What is Depression:
Depressive disorder commonly known as depression is a common but serious mood disorder. Negatively affecting emotions, thoughts and actions leading to various physical and emotional problems hindering daily performances (American Psychiatric Association, 2024). Statistics show that in the UK, depression can affect one in six individuals, with studies showing that women are twice as likely to experience depression during their lifetime compared to men (kuehner,2016).
Events such as losing someone, losing a job, or going through a divorce can occur in a person’s life. Such disruptive experiences cause low and unhappy moods for a few days. However, depression causes low and unhappy moods to last for weeks and months rather than just a few days. With the right treatment, positive lifestyle changes and support, most people feel better. Without treatment, depression can get worse and last longer.
Risk Factors:
The risk factors vary depending on age. For instance, a systematic review and meta-analysis conducted by Cole and Dendukuri in 2003 indicated that for individuals aged 50 and above, factors such as grief, sleep disturbances, disability, prior depression, and being female may have significant impacts. Similarly, a systematic review conducted by Maier and colleagues in 2021 found that for people aged 65 and above, chronic diseases and sleep disturbances increased the risk of depression. With the same token, young people have factors which can lead to an increased chance of depression. Factors like family history of depression, exposure to social stressors (such as bullying, difficult relationships, or stressful life events), and belonging to certain subgroups (such as those with chronic physical health problems or those who are part of a sexual minority are at higher risk of depression (Thaper et al.,2022).
Symptoms of the Depression:
Symptoms can differ from person to person, but some common symptoms include feeling sad, low mood, irritability, hopelessness, and feeling empty. These feelings occur throughout most of the day, for at least two weeks. Anxiety or feeling of unease, fear or worry is another symptom. While anxiety and depression are distinct mental conditions, it is not uncommon for individuals diagnosed with depression to also experience co-occurring symptoms of anxiety. For instance, a systematic review and meta-analysis conducted by Saha and colleagues in 2020 found strong evidence between co-occurring various mood disorders and anxiety-related disorders. Furthermore, depression can cause trouble sleeping, low energy, headache, other body pain and previously enjoyed actions to be no longer enjoyable. Finally, Individuals with depression are at a higher risk of committing suicide compared to those without depression (Cai et al., 2021).
If you are struggling with thoughts of suicide, please seek help immediately by speaking to someone you trust or contacting your local healthcare provider for support. Your well-being is important, and some people can help you through this difficult time.
Why depression is common in women:
As per the World Health Organisation, around five per cent of adults suffer from depression globally and it is the leading cause of disability. Women are at a higher risk of experiencing depression compared to men, with studies showing that they have twice the likelihood of suffering from depression as compared to their male counterparts.
Women go through multiple hormonal changes during which the risk of depression is higher. These changes are also only applicable to females. During pregnancy, the postpartum period, the menstrual cycle, and perimenopause, some women may experience depressive episodes triggered by physical and hormonal changes (NIH, nd).
Another reason may be is the disparity in self-reporting. A study by Shi and colleagues in 2021 proposes that male depression is underdiagnosed and under-treated, as it is often observed that females are more prone to reporting milder to moderate symptoms of depression. In contrast, males tend to display more severe forms of depression and there is a higher incidence of suicide among males.
Finally, there is a significant need for further research as men and women are different individuals with genetic differences. Understanding how this basic genetic difference causes differences between sexes in susceptibility to mental illness is a complicated puzzle that still needs to be explained (Albert,2015).
Treatment:
Dealing with depression can be tough, but many people find relief through medication, psychotherapy, or a combination of both, along with making some positive lifestyle changes.
The use of medications such as antidepressants, psychological treatment such as cognitive behavioural therapy, problem-solving therapy, interpersonal therapy, behavioural activation and self-care, and participation in support groups are the treatment options for addressing depression (WHO, 2023).
How to reduce risk?
Engaging in regular physical activity is crucial for maintaining overall health and well-being. Incorporating physical activity into daily routines can have positive effects on mental health.For example, a systematic review and meta-analysis conducted by Pearce and colleagues in 2022 found mental health benefits from being physically active.
Furthermore, it is important to prioritise maintaining a consistent and healthy sleep routine as it plays a vital role in decreasing the likelihood of experiencing depression. According to a meta-analysis conducted by Li and colleagues in 2016, it was established that insomnia is strongly linked to a higher risk of developing depression.
Where to seek help?
Dealing with symptoms of depression can be difficult. It is important to contact your GP or Local Healthcare provider for help.
Seeking support promptly can make a big difference in helping you feel better.
Support Group in Scotland: Visit the Scottish Action for Mental Health (SAMH) website if you live in Scotland.
References:
Albert, P. R. (2015). Why is depression more prevalent in women? In Journal of Psychiatry and Neuroscience (Vol. 40, Issue 4, pp. 219–221). Canadian Medical Association. https://doi.org/10.1503/jpn.150205
American Psychiatric Association. (2024). What is Depression.
Cai, H., Xie, X. M., Zhang, Q., Cui, X., Lin, J. X., Sim, K., Ungvari, G. S., Zhang, L., & Xiang, Y. T. (2021). Prevalence of Suicidality in Major Depressive Disorder: A Systematic Review and Meta-Analysis of Comparative Studies. In Frontiers in Psychiatry (Vol. 12). Frontiers Media S.A. https://doi.org/10.3389/fpsyt.2021.690130
Cole, M. G., & Dendukuri, N. (2003). Risk Factors for Depression Among Elderly Community Subjects: A Systematic Review and Meta-Analysis. In Am J Psychiatry (Vol. 160, Issue 6)
Kuehner Christine. (2016). Why is depression more common among women than among men? Pub Med.
Li, L., Wu, C., Gan, Y., Qu, X., & Lu, Z. (2016). Insomnia and the risk of depression: A meta-analysis of prospective cohort studies. BMC Psychiatry, 16(1). https://doi.org/10.1186/s12888-016-1075-3
Maier, A., Riedel-Heller, S. G., Pabst, A., & Luppa, M. (2021). Risk factors and protective factors of depression in older people 65+. A systematic review. PLoS ONE, 16(5 May). https://doi.org/10.1371/journal.pone.0251326
NIH. (n.d.). Depression in Women: 4 Things to Know.
Pearce, M., Garcia, L., Abbas, A., Strain, T., Schuch, F. B., Golubic, R., Kelly, P., Khan, S., Utukuri, M., Laird, Y., Mok, A., Smith, A., Tainio, M., Brage, S., & Woodcock, J. (2022). Association between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. In JAMA Psychiatry (Vol. 79, Issue 6, pp. 550–559). American Medical Association. https://doi.org/10.1001/jamapsychiatry.2022.0609
Saha, S., Lim, C. C. W., Cannon, D. L., Burton, L., Bremner, M., Cosgrove, P., Huo, Y., & J. McGrath, J. (2021). Co-morbidity between mood and anxiety disorders: A systematic review and meta-analysis. In Depression and Anxiety (Vol. 38, Issue 3, pp. 286–306). John Wiley and Sons Inc. https://doi.org/10.1002/da.23113
Shi, P., Yang, A., Zhao, Q., Chen, Z., Ren, X., & Dai, Q. (2021). A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. In Frontiers in Psychiatry (Vol. 12). Frontiers Media S.A. https://doi.org/10.3389/fpsyt.2021.589687
Thapar, A., Eyre, O., Patel, V., & Brent, D. (2022). Depression in young people. The Lancet, 400(10352), 617–631. https://doi.org/10.1016/S0140-6736(22)01012-1
World Health Organisation. (2023, March 31). Depressive Disorder (Depression). https://www.who.int/news-room/fact-sheets/detail/depression
© 2024 Dr Mukta Bhattarai Pandey (MD, PGDip Public Health, MRCP(UK), MRes)