Educationals

Life is full of emotional ups and downs. But when the "down" times are long lasting or interfere with an individual's ability to function, that person may be suffering from a serious, common illness-depression.

Women are disproportionately affected by depression experiencing it at roughly twice the rate as men. They have been considered to be predisposed by a number of different factors. Their predominant cultural situation, where men are more likely to be in positions of power and women in positions of subservience, results in reduced educational and occupational opportunity and leads to frustration. As a result, women are also often financially dependent on males. Societal values often stress the importance of females feeling the need to please others. There are also social inhibitions on their expression of anger. Women may be subject to role overload, with multiple and competing roles, e.g. partner, mother and housewife, as well as holding a job in the community.Sex role stereotypes make lifestyle transitions such as marriage and parenthood of a different importance for women than men. Her self-esteem is more likely to be related to career achievement. A female positive identity is thus more contingent on her relationships.

Women are also more willing to express emotional difficulties, seek psychiatric help and take psychotropic medication. Men may be more prone under stress to abuse alcohol and drugs and to reduce feelings of tension by antisocial, including violent, behaviour. When a male becomes depressed, for instance, he may take time off work and be looked after at home by his wife or partner. A woman with children who becomes depressed may have no such place to retreat. Women are also more likely to experience physical violence of sexual abuse, both in childhood and adulthood. Such victimisation may predispose women to subsequent depression.

Females are also subject to psychological and biological changes associated with their reproductive system. Psychiatric disorders frequently have biopsychosocial etiology and men and women are different in this respect. This may be reflected in differential prevalence of depression.

Epidemiology

It is difficult to estimate the exact prevalence of depression. However recent studies have estimated about 30 million people in India suffer from depression. As in other countries, the incidence of depression in India is 5% with females being affected twice as commonly. Future predictions made by a study by WHO estimate that depression will be the second most common lines in the world and India too by 2002. This study of Global Burden of Disease also predicts that women will be much more affected than men will. The age of onset is usually middle age, but can occur earlier and may be delayed up to late adulthood too. To grasp the specifics of depression in women, it is essential to have a broad understanding of the illness itself. There are three types of depression

To have a broad understanding of the illness itself. There are three types of depression.

1. Major depression

Also known as unipolar or clinical depression, people have some or all of the symptoms for at least two weeks or as long as several months or even longer. Episodes of the illness can occur once, twice, or several times in a lifetime.

Symptoms

• Persistent sad, anxious, or "empty" mood
• Loss of interest or pleasure in activities, including sex
• Restlessness, irritability, or excessive crying
• Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
• Sleeping too much or too little, early morning awakening
• Appetite and/or weight loss or overeating or weight gain
• Decreased energy, fatigue, feeling "slowed down"
• Difficulty in concentrating, remembering or making decisions
• Persistent physical symptoms that do not respond to treatment such, as headaches, digestive disorders, and chronic pain
• Thoughts of death or suicide, or suicide attempts

2. Dysthymia

In dysthymia, the same symptoms are present though milder, but lasting at least two years. People with dysthymia also can experience major depressive episodes, which is called "double depression".

3. Manic-depression or bipolar disorder

It involves disruptive cycles of depressive symptoms that alternate with euphoria, irritability, excitement or mania. Men and women have about the same rate of bipolar disorder though its course in women typically has more depressive and fewer manic episodes. Also, a great number of women have the rapid cycling form of this disorder, which may be more resistant to standard treatments.