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Depression in Women


Contrary to popular belief, clinical depression is not a “normal part of being a woman” nor is it a “female weakness.” Depressive illnesses are serious medical illnesses that affect more than 19 million American adults age 18 and over each year.[National Institute of Mental Health: “The Numbers Count: Mental Illness in America,” Science on Our Minds Fact Sheet Series. Accessed August 1999.] Depression is a treatable medical illness that can occur in any woman, at any time, and for various reasons regardless of age, race or income.

Prevalence
Approximately 12 million women in the United States experience clinical depression each year. [National Institute of Mental Health, Unpublished Epidemiological Catchment Area Analyses, (1999).] About one in every eight women can expect to develop clinical depression during their lifetime. Depression occurs most frequently in women aged 25 to 44. [National Institute of Mental Health: “Depression: Treat it. Defeat it.” Accessed June 1999.]

Contributing Factors
Many factors in women may contribute to depression, such as developmental, reproductive, hormonal, genetic and other biological differences (e.g. premenstrual syndrome, childbirth, infertility and menopause). [National Institute of Mental Health, D/ART Campaign: “Depression: What Every Woman Should Know,” (1995). Pub No. 95-3871.] Social factors may also lead to higher rates of clinical depression among women, including stress from work, family responsibilities, the roles and expectations of women and increased rates of sexual abuse and poverty.

Gender Differences
Women experience depression at roughly twice the rate of men. Girls 14-18 years of age have consistently higher rates of depression than boys in this age group. [Kandel DB, Davies M: “Epidemiology of Depressive Mood in Adolescents: An Empirical Study,” Archives of General Psychiatry 1982; 39:1205-1212.]

PMS/PMDD
Twenty to forty percent of women may experience premenstrual syndrome and an estimated 3 to 5 percent have symptoms severe enough to be classified as Premenstrual Dysphoric Disorder (PMDD). [National Institute of Mental Health. “Women Hold Up Half the Sky,” Updated June 1999.]

Marriage/Childbirth
Married people have a lower rate of depression than those living alone. However, unhappily married people have the highest rates of depression; happily married men have the lowest rates. Approximately 10%-15% of all new mothers get postpartum depression, which most frequently occurs within the first year after the birth of a child.[Seidman D: “Postpartum Psychiatric Illness: The Role of the Pediatrician,” Pediatrics in Review, 19 (1998):128-131.]

Co-occurring Illnesses
Research shows a strong relationship between eating disorders (anorexia and bulimia nervosa) and depression in women. [Willcox M, Stattler, DN: “The Relationship Between Disorders and Depression, ” The Journal of Social Psychology 1996; 136:269.] About 90-95% of cases of anorexia occur in young females. Reported rates of bulimia nervosa vary from one to three out of 100 people. Research shows that one out of three depressed people also suffers from some form of substance abuse or dependence. [National Institute of Mental Health: “Co-Occurrence of Depression with Medical, Psychiatric and Substance Abuse Disorders,” Accessed July 1999.]

Suicide
Although men are more likely than women to die by suicide, women report attempting suicide approximately twice as often as men.[Horton JA: “A Profile of Women’s Health in the United States,” The Women’s Health Data Book, 2nd ed., Jacobs Institute of Women’s Health, 1995.] An estimated 15 percent of people hospitalized for depression eventually take their own lives. [National Institute of Mental Health. “Helpful Facts About Depressive Illnesses,” (1994). Pub. No. 94-3875. Accessed June 1999.]

Treatment
Depression in women is misdiagnosed approximately 30 to 50 percent of the time. [McGrath E, Keita GP, Strickland BR, Russo NF: “Women and Depression: Risk Factors and Treatment Issues. Washington, DC, American Psychological Association, 1990.] Fewer than half of the women who experience clinical depression will ever seek care. [Rupp A, Gause E, Regier D: “Research Policy Implications of Cost-of-Illness Studies for Mental Disorders,” British Journal of Psychiatry Suppl 1998; 36:19-25.] Fortunately, clinical depression is a very treatable illness. More than 80 percent of people with depression can be treated successfully with medication, psychotherapy or a combination of both.

Women’s Attitudes Toward Depression:
According to a National Mental Health Association survey[National Mental Health Association, “American Attitudes about Clinical Depression and its Treatment,” (March 27, 1996).] on public attitudes and beliefs about clinical depression:
  • More than one-half of women believe it is “normal” for a woman to be depressed during menopause and that treatment is not necessary.
  • More than one-half of women believe depression is a “normal part of aging.”
  • More than one-half believe it is normal for a mother to feel depressed for at least two weeks after giving birth.
  • More than one-half of women cited denial as a barrier to treatment while 41% of women surveyed cited embarrassment or shame as barriers to treatment.
In general, over one-half of the women said they think they “know” more about depression than men do.

(The content of this fact sheet was adapted from material published by the National Mental Health Association).

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