.
