Depression in Women
By Allan R. Handysides and Peter N. Landless
My friend has a great husband and two lovely children, but I’m worried about her. She is so depressed. I try to urge her to pray more and to buck up, but she seems resistant to my efforts. What do you suggest?
Depression is very often disabling. There are millions of people who have lived lives in the dark shadow of a sense of sadness, a gloomy hopelessness, and often a feeling of inadequacy and worthlessness. While there are degrees of depression—and we all experience minor feelings of depression—there is a lifetime prevalence of a major depression disorder that affects 21.3 percent of women. This is almost double the prevalence in men (12.7 percent), and certainly is a cause for thought. Youngsters up to the age of 10 may also experience depression, though the gender difference is not apparent until the reproductive years. After menopause, women become less prone to depression.
Multiple factors are operative, and women are more susceptible to stress-induced depression than are men. They also are about four times more susceptible to seasonal affective depression than are men. The hormonal fluctuations of the reproductive years may well influence neurotransmitters in the brain, increasing vulnerability to depression.
Women in many societies do not enjoy equal status with men, and this discrimination could also play a role in depression. The demands placed upon women to produce children or to regulate family size means that they often carry disproportionate responsibilities and accountability for reproductive function. Infertility or a miscarriage may be viewed as a failure to fulfill their role. Oral contraceptives may carry a potential for depression in susceptible women. Hormonal factors may play a role in depression that is cyclical or in the postpartum state. Whatever the associated factors and contributors, a woman with depression deserves and requires serious and compassionate care.
Minor depressions will often respond to programs of exercise; dietary modification may also ease some of these situations. In cases related to depressive disorders, proper stress management can be helpful, as well as a balanced spiritual relationship with Jesus.
It is the major depressive disorders that need to be recognized as equally a disorder as more physical diseases such as diabetes or hepatitis. Ill-advised comments such as “pull yourself together” or “get a grip” are reflective of the ignorance of the one making them, and may induce further pain and depression.
“Health” promoters are often ignorant of pathophysiological mechanisms, and may use our health message as a cure-all.
Professional help is necessary in the case of a person with a major depressive illness. It is meddlesome and ill-advised for well-meaning but untrained “health reformers” to try to interfere in the life of a person with this disorder. Those of us who have lost friends or family members to this disease when they committed suicide well understand the torment such individuals experience. Even our religious judgments and pronouncements about what will happen in eternity to someone who commits suicide are a contravention of the command of Jesus to “judge not, that you be not judged” (Matt. 7:1).
A sweet, supportive spirit; a clear referral to appropriately trained experts; and the avoidance of condemnatory talk are important if we wish to be like Jesus.
We suggest you provide such support to your friend.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG,
is director of the General Conference Health Ministries Department.
Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C.,
is ICPA executive director and associate director of the Health Ministries Department.