Women and Depression

1
Women and Depression

• Depression mood disorder characterized by one
  or more major depressive episodes (gt2 wks)
• Accompanied by 5 or more additional symptoms
• Changes in sleep, appetite, weight
• Decreased energy
• Feelings or worthlessness or guilt
• Difficulty thinking, concentrating, making
  decisions
• Recurrent thoughts of death, suicide
• Dysthymia at least 2 yrs of depressed mood for
  more days than not, accompanied by addtl dep.
  symptoms

2
Women and Depression

• 17 million American adults affected
• Women are 2-4 times more likely to be affected by
  major dep.and dysthymia
• prevalence rates of depression for adult women
  are between 5-9 (vs. 2-3 for adult men)
• Results
• Impairment of social, physical functioning
• Precipitating factor in suicide
• Higher medical costs
• Greater disability
• Poor self-care gt greater morbidity, mortality
• Depression is treatable!

3
Risk factors for depression

• Low socioeconomic status
• Ethnicity
• Sexual, physical abuse
• Marriage! (for women only)
• Number of children

4
Recent study of depression in women

• lower mastery (lower sense of control)
• more chronic strain and rumination (chronically
  and passively thinking about feelings)
• Women carry a greater load of the housework,
  child care,more of strain of parenting
• women feel less appreciated by their partners

5
Biology of depression

• Mood related to levels of serotonin in the brain
• Low serotonin gt depression
• Neuronal mechanisms regulating serotonin levels
  in synapses
• Reuptake
• Monoamine oxidase (MAO)
• Antidepressants regulate these mechanisms

6
Antidepressants

• SSRIs selective serotonin reuptake inhibitors
• Examples Paxil, Prozac, Zoloft
• MAO inhibitors inhibit activity of degradative
  enzyme
• Examples Marplan, Nardil, Parnate
• Tricyclic antidepressants inhibit reuptake
  other effects
• Examples Pamelor, Norpramin

7
Treatment

• Focus on prevention!
• Most effective treatment psychotherapy plus
  antidepressant medication
• 70 of people respond to SSRIs
• Drugs have side effects (e.g., sexual
  dysfunction)
• Withdrawal must take place slowly!
• Safety during pregnancy, breastfeeding?

8
Estrogen effects

• Estrogen facilitates destruction of MAO
• Less MAO gt more serotonin
• Low estrogen gt more susceptible to depression?
• Postpartum depression

9
Assignment for Wednesday

• Read articles at the following web addresses
• http//www.cnn.com/2001/HEALTH/parenting/06/26/pos
  tpartum.depression/
• http//www.cnn.com/SPECIALS/2001/yates/
• Prepare three discussion questions to share with
  classmates.