Depression Hurts - Healthy Living on Shine

Nobody--not even Kelly Ripa--is cheerful all the time. If you can't shake the blues, here's what you need to know.

Depression disproportionately affects women. According to the National Institute of Mental Health, women experience double the rate of clinical or "major" depression--depression that isn't a temporary state caused by life events such as a death or divorce--than men do. An estimated 12 million women a year experience it, and one in eight women in their lifetime will suffer from it. Notably, many experts put that number closer to one in four.

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Why are women at such a high risk? "There's no one trigger, but we believe hormones can play a role, as can genetic predisposition," says Roselyn Watkins, Ph.D., supervising psychologist at Friends Hospital in Philadelphia. Watkins notes that societal expectations have an impact as well. "Women are expected to be perfect wives, great moms and flawless workers, and to appear young and beautiful at all times too. That pressure can contribute to depression."

One landmark study from the 1970s found that nearly half of women physicians and 73% of women Ph.Ds had experienced depression, while another 1999 study of female physicians conducted by Emory University in Atlanta found that some 20% were depressed. A 2007 study from British researchers found that workers (male or female) with high levels of job stress are twice as likely to develop depression as those with low levels of career-related stress.

But those figures don't only reflect the professional and highly educated. More women, including women of color, are likely to work second or third shifts, head single-parent households and have sub-prime mortgages. They might feel guilty about their depression or simply not have time for it and push the blues to the mental back burner.

Even in an age where sexual dysfunction and menstrual cycles are all brunch fodder, depression unfortunately remains a taboo topic--which may explain why surveys show that fewer than half of women who experience depression seek help. That shouldn't be the case, insists Charles Conway, M.D., associate professor of psychiatry at Washington University School of Medicine in St. Louis. "I tell patients to think of depression as a stress reaction. It is not a weakness in character or a defect; it's simply a [physical response]." He adds, "You should absolutely not avoid getting help because of a stigma surrounding depression. There are so many treatments that are proven effective and very safe. [Plus] quite a few studies now suggest that it's dangerous for your brain to be in that state.

In fact, untreated depression can be devastating. A recent Finnish study reveals that depressed people are twice as likely to develop metabolic syndrome, a condition that can lead to heart disease and diabetes--which may help explain why depression also increases the risk of both conditions. Research shows that women who are depressed are more likely to have eating disorders or to gain weight. Of course, depression can also cause relationship rifts, hurt your performance at work and sap your libido--all of which can make your blues even worse.

If you're feeling depressed, the last thing you should do is wait it out in the hopes that you'll suddenly feel better. "It's dangerous to pretend it isn't a big deal, especially if you've been feeling blue for more than two weeks," says Stacey Rosenfeld, Ph.D., a clinical psychologist in private practice in New York City who is also a staff psychologist at Columbia University Medical Center. Notably, depression isn't just about sadness, and in fact many symptoms, such as feelings of irritation and frustration, are overlooked.

Other oft-ignored signs include sleeping and eating more or less than usual, avoiding being around others, diminished or nonexistent sex drive and reoccurring thoughts of suicide. ''If you can't feel good, and the things that you used to do to make yourself feel better or that brightened your mood, like going out for a walk or seeing a friend, don't do the trick anymore, see a therapist or your doctor," urges Watkins.

Studies suggest that more than half of women who undergo treatment, and stick with it, will get significant relief. Talk therapy, a.k.a. psychotherapy, is still considered a gold standard of depression treatment and is especially helpful for milder forms of depression; it even appears to help reduce the incidence of further depressive episodes. Women with major depression should consider talking to their doctor or psychiatrist about antidepressants, either alone or in conjunction with psychotherapy. "Studies show that a combination of antidepressants and talk therapy is especially effective for treating moderate to severe depression, and in a perfect world, every patient would have access to both," says Dr. Conway.

And although this advice extends to all women, if you're depressed, it's especially important to take care of yourself. "Stay active and exercise as much as you can, and get adequate sleep," recommends Rosenfeld. "Seek social support and find people who make you feel good." She also strongly advises delegating. "Don't try to be superwoman; it's not a failure to say, 'I can't do this.' Take on what you can, and let the rest go."

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