Depression doesn’t discriminate; it can affect anyone and everyone. But unfortunately, if you’re a woman, you’re at higher risk for developing depression: approximately twice as many women are diagnosed with depression as men.
The numbers are sobering — but why is this happening? So far, scientists haven’t found one specific gene or reason we can point to and say, that’s what causes depression. Experts think that depression is caused by a combination of different factors. When thinking about women and depression specifically, it’s important to consider not only what causes depression, but also what, specifically, causes women to experience higher rates of depression than men.
There is a growing base of scientific evidence that links depression to a whole host of biological changes in the brain. In many cases, depression can be associated with loss of brain gray matter (or brain shrinkage) Additionally, our brains also don’t release the appropriate balance of certain neurotransmitters, like serotonin and dopamine, when we’re sick with depression.
People with female reproductive organs also have an additional biological factor that may lead to depression: hormonal changes. Depression can be caused by changes that happen during a woman’s life, like pregnancy, menstruation, and menopause. We’ll talk more about these specific types of depression in the next section.
Research also indicates that depression almost certainly has a genetic component to it. Through studies of identical twins, scientists have found the heritability of major depressive disorder is likely around 40 to 50 percent. The likelihood of having inherited depression may be even higher for people who have severe depression.
Research shows that environmental stressors also play a large role in the development of depression for most people. This is another area where women face unique risk factors that can lead to depression.
Drugs and alcohol have an interesting, two-directional relationship. People who are depressed are more likely to start using drugs and alcohol to self-medicate. But the opposite is also true: people who have a substance use disorder are more likely to be diagnosed with depression. Alcohol, in particular, is a depressant drug, and can cause depression or make depression symptoms worse when they’re already present.
Women today face intense scrutiny in both the workplace and at home. Not only are they expected to be successful in their careers, but they also continue to take on a majority of child-rearing and housekeeping responsibilities for their families. As if that weren’t enough, women still face enormous inequality in pay and other opportunities. The stress that comes along with this type of institutional sexism can definitely put women at higher risk for depression.
Trauma and loss can happen to anybody, but women are at high risk for a particular kind of trauma. Women around the world are still often victims of gender-based violence and femicide. The numbers are terrifying: 1 in 5 women will be raped in her lifetime, and 1 in 7 women have been seriously injured by an intimate partner (compared to 1 in 25 men). Of the murder-suicides that involve an intimate partner, 94 percent of the victims are female.
With these kinds of experiences, it’s no shock that women experience higher rates of Post-Traumatic Stress Disorder (PTSD) than men. Traumatic experiences can put women at high risk for depression, as well.
Certain chronic illnesses have been linked to depression in people of every gender, and it isn’t hard to understand why. Life with chronic pain or illness is difficult, and the constant medical stress and pain can lead to feelings of hopelessness and helplessness.
The start of the pandemic has only made women more at risk for depression. Many women are now finding themselves working full-time from home while balancing being a teacher and daycare for their kids. All of this, of course, on top of all of the former responsibilities women already carried at work and for their families — it isn’t hard to understand why women are at such high risk for depression.
If women were stressed before, then they’re even more so now since the pandemic started. Emerging research about the mental effects of Covid has shown us that women have started drinking more alcohol during the pandemic than any other group. Not to mention the rates of mental illness (like depression and anxiety) for everyone has shot through the roof.
Although only a qualified mental health professional can diagnose you with depression, it helps to know what to look out for so that you can determine if your feelings of sadness are a healthy reaction to stress or if they signify depression. Here, we’ll talk about the symptoms of major depressive disorder as well as other signs to look out for as a woman.
All of us might feel “depressed” from time to time, especially after a big loss or sad event in our lives. However, what differentiates clinical depression is that it’s bigger than a feeling — it’s a diagnosable illness. The Diagnostic Statistical Manual Fifth Edition (DSM-V) lists the following symptoms of depressive disorders. Ask yourself — have you experienced:
If you said yes to these questions, you may be experiencing clinical depression. The severity of depression depends on how many of these symptoms you’re facing, and to what degree.
Depression is depression, and there are no separate diagnostic criteria that only apply to women. However, depression can show up differently in women vs. men.
Women with depression are more likely than their male counterparts to:
It’s important to note, though, that depression in women isn’t an entirely different disease than depression in men. Although research has shown that women do tend to experience these things at a higher rate than men, that doesn’t mean that you, as a woman, will necessarily have symptoms like hypersomnia or somatic symptoms if you’re depressed.
When we talk about “depression”, we’re mostly referring to major depressive disorder, the most commonly diagnosed type of depression. However, other types of depressive disorders do exist, as well as different forms of major depressive disorder. Here are some different types of depression that women experience.
Major Depressive Disorder is the official name for what we usually refer to as “clinical depression”. It means that you’ve had the above symptoms of depression for weeks, and they’re seriously interfering with your life.
Persistent depression, or chronic depression, doesn’t go away. Some people experience one depressive episode, and never feel depressed again. Some people experience a chronic depressive disorder that doesn’t go away for a long time, maybe even years.
Depressive episodes are on one of the “poles” of bipolar disorder. Bipolar disorder causes people to experience extreme mood swings: on one end of the pendulum, they can experience mania, which is a feeling of elation, recklessness, and grandiosity. On the opposite, low end of bipolar disorder is depression, which looks like a major depressive episode.
For some people, depression is caused by a change in the seasons or weather. Although we typically associate seasonal affective disorder with the “winter blues”, you can also experience depression in the summer as well.
A depressive episode, when it’s very intense, can come with psychotic features like delusional thinking or auditory and visual hallucinations. These types of symptoms are usually associated with psychotic disorders like schizophrenia, but are sometimes linked only to a person’s depression, even though they don’t have a separate psychotic disorder.
Atypical depression just refers to someone with major depressive disorder that doesn’t experience standard symptoms of depression. For example, they might temporarily feel better when there’s something good in their lives, instead of facing a perpetual depressed mood.
In addition to these types of depression, which can affect anyone, there are also three types of depressive disorders that are specific to women or other people with uteruses. These are:
Up to 1 in 5 women experience peripartum depression either during pregnancy or after giving birth. Unfortunately, this fact is still stigmatized and many women just aren’t talking about it. Some of the most common symptoms of peripartum or postpartum depression are not feeling like you’re bonding with your baby, feeling like a bad parent, and other symptoms that are shared with major depressive disorder.
As women, most of us are familiar with feeling irritable or emotional when we’re about to get our period. However, for some women, PMS can turn into something more intense. Premenstrual dysphoric disorder, or PDD, is diagnosed when people experience the above symptoms of depression, but only during certain times in their menstrual cycles.
Menopause is another period in life when women face a higher risk of depression. The hormonal changes that come during menopause have been associated with symptoms of depression like sad mood and irritability. Although most women don’t experience perimenopausal depression, it’s more common than you’d expect: around 40 percent of women experience symptoms of depression during menopause.
Depression is a serious illness, but the good news is that it’s also a treatable one. With the right treatment, you can recover from depression and start living the life that’s waiting for you.
Research has shown us that the most effective treatment plan for depression usually includes a combination of psychotherapy and psychiatric medication. For treatment-resistant depression, which just refers to depression symptoms that don’t go away with this standard treatment (therapy and medication), alternative techniques like brain stimulation therapies can be used.
Usually, the first-line treatment for women who are experiencing depression is some form of talk therapy. Some of the evidence-based therapy techniques that have been proven to be effective for women and depression are:
CBT is the most commonly used treatment method to help women recover from depression. CBT is based on the theory that our thoughts, feelings, and behaviors are interconnected. When you’re depressed, you have strong feelings of sadness, hopelessness, and maybe even anger. CBT teaches women that usually, those feelings are caused by irrational and untrue thoughts.
During CBT treatment, your therapist will help you to challenge those irrational thoughts and replace them with ones that are more logical and helpful. When you learn how to not believe everything you think, then your feelings of depression will get better and better.
DBT was originally created to treat Borderline Personality Disorder. But since its inception, research has been conducted that proves it’s also helpful for women experiencing depression. DBT teaches people important skills for regulating their emotions and improving their relationships. Some of its main concepts include radical acceptance, distress tolerance, and mindfulness.
DBT has the added virtue of having been created by a psychologist who is a woman herself. Dr. Marsha Linehann suffers from Borderline Personality Disorder, and created DBT to help meet the needs of women, like herself, and other people suffering from mental illness.
ACT is a mindfulness-based treatment method that teaches people to accept their difficult feelings instead of constantly fighting against them. It combines mindfulness techniques with behavioral therapy to help people commit to making necessary changes in their lives instead of just fighting against the discomfort of whatever’s going on in the moment.
Dr. Jon Kabat-Zinn created Mindfulness-Based Stress Reduction in the 1970s. Dr. Kabat-Zinn studied under Zen teachers like Thich Nhat Hanh; he personally experienced the mental health benefits of meditation and mindfulness, and wanted to help other people with these techniques, too.
MBSR uses mindfulness-based techniques to teach people how to be more present in their everyday lives, even the hard parts like depression. It uses a combination of yoga, cognitive therapy, and sitting meditation to help people learn how to manage their stress in a healthy way. Especially for women who are suffering from comorbid depression and anxiety, this is an incredibly effective technique.
Medication is another tool that’s used in conjunction with talk therapy to treat depression. There are many medications approved for the treatment of depression, here’s a short list:
Women need to consider pregnancy and breastfeeding before starting to take any medication. Many antidepressants are safe during pregnancy and breastfeeding, but some may be discouraged. Tell your doctor if you’re pregnant or planning on getting pregnant.
When the combination of psychiatric medications and first-line talk therapy methods don’t work (or cause too many side effects), other alternative treatments may be considered. The following alternative treatments have some promising research about their effectiveness for treating depression symptoms.
TMS therapy uses electromagnetic coils to deliver stimulation to certain areas of the brain. TMS is a non-invasive procedure that is safe and well-tolerated by most people. Additionally, it’s been shown to be very effective for people who experience treatment-resistant depression. Which means that traditional treatments like talk therapy or medication aren’t providing relief.
EMDR was originally designed to treat PTSD, but new research has shown that it can be effective for depression, as well. In EMDR treatment, the therapist guides your eyes in specific bilateral movements that are thought to access deep parts of your memory and brain.
Electroconvulsive therapy delivers electric shocks to certain parts of the brain to stimulate neuronal activity. ECT is similar in concept to TMS therapy. There is a small risk of seizure associated with ECT, but overall it’s been found to be an effective treatment.
Experiential therapies include treatments like art therapy, drama therapy, music therapy, yoga therapy, adventure or wilderness therapy, and animal-assisted therapy. The research on these techniques is still lacking, but people have reported experiencing benefits in their depression symptoms after receiving a type of experiential therapy. It may be worth a try if other, more evidence-based treatments haven’t worked for you.
If you think you may have depression, it’s important that you talk to a licensed mental health professional as soon as possible. Depression is treatable, but it’s unlikely to go away on its own. To get treatment for your depression, follow this plan:
The first step is to begin your therapist search. Consider their license type (only psychiatrists with a medical license can prescribe medication) as well as their costs and insurance policies. You may also have other requirements, like wanting to work with a woman, a transgender woman, or a woman of color.
Call or e-mail the therapist and ask to schedule an assessment. Some therapists conduct free consultations over the phone, and some may ask you to make an appointment to come in. In the assessment, the therapist will ask you questions to get to know you. They want to know your symptoms, previous treatment and goals for current treatment.
Your first contact with the therapist is a chance for you to ask questions, as well. Not all therapists are created equal, and it’s important that you ask questions to figure out if this is who you want to work with. You might ask, for example, about their experience working with women, their views on feminism, and what specific therapy methods they use to treat depression.
Feel free to consult with several different therapists to see what options are available to you. Consider the different factors that are important to you when choosing a therapist, like availability, what insurance plans they accept, and whether or not you get a good “vibe” from them.
Lastly, try therapy out with the person you chose. Sometimes, the relationship between a therapist and client doesn’t work out — but we recommend you give it at least 1 to 3 months before deciding to change therapists. Therapeutic rapport can take a while to build. Make sure you take care of yourself between sessions, too, by eating well, exercising, and implementing a regular relaxation practice.
Life as a woman is hard enough, and depression only makes it harder. You are beautiful, valuable, and deserve to live a life that’s free of depression. It takes courage to admit to yourself that you’re struggling. If you’re ready to get started with therapy, contact us today to learn more.
Get our FREE Workbook that we published last month – Depression Issue
National Institute on Mental Health: Depression in Women
Mental Health America: Depression in Women
Anxiety and Depression Association of America: Types of Therapy
Center for Disease Control and Prevention: Depression Among Women