What causes depression in women?

Everyone occasionally feels blue or sad, but these feelings are usually fleeting and pass within a couple of days.

When a woman has a depressive disorder, it interferes with daily life and normal functioning, and causes pain for both the woman with the disorder and those who care about her. Depression is a common but serious illness, and most who have it need treatment to get better.

Depression affects both men and women, but more women than men are likely to be diagnosed with depression in any given year.

Efforts to explain this difference are ongoing, as researchers explore certain factors (biological, social, etc.) that are unique to women.

What are the basic symptoms of depression?

Women with depressive illnesses do not all experience the same symptoms. In addi¬tion, the severity and frequency of symptoms, and how long they last, will vary depending on the individual and her particular illness.

Symptoms of depression include: Persistent sad, anxious or "empty" feelings.

Feelings of hopelessness and/or pessimism, rritability, restlessness, anxiety, feel¬ings of guilt, worthlessness and/or helplessness. Loss of interest in activities or hobbies once pleasurable, including sex.

Fatigue and decreased energy, difficulty concentrating, remembering details and making decisions. Insomnia, waking up during the night, or excessive sleeping.

Overeating, or appetite loss, thoughts of suicide, suicide attempts.

Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.

What causes depression in women? Scientists are examining many potential causes for and contributing factors to women's increased risk for depression. It is likely that genetic, biological, chemical, hormonal, environmental, psychological, and social factors all intersect to contribute to depression.

Genetics

If a woman has a family history of depression, she may be more at risk of developing the illness. However, this is not a hard and fast rule.

Depression can occur in women without family histories of depression, and women from families with a history of depression may not develop depression themselves.

Genetics research indicates that the risk for developing depression likely involves the combination of multiple genes with environ¬mental or other factors.

Chemicals and hormones

Brain chemistry appears to be a significant factor in depressive disorders. Modem brain- imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people suffering from depression look different than those of people without depression.

The parts of the brain responsible for regulating mood," thinking, sleep, appetite and behaviour don't appear to be functioning normally.

In addition, important neurotransmitters chemicals that brain cells use to communicate - appear to be out of balance. But these images do not reveal WHY the depression has occurred.

Scientists are also studying the influence of female hormones, which change throughout life. Researchers have shown that hormones directly affect the brain chemistry that con¬trols emotions and mood.

Specific times during a woman's life are of particular interest, including puberty; the times before menstrual periods; before, during, and just after pregnancy (postpartum); and just prior to and during menopause (peri-menopause).

Pre-menstrual dysphoric disorder

Some women may be susceptible to a severe form of pre-menstrual syndrome called pre-menstrual dysphoric disorder (PMDD).

Women affected by PMDD typically expe¬rience depression, anxiety, irritability and mood swings the week before menstruation, in such a way that interferes with their normal functioning.

Women with debilitating PMDD do not necessarily have unusual hormone changes, but they do have different responses to these changes. They may also have a history of other mood disorders and differences in brain chemistry that cause them to be more sensitive to menstruation-related hormone changes.

Scientists are exploring how the cyclical rise and fall of oestrogen and other hormones may affect the brain chemistry that is associated with depressive illness.

Postpartum depression

Women are particularly vulnerable to depression after giving birth, when hormonal and physical changes and the new responsibility of caring for a new-born can be over-whelming.

Many new mothers experience a brief episode of mild mood changes known as the "baby blues," but some will suffer from postpartum depression, a much more serious condition that requires active treatment and emotional support for the new mother.

One study found that postpartum women are at an increased risk for several mental disorders, including depression, for several months after childbirth.

Some studies suggest that women who experience postpartum depression often have had prior depressive episodes.

Some experience it during their pregnancies, but it often goes undetected. Research suggests that visits to the doctor may be good opportunities for screening for depression both during pregnancy and in the postpartum period.

Menopause

Hormonal changes increase during the transition between premenopause to menopause. While some women may transition into menopause without any problems with mood, others experience an increased risk for depression. This seems to occur even among women without a history of depression. However, depression becomes less com¬mon for women during the post-menopause period.

Stress

Stressful life events such as trauma, loss of a loved one, a difficult relationship or any stressful situation - whether welcome or unwelcome - often occur before a depressive episode. Additional work and home responsi¬bilities, caring for children and ageing parents, abuse, and poverty also may trigger a depres¬sive episode.

Evidence suggests that women respond differently than men to these events, making them more prone to depression. In fact, research indicates that women respond in such a way that prolongs their feelings of stress more so than men, increasing the risk for depression.

However, it is unclear why some women faced with enormous challenges develop depression, and some with similar challenges do not.