Womenʼs Health Day Marsha McInnis, Family Member and President, NAMI Tri-Valley September 25, 2008
Introduc)on Depression Symptoms Depression Facts What Causes Higher Rate of Seeking Professional Help Helping Yourself Resources
Depression Symptoms Depressed or irritable mood most of the day nearly every day Loss of interest or pleasure in ac)vi)es (such as hobbies, work, sex, or being with friends) most of the day nearly every day A sudden change in weight (weight loss without die)ng, gaining more than 5% of body weight in 1 month) or a change in appe)te
Depression Symptoms Inability to sleep or sleeping too much nearly every day Agita)on or restlessness (observed by others) nearly every day Constant fa)gue or loss of energy nearly every day
Depression Symptoms Frequent feelings of worthlessness or inappropriate guilt nearly every day Difficulty concentra)ng or making decisions nearly every day Frequent thoughts of death or suicide (or a suicide apempt or plan)
Depression Facts 10 to 14 million people experience a clinical depression annually Women 18 45 yrs account for largest propor)on of this group Serious illness, can develop in anyone, regardless of race, culture, social class, age or gender Women more likely than men to experience depression
Depression Facts Depression is highly treatable, but frequently a life long condi)on in which periods of wellness alternate with recurrences of illness Sixty percent of depressed individuals will experience at least a second episode of depression. 75% to 80% will experience recurrent depression
Depression Facts Clinical depression affects two to three )mes as many women as men (U.S. and world) It is es)mated that one out of every eight women will suffer from clinical depression in her life)me. Women also experience higher rates of Seasonal Affec)ve Disorder (SAD) and dysthymia (chronic depression) than men.
What Causes Higher Rate of Combina)on of: Biological Gene)c Psychological and/or Social Factors
What Causes Higher Rate of Biological Factors Important links between mood changes and reproductive health events Gender differences rates of depression emerge when females enter puberty Remain throughout childbearing years into late middle age
What Causes Higher Rate of Biological Factors Hormonal factors seem to play a role in some of the mood disturbance Twenty to 40% of menstrua)ng women experience premenstrual mood and behavioral changes. Approximately 2 to 10 percent of women experience Premenstrual Dysphoric Disorder, a severe form of premenstrual syndrome that is characterized by severely impairing behavior and mood changes
What Causes Higher Rate of Biological Factors As many as 10% to 15% of women experience a clinical depression during pregnancy or a`er the birth of a baby appear to be the case There appears to be an increase in depression during the perimenopausal period, but a`er menopause, this does not appear to be the case
What Causes Higher Rate of Biological Factors Differences in thyroid func)on between men and women may also contribute to the gender difference in the prevalence of mood disorders Another biological factor that may contribute to gender differences in depression can be linked to circadian rhythm paperns, the complex system that regulates sleep and ac)vity over each 24 hour period
What Causes Higher Rate of What Causes Higher Rate of Biological Factors Depressed women report more hypersomnia (excessive sleeping) than do men Gender differences in the ac)vity of neurotransmipers including serotonin and the effects of estrogen on theses neurotransmipers may also be linked to the gender disparity in rates of depression
What Causes Higher Rate of Genetic Factors Some forms of depression run in families Depression also occurs in people who have no family history of the disease 25 percent rate of depression in the first degree rela)ves (mother, father, siblings) of people with depression and greater prevalence of the illness in first degree and second degree female rela)ves
What Causes Higher Rate of Genetic Factors Men and women from families with depression are both at greater risk than those who come from families with no depression
What Causes Higher Rate of Psychosocial Factors Psychosocial factors that may contribute to women s increased vulnerability to depression include: Stress of mul)ple work Family responsibili)es Sexual and physical abuse Sexual discrimina)on Lack of social supports Trauma)c life experiences Poverty
What Causes Higher Rate of Psychosocial Factors Several studies of depression among college students and within the Amish community of eastern Pennsylvania have shown no gender difference in the rates of depression, sugges)ng that greater social equality may lead to more equal rates of depression in men and women
What Causes Higher Rate of Psychosocial Factors Individuals with low self esteem, pessimis)c views, and tendencies towards stress are prone to clinical depression Sexual and physical abuse are major risk factors for depression Women are twice as likely as men to have experienced sexual abuse 3 out of 5 women diagnosed with depressive illness had been vic)ms of abuse 100% of women who experienced childhood sexual abuse developed depression later in life
What Causes Higher Rate of Does Pregnancy Influence Depression? Over 10% of pregnant women and approximately 15% of postpartum women experience depression Related hormonal and biological changes associated with pregnancy or giving birth may ini)ate a clinical depression As many as 80 percent of women experience the postpartum blues, a brief period of mood symptoms that is considered normal following childbirth
What Causes Higher Rate of Does Pregnancy Influence Depression? Changes in lifestyle associated with caring for a young infant may cons)tute a set of stressors that have mental health consequences for the mother Three fold increase in risk for depression during or following a pregnancy among women with a history of mood disorders Once a woman has experienced a postpartum depression, her risk of having another reaches 70 percent
What Causes Higher Rate of Does Pregnancy Influence Depression? One woman in a thousand experiences a postpartum psychosis a medical emergency in which the woman may inflict harm upon herself and/or her baby The first episode of bipolar disorder in women frequently occurs following the birth of a child
What Causes Higher Rate of Are There Gender Differences in the Course of a Depression? One large na)onal study completed about a decade ago found that there are no differences between men and women and major hos)lity Women specifically report more atypical symptoms including anxiety, soma)za)on (the physical expression of mental processes such as aches and pains with no physiological cause), increases in weight and appe)te, oversleeping, and expressed anger and hos)lity
What Causes Higher Rate of What Causes Higher Rate of Are There Gender Differences in the Response to Treatment of Depression? Psychotherapy Women and men appear to respond equally well to these to forms of depression specific Psychotherapy may be par)cularly useful for women pa)ents when they are trying to conceive, during pregnancy or while nursing because it allows the woman to avoid possible effects of the medica)on on the developing fetus or nursing infant
What Causes Higher Rate of Are There Gender Differences in the Response to Treatment of Depression? An)depressant Medica)ons There is no clear evidence of gender differences in the effec)veness of an)depressant medica)ons; although, women experience more adverse side effects than do men Selec)ve Serotonin Reuptake Inhibitors (SSRIs) such as Prozac, Zolo`, Paxil, Luvox and Lexapro have fewer side effects and have been found to be par)cularly useful and effec)ve in women pa)ents
What Causes Higher Rate of Are There Gender Differences in the Response to Treatment of Depression? Bright Light Therapy Bright light therapy has been used successfully for seasonal affec)ve disorder, but there is as yet no evidence that it is useful for other forms of depression
What Causes Higher Rate of Are There Gender Differences in the Response to Treatment of Depression? Alterna)ve Treatments Other treatments such as acupuncture and nutri)onal supplements (omega 3 fapy acids) may be helpful in specific circumstances. Women should always talk to their primary care provider or mental health specialist before beginning any treatment for their depressive symptoms. Together, they can choose most appropriate treatment for the specific kind of depression the woman is experiencing
Seeking Professional Help Many women avoid seeking professional help because they do not realize the benefits Some good reasons to seek help: Medical problem could be responsible for your condi)on Talking to a professional adds another layer of support Perhaps it s difficult to talk openly with family about what is bothering you You are not alone, other women feel the same as you
Seeking Professional Help Depression is Treatable Major depression is highly treatable 3 well established types of treatment for clinical depression: Medica)ons Psychotherapy Electroconvulsive Therapy (ECT) Medica)on and psychotherapy best combina)on Aerobic exercise for mild to moderate depression
Seeking Professional Help Medica)on Many types of an)depressants, newer kinds more popular because of fewer side effects and are safer 2 to 4 weeks for an)depressants to take effect 6 to 12 weeks for full effec)veness
Seeking Professional Help Psychotherapy Cogni)ve Behavioral Therapy (CBT) CBT helps to create a more effec)ve and beneficial behaviors by replacing nega)ve thought paperns with posi)ve ones Interpersonal Therapy (IPT) Focuses on improving one s personal rela)onships that may contribute to depression Taught to evaluate interac)ons with others to become aware of self isola)on and problems genng along with, rela)ng to, or understanding others
Seeking Professional Help Electroconvulsive Therapy (ECT) Highly effec)ve treatment for episodes of major depression Used only if medica)on, psychotherapy or combina)on of both are too slow to relieve severe symptoms When an)depressants can t be taken
Helping Yourself Here are some prac)cal things to manage stress and depression: Remember to take care of yourself Eat well, exercise, relax and get enough sleep Regular exercise and healthy diet have posi)ve effect on moods Some women find yoga relaxing and a stress reliever
Helping Yourself Here are some prac)cal things to manage stress and depression: Time management Developing realis)c expecta)ons of yourself Build a strong reliable support network Support groups
Resources Na)onal Alliance on Mental Illness (NAMI) www.nami.org NAMI California www.namicalifornia.org NAMI Tri Valley (Livermore, Pleasanton, Dublin) www.nami trivalley.org Depression Bipolar Support Alliance www.dbsalliance.org Na)onal Ins)tute of Mental Health www.nimh.nih.gov