Depression in Women

Depression is invading people’s lives all over the world. Just until recent years, the diagnosis of depression did not exist, and treatment was not possible because depression was not considered an illness, simply something demonic. Researchers have paved a hefty path towards the discovery of depression, its symptoms, and possible treatments; following the first sighting of depression with Job and Saul in the First Testament. The understanding of this illness is still incomplete and will continue to be the subject of research and discussion until lab tests are created, concrete symptoms declared, and effective treatments are accomplished. Individuals diagnosed with depression have been reported to have shorter life expectancy, this is due to lower immune systems that combat illnesses and the susceptibility to suicide. Depression can affect any race, ethnicity, gender, and age group throughout the world. However, when groups of men and women are compared and surveyed it is often found that women are more likely to be depressed and show enhanced symptoms.
According to Stoppard (2000),“The term depression refers to a condition characterizing an individual that encompasses a set of experiences which include symptoms such as the following: feelings of sadness, dejection, hopelessness or despair, coupled with extremely pessimistic thoughts about one’s self, situation and future prospects; lack of interest or pleasure in activities usually engaged in, along with social withdrawal; various bodily complaints including aches and pains, difficulty sleeping, fatigue, loss of appetite; and in some cases suicidal thoughts or actions.” (p.7)
The National Institute of Mental Health (2012) found “several factors may contribute to depression in women; Genes, Brain chemistry and hormones, postpartum depression, and stress”.
Depression has shown some tendency to run in families. If someone in a family is clinically depressed, a very close relative has a higher risk than someone in the general population of developing depression. However, this is not a concrete rule. When very close relatives to more distant relatives are analyzed, the likelihood of a depressive illness occurring begins to decrease. It seems the combination of several genes with environmental or other factors may be the constant factors of the development of depression; Robins (1993) agreed with these factors in Understanding Depression, “What we have in some people is a genetic vulnerability that increases the risk of becoming depressed should environmental conditions develop that promote depression.” A significant factor in depressive disorders is brain chemistry. Researchers using technology such as MRI’s have discovered that the brain of a depressed person looks significantly different than that of a relatively healthy person. In a depressed individual’s brain, certain sections seem to be functioning abnormally. Usually the areas affected during depression are held responsible for certain moods, sleep, appetite, cognitive thought and behavior. The cells in the human brain use chemicals called neurotransmitters for communication with the body. Two neurotransmitters in particular, norepinephrine and serotonin, appear to play a big role in depression. In many depressed people, there are problems in the way these neurotransmitters are working; there are imbalances in norepinephrine and serotonin. These neurotransmitters are targeted in antidepressants. A concerning discovery is that serotonin is linked to suicide. Low levels of serotonin activity have previously been discovered in autopsies, this is especially displayed when the suicide committed was a violent act. Although serotonin levels are believed to affect depression, there is no way to measure or prove this theory as of yet. Hormones in females are believed to highly affect depression. Puberty, before menstrual periods, during, and just after pregnancy, premenopausal and during menopause are the optimal periods for depression to develop.
A unique time in a young girl’s life is when she is experiencing puberty. Girls seem to be experiencing puberty earlier than ever before, exposing them to female hormones for a lot longer. There could potentially be a link between the first menstruation in a young girl and the symptoms of depression. In some studies it was found that subjects that got their period before the age of eleven carried a higher risk of depression than girls who got it afterwards. During puberty, changes in the body and behavior are naturally happening, making it important for close supervision in order to detect possible symptoms of depression. Separation from parents, irritability, and identification with peers are considered normal behavior during puberty. However, signs of negativity, academic decline, unexplained guilt/crying, and difficulty concentrating are potential symptoms in recognizing depression. At a young age, girls are learning to deal with the hormonal changes in their body. During puberty, girls must also meet the pressure to succeed in all areas of life, have to deal with their emerging sexuality, which can be confusing, and learn to cope without the aid of parents, due to the conflictive relationship that has developed. Girls are more likely to develop depression before boys because they usually reach puberty before boys do. However, this gap only lasts until a woman ends menopause.
“PMS is common, affecting from 30-80% of women of the reproductive age”, reported Braverman (2007)., an MD from Cincinnati. PMS is an acronym thrown around quite commonly in jest to describe women negatively during the period cycle, but in reality, PMS symptoms are PMDD symptoms enhanced to optimal level making it hard to function. Common symptoms of PMS are bloating, breast tenderness, headache, anxiety and irritability; also known as passerby symptoms. However, Smith (2012) declared that, “For up to one out of ten women, symptoms are so distressing and disabling that they warrant a diagnosis of premenstrual dysphoric disorder (PMDD)”. “PMDD affects about 5 percent of women”, states Iliades (2013); this small female population lives with these severe symptoms that cause disruption in all areas of their lives varying from their studies, to even social relationships or other areas. Generally PMDD may show up in women in their twenties and usually worsens as the years go by. In some cases, though, it has been reported that it gets even worse before menopause. In a lighter note, these severe symptoms don’t occur during pregnancy or when the period cycle isn’t happening. There are two scales that are used to diagnose PMDD. These are called: the Calendar of Premenstrual Experiences and the Prospective Record of the Severity of Menstruation. It helps when women keep a chart to anticipate when moods will be at charged levels. Although irregular hormone levels may affect people in some cases of depression, in PMDD this is not the case. There is sensitivity present during hormonal changes; unstable circulating estrogen and other hormones affect specific neurotransmission pathways. There are a lot of factors pertaining to PMDD but most are yet to be recognized and catalogued for what their role is in the development. There are a lot of steps that can be taken to alleviate PMDD. PMDD patients are recommended to abstain from coffee, sugar, and foods containing sodium. Exercise has also proven to be helpful in both an emotional and physical state. Women are also experimenting with herbal remedies that seem to make a difference in moods, water retention, and other symptoms. Doctors usually prescribe SSRI’s and improvement is shown rapidly in women with PMDD. Xanax is well known and used by many women with severe symptoms, but doctors warn it can be addictive. Many women turn to the birth control pill to alleviate menstrual related depression and symptoms. However, different pills seem to affect depression in all kinds of negative and positive ways. It is known, though, that the pills containing a hormone called progesterone worsen depression. PMDD generally requires treatment because the enhanced symptoms begin a week before the period cycle commences and only begin to alleviate when the period actually starts. Treatment and diagnosis are the key to getting results of any kind.
While pregnant, women can feel stress, sadness, and even depression when life situations warrant it. Antepartum depression tends to occur to women who don’t want to be pregnant, can’t afford being pregnant or a baby, have experienced previous pregnancy loss, and/or complications in pregnancy, history of abuse or trauma, or have experienced a difficult life situation. Difficult life situations, such as the death or abandonment of the father of the child, being fired from work, or dropping out of school can be tough to deal with. If depression is ignored and not treated, there may be potential risks to the child’s well being, as well as the mother. An untreated mother will most likely eat less, smoke, drink, and show risky or suicidal behavior. These actions can cause premature birth which is dangerous for the innocent baby. “Babies born to mothers who are depressed may also be less active, show less attention and are more irritable and agitated than babies born to moms who are not depressed”, analyzes D’Amico (2002). In the aftermath of birthing a child, a woman is particularly vulnerable to depression. During this time, mothers are overworked with caring for a newborn while dealing with hormonal and physical changes occurring in the body. “Baby blues” is a common term used to describe some women after birth but sometimes it’s much more serious than the blues. “Postpartum depression (PPD) affects 10%--15% of mothers within the first year after giving birth”, claims the Center for Disease Control and Prevention (2008). Postpartum depression is such a serious illness that Formanek (1987) concluded, “During the first month postpartum, women are at the highest risk in their entire lives for psychiatric hospitalization, although few have had a prior psychiatric history.” After being diagnosed with depression, the new mother should receive treatment and stick to it. The new mother should also be able to depend on emotional support from family and friends. Without support the journey to health can be longer or sometimes even impossible for some cases. Antidepressants taken during pregnancy are sometimes linked to health problems in babies that are born malformed, have heart issues, and low birth weight. It is vital that pregnant women ask questions about everything the doctor prescribes and says regarding health. During pregnancy as well as in the postpartum period it is a good idea to visit the doctor to screen for depression that might go undetected to the common eye. It really isn’t uncommon for new mothers to experience emotions such as sadness, anger, and feel at the verge of tears at the drop of a hat. But usually these symptoms tend to go away in a week or two. However, if the symptoms persist they might be an indication of postpartum depression. If a new mother is unable to care for her newborn baby or herself, shows signs of low self-esteem, agitation, and negative thoughts, she is displaying common signs of postpartum depression. It is important to detect these symptoms as soon as possible because depressed mothers tend to harm their children physically and emotionally, not only themselves. Medication is helpful in this form of depression but electroconvulsive therapy seems to contain less risk for the fetus and severely depressed mothers who are breastfeeding. While the patient is under anesthesia during ECT, a controlled electric current emits a short spanned seizure in the brain, which seems to alleviate symptoms of depression. Many women recover from antepartum and postpartum depression by joining support groups or getting professional help such as counseling/therapy, as well as a physician consultation.
There seems to be a definite increase in hormonal changes when the body transfers from premenopausal to menopause. The perimenopause stage starts eight to ten years before menopause sets in. This development accompanied with hot flashes and lack of sleep contributes to depression in middle aged women. In some situations, women manage to smoothly transfer into menopause without developing depression, while other women carry a higher risk to experience it. Oddly enough, even women without a history of depression can develop depression during this transition. When a woman is entering menopause and suspect’s feelings and symptoms of depression, she should visit a gynecologist to adequately diagnose the issue. In early menopause or after menopause, estrogen levels are significantly reduced, which increases the risk of depression. On average, the women who experience severe menopausal symptoms don’t always develop depression. However, when sleep is constantly eluding the menopausal woman for long periods of time, the depression risk is rather higher. Depending on how severe symptoms are in the menopausal woman at the time of consultation determines the treatment necessary. However, when symptoms are severe women are prescribed hormone replacement therapy with antidepressant medication. If the case of depression is not serious, only one treatment is chosen to experiment with, used to determine which method works best. Estrogen in the form of pills or patches can be prescribed, but there are risks of breast cancer and stroke attached to this form of medication. Therapy is also recommended but if it is experienced without medication the odds of positive outcomes are slim to none. As you can see, there are options to better any type of situation a women can have during the hard transition into menopause; it’s in the woman’s hands to seek help.
Although a woman’s family link to depression is more common, women’s higher rate of depression isn 't caused by biology alone. Life situations and cultural stressors play a big part in the equation too. These problematic stressors occur in men’s lives also, but never up to par with a woman’s. Women deal with stressful situations daily. When a stressful situation persists, the focus in the persons perspective changes from the situation to the depleting functionality of the self. Solely concentrating on negative symptoms and illnesses can lower the self esteem making the individual vulnerable. With a lower self esteem, the person then avoids confrontation with the stressful situation; drops out of class, quits work, or avoids social contact. Depression in this sense functions like a psychological defense trying to protect the ego. Major life changes act as stressors and may trigger depression in those who are vulnerable. By major life changes, this means situations like serious illnesses, changing jobs, moving to another part of the country, getting divorced, having a child or losing a close friend. These cases come down really hard on women because they are not up to par with men in society. Women tend to live in poverty more often than men. Poverty is a stressor that commonly affects women of all ages. With poverty accompanies the uncertainty of tomorrow and the denial of basic necessities like health care services and access to a community. Most of these basic necessities are vital to women that have children; they aren’t able to provide most of the time because of social status and unequal power. Men deal with cultural stressors of their own, but at the same time do nothing to aid women, and have no qualms of adding to the woman’s workload. Juggling work and home responsibilities, caring for several family members including the self, abuse of any kind (physical and emotional), and low income may trigger a depressive episode. Often women work outside the home and still handle domestic responsibilities with little to no help from anyone else. In most cases women have someone to share the burden with; however, single parenthood is really difficult, especially when the mother must work several jobs to maintain the family. It must also be taken into account that the single mother may be juggling taking care of parents, children and the self, which can become stressful very quickly. Stressors like the examples above can make the rate for developing depression go up drastically; especially when there is no one to lean on or talk about the stress and depression. Women are less likely to turn to harmful behavior like abusing alcohol and drugs to cope, but they are usually associated with eating disorders. Depression tends to drive women into worse disorders like bulimia, binge eating, and anorexia. To avoid these drastic measures, women should abstain from thinking negatively in hard times and try to pull through, with prescribed medication, or not; it’s up to the individual.
There are several forms of depression and subtypes. These include: major depression, dysthymia, postpartum depression (which has already been discussed above), seasonal affective disorder, atypical depression, bipolar disorder, psychotic depression, premenstrual dysphoric disorder (also discussed above), and situation depression.
Major depression (also known as clinical depression) is the most common form of depression, as well as of all psychiatric disorders. It holds high standing in the leading causes of disability worldwide, especially in the United States. The depressive individual experiences loss of interest or pleasure, and nagging depressive moods. Symptoms interfere with everyday necessary actions like eating, sleeping, and even work. Symptoms regarding major depression must last more than two weeks. Depression can even appear as anger, not always sadness. This condition can begin at any age, but has a history of developing in the mid 20’s spanning all the way to age 40 and 50. This condition tends to reappear through a person’s lifetime while preventing the individual from functioning normally. It may be possible that an individual can have bouts of depression separated by many years with no signs of any symptoms. Others report clusters of episodes, while the rest claim the episodes frequent more often as they grow older. A woman experiencing major depression is more likely to commit suicide than a man. Unfortunately, to date there are no lab tests to diagnose major depression. If a person or loved one suspects major depression is an issue it is suggested to consult a health care provider. Gathering information is important, so the doctor will ask about health/family history and any symptoms that are recognizable. This will help the doctor determine how severe the depression is.
Dysthymia is not nearly as serious as major depression, but it shares common symptoms like: depressed moods, lack of sleep, poor concentration, and very low energy. This condition has less serious symptoms but tends to last for longer periods of time. Symptoms must last for at least two years. Dysthymia shares the shortened REM latency (vivid dreaming early in sleep) symptom with major depression. Also, dysthymia is more common in women than men, like major depression. People that develop dysthymia eventually experience major depression; there are many people dealing with this double depression. Roots of dysthymia can be identified as: childhood/adult stress, genetic susceptibility, lack of help, and traumatic events. Dysthymia most likely contains a hereditary component and has been known to run in families. Most dysthymia patients live with other illnesses or disorders as well. In essence, this makes recovery even harder. Dysthymia patients are usually undertreated and under diagnosed because doctors fail to diagnose the problem correctly or even at all. For example, older people may not be diagnosed for dysthymia because doctors believe it is dementia. For dysthymia in particular, medication has shown some superiority over psychotherapy. All sorts of complications arise when there is no concrete exam to diagnose all these different forms of depression, but no diagnose at all is worse.
Seasonal affective disorder tends to occur during the same time every year, mostly during the times of winter, due to the lessening of natural sunlight. This depression typically lessens if the affected person is treated with artificial lighting also known as light therapy. Women tend to experience seasonal affective disorder more often than men do. Individuals who live in places with long periods of winter are at a higher risk of developing this condition than the general population. Although uncommon, the reverse, depression during the summer months, is totally possible. A unique symptom is increased sleep, as opposed to other depressions where the person mainly lacks sleep. There are certain instances when SAD can become long term depression. Social and environmental factors will determine whether the individual will be able to surpass the long term bout of depression. As mentioned before, light therapy is very effective; a special lamp is used to imitate the light from the sun. It is of extreme importance that light therapy is used before symptoms begin for the winter/summer or the effectiveness rate will diminish. It is recommended to sit by the light for 30 minutes every day in early morning with the eyes open but not staring directly into the light. An eye exam is also recommended before starting light therapy. In approximately three to four weeks, improvement should be notable if the light therapy worked. If not, psychotherapy and medication are also available for experimentation.
Atypical depression is considered a subtype of major depression. It was given its own diagnosis because patients showed better results from MAOI’s than tricyclic antidepressants. This condition is usually under diagnosed because it is less understood. It is odd, but a symptom of atypical depression is a sort of paralysis, feelings of heaviness in the arms and the legs occur. It’s been reported that this condition exhibits greater functional impairment than other forms of depression recognized today. This is not the most important and talked about symptom though, overeating and oversleeping are because other forms of depression tend to display the opposite. Usually women display more symptoms of atypical depression than men do. There seems to be an earlier age of onset, starting as early as high school. Treatment in atypical depression has proven over the years that older antidepressants work better but SSRI’s work also. In most cases second medication is used as a booster combined with psychotherapy. A form associated with atypical depression proves to be bipolar disorder, especially in the early onset cases.
Bipolar disorder is also known as manic depressive disorder because the symptoms tend to alternate between mania and depression. Bipolar disorder has one of the highest risks of suicide and paranoia. This condition is classified by the daily fluctuating mood swings, and frequent episodes of depression with at least one episode consisting of mania. This disorder contains two subtypes: bipolar I & bipolar II. Bipolar I is the more serious form of the two and mainly deals with mania or “high periods of elation”. Hypomania is a characteristic of Bipolar II; milder periods of elation are expressed. Bipolar II patients can also experience episodes containing minor or major depression. This illness is usually not as common as dysthymia or major depression but affects men and women equally. Bipolar disorder is not thought to be inherited genetically, but is a result of genetic, psychological, and environmental factors combined. If the affected patient undergoing treatment is pregnant or currently breastfeeding, health care professionals try really hard to keep balanced the need to maintain the mothers’ mood and behavior stable, while lessening the risk medications carry that might affect the child. Mood stabilizers are used as treatment for bipolar disorder patients. In some cases antidepressants are prescribed also; they are used to boost the depressed mood.
Psychotic depression is to be taken very seriously but has been neglected for a long time. Psychotic symptoms such as breaks with reality, delusions, and hallucinations characterize this depression. Affected patients with psychotic depression may not speak or function and will hallucinate (see or hear things that are not real). Anhedonia, which is when someone can’t experience pleasure, is common in patients with this illness. A sense of paranoia also accompanies psychotic depression because patients display feelings of impending doom or disaster where there is none to be seen in reality. Diagnosed psychotic depressives tend to get really angry for no obvious reason and spend a lot of their time alone Diagnosis for psychotic depression is important because one bout of psychotic depression raises the risk of bipolar disorder. When a patient is diagnosed, treatment tends to be administered at a hospital so the individual can be under observation and can have close follow up sessions with professionals. Antipsychotic medications are used to control neurotransmitters; to better organize information about the world around us. These medications have a high rate of effectiveness so patients are able to recover in as little as a year. If they don’t end up working, there are other options like electroconvulsive therapy that can be used and tested.
Situational depression is usually triggered by a stressful situation or a life altering event, however, it tends to disappear after adaptation occurs. This depression usually affects everyone at least once in the lifespan. If not treated, situational depression can rapidly turn into major depression. There are specific situations that hold very high stress levels which may result in depression; these contain: divorce, loss of a person, job, or home, and failure in all aspects of life. These events can affect a person’s mood mildly or majorly, depending on the individual. Women tend to take difficult situations like the stated above, and become majorly depressed unlike most men. When the periods of depression are considered long it usually means the loss was big from the person’s perspective. Clinical depression has similar symptoms to situational depression which makes it hard to diagnose either. Keeping an inventory of life events helps professionals distinguish between clinical and situational depression. In most cases, exercise, the removal of stressors, changing ones worldview, and implementing a new diet prove to be a great treatment for situational depression.
Even serious bouts of depression can be treated. Treatment varies with the type of depression. The ideal first thing to do is consult a mental health professional. Even though depressive symptoms may be recognized it could easily be another illness. It’s important to get a definite diagnosis from a professional. A well known and commonly used treatment for depression is antidepressants. Antidepressants primarily work on the chemicals in the brain that are known to affect the function of the body. Potential side effects may be dangerous though, so it all comes down to what the patient is willing to do to get better. However, side effects can be monitored and lessened by lowering or upping the dosage by the doctor’s recommendation. There are newer antidepressants these days but the oldest would be Monoamine oxidase inhibitors. This antidepressant is potentially dangerous because a lot of foods, drinks, and medications must be avoided. The patient must be aware of everything the body is taking at all times. It’s important to keep track of intake because these listed foods, drinks, and medications contain tyramine, and this mixture can increase blood pressure to very unhealthy levels. Antidepressants should not be taken at the same time. Doctors are adamant about this because there have been cases where desperate patients take two different antidepressants and put themselves in life threatening situations. Once medication is started it must only be stopped under doctors orders. If the patient stops cold turkey the body might go under shock. Usually antidepressants take six weeks before they fully start working or show any effects. It is not wise to stop taking medication after the wanted results are acquired because more times than not, the depression returns. There are patients that have serious depression and they may need to be on medication such as antidepressants for their entire lifetime. It is vital not to give up seeking for help. If one medication does not work there are others to try. People experiencing thoughts of suicide taking antidepressants should be closely monitored because in certain cases medication may heighten thoughts of suicide. Antidepressants may be dangerous to take during pregnancy, but if a depressed soon to be mother doesn’t take them, it may also be dangerous to the health of baby and mother. In this case a doctor must be consulted. When certain medications have extreme side effects the FDA warns people by placing a “black box” warning on the item. This is another factor to take into consideration. It always helps to have someone to talk to and consult.
Electroconvulsive therapy or electric shock therapy carries a negative stigma as a result of its early history. Early treatments of ECT were administered to patients with high voltage and anesthesia-less. This caused many negative reactions like the loss of memory. However, today health care providers are considerably less savage. Anesthesia is provided and the experiencing ECT is much safer nowadays because the electrical currents are controlled to avoid as much risk as possible. This therapy is used in cases of depression when patients don’t want to use medication or medication isn’t working. This therapy causes changes in the brain that have been known to reverse symptoms. Although ECT still has side effects to consider, it is an option when other measures aren’t working.
Talk therapy is usually recommended when depression is involved. Psychotherapy’s goal is to promote control of mood and regaining control of the body functioning properly. Psychotherapy is directed more towards moderate cases of depression when it is not considered as life threatening as major depression. When depression is at a serious level, psychotherapy and medication should be experimented with, but only under doctor supervision. Cognitive Behavioral therapy and Interpersonal therapy are two main types of psychotherapy commonly used, and are known to be effective in curing depression. In cognitive behavioral therapy, talking to a professional about the issues that have you depressed helps to recognize the key stressors. It also helps patients learn to interpret life in a more positive way while also working on changing behaviors that keep igniting the depression. In this combined approach of behavioral and cognitive therapy, recurring negative thought patterns are restructured, and behavioral patterns to stressors are identified and worked with. CBT is a short term therapy that doesn’t usually require more than twenty sessions per person. The idea is to help identify current situations in the patient’s life that may be causing stress and offering alternatives. Interpersonal therapy is directed more towards patients with troubled relationships of all forms. Whether it is wife/husband, work related, or family related relationships. These relationships may be the cause of the depression or are simply worsening it. The therapist aims to make the patient feel understood and steers the person away from self blame. In this form of therapy, the therapist tries to make a link between the patients’ mood and a disturbing situation. IPT contains three phases and is on a time crunch of a few weeks. IPT focuses on a specific outcome; whether the treatment will work or not, which is a new concept. IPT works so well that it is also used in other illnesses. However, only just recently IPT commenced spreading into clinical practice, and in the hands of untrained therapists, it is pretty much useless. People who react effectively to the combination of medication and therapy hardly ever get depression again in their lifespan.
Depression has one casually related outcome: death by suicide. One thing that is known for certain now, is that suicide is preventable if depression is treated. “In too many countries death by suicide is not declining, it is staying level or rising”, reports Sackler (1981). These countries fail to reduce death by suicide caused by depression simply because of lack of knowledge. Suicide is a subject many people don’t want to educate themselves in because of personal or religious beliefs. However, it is a very serious social issue that just keeps increasing in size. It is such a huge problem that, “In 2006, suicide was the eleventh leading cause of death in the U.S., claiming 33,300 lives per year”, reported The American Association of Suicidiology (2009). It has been reported that women attempt suicide more often than men, but more often than not, men actually go through with it. Younger women from the age group thirty and younger, tend to resort to suicide most commonly. Women tend to resort to less lethal forms of demise, which explains the higher rate of male suicide. “Self-poisoning is the method employed in 70 percent of all suicide attempts by women”, reported Subhash (1999). Therefore, doctors tend to prescribe fewer amounts of antidepressants to female depressives, and try to receive support from the family and friends of the patient to monitor the intake. Patients that display signs of acting on a suicide attempt and don’t have social support end up hospitalized and monitored by a psychiatrist. It’s not that suicidal people really don’t want to live; they just feel closed off to any other alternatives. They feel closed off and in most countries there just aren’t the resources needed to educate and help the affected population. In most cases the affected patient shows signs of suicidal thought. Outside sources and the person themselves probably can’t diagnose these symptoms or know what to do about it. This is a problem when depressive disorders have occurred more than once in a person’s lifetime; that person is at a greater risk for suicide. A lack of common knowledge connected to depression is made worse when people self medicate or drown their troubles in illegal drugs. When you mix alcohol or drugs into episodes of depression it is even more likely that suicide will come to mind. Drugs affect the neurotransmitters in the brain and it can have a negative or positive effect on the mood. Although women do sometimes turn to alcohol and drug abuse during depression, this is an area where men overpower women statistically. “The suicidal state is less of a crisis than it is a chronic state, and the end product of a gradually increasing sense of hopelessness”, reported Friedman. In comparison to men, women have a lot more factors and social/cultural stigmas working against them in regards to depression. This shouldn’t be the most important concept though. Depression is a serious illness that is taking the world by storm. In times like these, when the economy and family dynamics are so complicated, the education and information of this illness should be spread like wildfire. Till this day many people don’t seek treatment or answers for their symptoms and horrible crimes happen when depression is denied or ignored. Not only is it important to inform the people in the United States about depression and all it entails, but also, the entire world. Lower economy countries aren’t as caught up in depression as we are, but if we share the information and work together, more treatments and facts can be discovered and created. Depression is treatable, and in most cases curable, but it is still a hardship the world is fighting against.

Citations
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Citations: Stoppard. M. Janet. (2000). Understanding Depression: Feminist social constructionist approaches D’Amico, Christine. (2002). The Pregnant Woman 's Companion: Nine Strategies That Work to Keep Your Peace of Mind Through Pregnancy and Into Parenthood Center for Disease Control and Prevention. (2008). Prevalence of Self-Reported Postpartum Depressive Symptoms: 17 States, 2004--2005 Sackler, M. Arthur. (1981) Prevention and Treatment of Depression. Depression as a Social Problem American Association of Suicidology. (2009). Some Facts about Suicide and Depression. Retrieved from Friedman, J. Raymond & Katz, M. Martin. (1974). The Psychology of Depression: Contemporary Theory and Research Subhash C. Bhatia, M.D., & Shashik. Bhatia, M.D. (1999). Depression in Women: Diagnostic and Treatment Considerations