HealthyCanada.com

Why are women so prone to depression? Some argue that the tendency of many women to attend to everyone's needs but their own is to blame. Others suggest that the gender gap exists because women are more willing to step forward and seek help - men with depression are simply uncounted. And some researchers are volleying around the notion that depression is more common among women because of their ebb and flow of estrogen.

All in our hormones?

The amount of the hormone estrogen in the brain rises and falls during a woman's monthly cycles, pregnancy and menopause. Estrogen levels affect serotonin levels, and serotonin is known to affect mood. (Serotonin is a neurotransmitter in the brain.)

The estrogen theory of depression coincides with the finding that girls are more prone to depression than boys only after puberty, when they begin menstruating and experiencing hormonal fluxes. It also may explain, in part, why a drop in mood can occur before the start of a woman's period. Estrogen levels are low before menstruation.

After a woman gives birth, she enters a high-risk period for depression, especially if she has already suffered a depression. Ten to 15 per cent of new mothers suffer from postpartum depression, which is thought to be triggered by post-birth hormonal fluctuations.

While the onset of depression for women is usually in their late-20s, depression peaks in women between the ages of 30 and 40. During menopause, estrogen levels drop so one would expect the incidence of depression to increase. But it doesn't. And this is where the estrogen theory crumbles. After age 50, there's a major decline in depression in women.

Depression is a syndrome

Clearly, there is no single cause for depression. Experts think a genetic vulnerability combined with environmental factors (such as stress or physical illness) may trigger a depression. At high risk for depression are people with a chronic illness such as heart disease, stroke, diabetes or cancer.

Social isolation can also trigger depression. It's a quick slide from sadness to depression if there's no one to catch you on your downward descent. Depression rates are higher among divorced people and those who live alone, and lower among married people.

While depression rates are very low for married men, married women who work outside the home while shouldering the bulk of parenting and household chores can suffer from depression. Also, women who stay home with the kids can be vulnerable to depression because of isolation and lack of support.

Not a weakness  

Only one in 10 people who have a depressive episode requiring treatment will get the help they need. Some women are ashamed of being unable to control their moods so try to hide the problem. Others don't admit to depression because they want to spare themselves and their family what they perceive as the stigma of mental illness. For others, the feelings of helplessness brought on by depression stops them from seeking treatment. They feel no one can help - but they can.

Help is available

The combination of counselling and antidepressants has helped many thousands of women with depression. Through talk therapy you discover how low self-esteem, being self-critical, pessimistic and easily overwhelmed by stress can make you vulnerable to depression.

Antidepressants are not "happy pills." They correct imbalances in the levels of neurotransmitters, such as serotonin, in the brain. Selective serotonin re-uptake inhibitors (SSRIs) include Prozac, Paxil and Zoloft. They work by preventing the reabsorption of serotonin in the nerve cells in the brain. Since the serotonin is more available, it initiates a series of physiological events that help lift the depression. SSRIs are non-addictive and non-tranquilizing. The side effects are generally mild but may include sexual dysfunction, weight gain, headaches, nausea and insomnia.

If you're depressed you may feel it's hopeless to reach out for help. You're wrong. Just about everybody with depression can be helped. Finding help can begin with a phone call to your family doctor to make an appointment to discuss your symptoms. If you feel unable to take this first step, ask a friend of family member to phone for you. You've won half the battle once you recognize that depression is not a weakness, it's an illness that can be treated.

For more information on depression, phone the Canadian Mental Health Association, Ontario Division, at 1-800-875-6213 or visit its website at www.ontario.cmha.ca; or phone the Mood Disorders Association of Ontario at 1-888-486-8236 or (416) 486-8046 or visit its website at www.mooddisorders.on.ca.