Women are twice as likely as men to surfer from major depression. Between the onset of menstruation and menopause, monthly cycles keep changing the levels of the female hormones, estrogen and progesterone, which can affect how women feel. During the last few decades, there have been rapid social changes in women’s lives as well. Both the hormonal cycles and these social factors, acting together, give women a greater chance of becoming depressed.
Much has been written about the social changes in the lives of women in the last generation. Many women feel they have to measure up in a host of areas. To be a good mother, wife and daughter; a success at work; and attractive and slim, all at the same time, can be a bit much. Paradoxically, if your sense of worth comes from several roles at once, you are less likely to become depressed; setbacks in one area are often compensated for by success in another. Mothers who work are depressed less often than those who stay at home, probably because, when they are having difficulties in one role, they still get a sense of satisfaction from another in which they think they are doing well.
Depression looks a little different in women than in men. It usually begins in late adolescence. Irritability and anxiety are prominent symptoms, rather than sadness and guilt. Diffuse aches and pains, fatigue, and sleeping and eating disturbances may all be present. Stress and feelings of helplessness seem to aggravate the symptoms.
Let’s follow the monthly hormone cycle starting when the period begins. The estrogen level starts low, increases through the next few days, and gradually peaks just before the egg is released from its sac in the ovary, halfway through the month. The pituitary gland, in the brain, secretes follicle-stimulating hormone so that the ovary will develop a mature egg that can be released into the uterus for fertilization. The empty follicle in the ovary is stimulated by luteinizing hormone from the pituitary gland to produce progesterone, which thickens the lining of the uterus so the egg can implant itself if it’s fertilized. After ovulation, the estrogen level falls and the progesterone level rises. If the egg is not fertilized and implanted, the progesterone level drops abruptly, causing the lining of the uterus to break off and menstruation to begin.
The mood swings caused by these monthly hormonal changes can be unpredictable. Irritability and discomfort can be a problem whenever there is an imbalance of hormones, such as premenstrually, after childbirth, while using birth control pills, and just before menopause, when the ovaries no longer produce eggs and the cycles are less regular. Many women inherit a particular sensitivity to these hormone changes, and can even develop major depression. Upsetting and stressful events can aggravate this sensitivity.