Dan's Papers - June 27, 2008 - Inspirations by Emily J. Weitz

It's nearly the Fourth of July, a time for fun and relaxation. But don't let depression ruin your plans for the holiday.

The truth is, depression is a chemical imbalance that occurs in 9.5% of the US adult population each year. It can range from very mild to extremely severe. And the occurrence of major depression is about two times higher for women than men. This gap begins in early adolescence and persists through middle age.

Since one of the major causes of depression is hormonal fluctuation, it makes sense that women are more susceptible to it during their childbearing years. Every month our hormones shift, not to mention the major shifts that occur during pregnancy, miscarriage, the postpartum period and menopause.

Often, people who are suffering from depression will spend a lot of time trying to pull it together on their own. But since depression is a medical condition, it requires medical attention. This doesn't necessarily mean medicating yourself with a quick pharmaceutical fix (though it might). It also may mean incorporating exercise, nutrition awareness and therapy into your life. Many times, it's possible to combat depression without drugs. However, this doesn't mean you should be combating it alone.

In fact, one major symptom of depression is a feeling of being cut off from the world. As humans, we have an innate desire to connect. By holing up in our own isolation, we compound the problem. However, when you're feeling low, one of the last things you want to do is go out and socialize. This is why therapy can be extremely effective. The empathy that a therapist can provide brings a sense of connection.

Because of the hormonal variations that affect depression, women and men suffer in markedly different ways. For example, women are at a greater risk of developing eating disorders and/or anxiety issues than men. Also, depression presents itself to women in different ways and at different points in life.

During the premenstrual cycle, women are more susceptible to becoming depressed. Studies have shown that women who suffer from severe PMS - including mood swings, anxiety and irritability - experience levels of impairment similar to levels observed in patients with major depression. For women who experience severe depression during PMS, there is an anti-depressive treatment that can be taken on day 14 or 15 of the menstrual cycle to regulate these tendencies.

Pregnancy is another time when the hormones experience a major shift. Mood swings are common, and a changing body image can cause feelings of insecurity. Therapy and exercise are recommended. Medications should be avoided if at all possible because they affect the fetus. However, if a woman is on medication for depression and then becomes pregnant, she should talk to her doctor about the costs and benefits of staying on medication, for herself and her baby.

Postpartum depression (PPD) is a severe form of depression that occurs after delivery. It can occur anywhere from a few days after birth to a few months later. A woman suffering from PPD may have intense feelings of sadness, despair, anxiety and irritability. She may find herself unable to do the things she needs to do every day. Often, this state of paralysis can lead to feelings of self-loathing that intensify depression. However, there are effective treatments, including counseling and antidepressant medications that can help.

Another major period of hormonal flux for women is menopause, and not surprisingly, depression is quite common during that time as well. Dropping estrogen levels are one probable cause of this form of depression. Therefore, hormone therapy has been known to help. Estrogen therapy improves both response and remission rates for SSRIs, which are drugs that help increase serotonin levels in the body.

Now that it's summer and the world is bursting forward with life, there's no reason to let a treatable medical condition hold you back. If you think you or someone you know might be going through a period of depression, talk to your doctor. Then, with your serotonin levels up and a smile on your face, you can get out there and dance in the rain.