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December 2012 Women's Connection luncheon presentation on Women and Depression by Connie Marsh, MD, associate medical director of Via Christi Senior Behavioral Health.
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Women and Depression:What’s Culture Got To Do
With It?Connie Marsh MD
University of Kansas School of Medicine-Wichita
Importance of topic
By 2020, depression will be the second greatest cause of disability world wide
Women and Depression
In any given year, what percentage of individuals will have depression?a. 2%b. 5%c. 10%
Women and Depression
True or FalseWomen and men have the same rates of depression.
Women and Depression
What percentage of women, over a life time, will have depression?a. 7%b. 13%c. 21%
Women and Depression
Importance◦ impact
Women and Depression
Impact◦ Isolation◦ Work problems◦ Family problems◦ Worsening medical problems◦ Suicide attempt and completion
15%
Women and Depression
Importance◦ Impact on illness
Greater disability and impairment Diabetes Lung disease High blood pressure Back problems Heart disease
Women and Depression
For most women, depression usually first occurs
a. Age 15-24b. Age 25-44c. Age 45-55
Women and Depression
Neglected◦ 60% detection by primary care doctor◦ Less than 2/3 of people with depression seek
treatment Inadequate treatment is common
Women and Depression
What does depression look like?
Women and Depression
Mood Sleep Appetite Energy Interests Guilt Concentration Slowed down Thoughts of suicide
Depression
Women more likely ◦ Seasonal component◦ Excess eating◦ Excess sleeping
Depression and Women
What does depression look like?
What’s Culture Got To Do With It?
Perception of mental illness Stigma Willingness to accept treatment Compliance to treatment Role expectations Immigration
What’s Culture Got To Do With It?
Rates of depression across races/ethnic groups◦ Globally◦ Within US culture
900 young women 21% of whites 28% of African Americans 29% of Hispanics
What’s Culture Got To Do With It?
Male/female disparity
What’s Culture Got To Do With It?
Social◦ Introspection encouraged in girls
Socioeconomic◦ Single parent◦ Social isolation
Psychological◦ Increased rates of sexual/physical abuse in
females
What’s Culture Got To Do With It?
Male/female disparity◦ ENDOCRINE/neurotransmittors
ESTROGEN
What’s Culture Got To Do With It?
Puberty Premenstrual Pregnancy/lactation Postpartum Perimenopause
When?
Estrogen
What are risk factors for depression?
Risk Factors
For males and females◦ Family history◦ Personal history◦ Serious medical illness◦ Decreased social support◦ Serious life stress◦ Substance abuse, including alcohol, MJ, cigarettes
Risk Factors
For females◦ Loss of parent before age 10◦ Childhood sexual/physical abuse◦ History of depression after pregnancy◦ Single parent◦ Unhappy/abusive marriage◦ Presence of young children in home
Risk Factors
Psychotherapy Antidepressant medication Life style changes
◦ Exercise◦ Nutrition◦ Socialization
Treatment
If risk factors◦ Recognize susceptibility◦ Don’t ignore symptoms, including irritability◦ Get therapy
Stay healthy◦ Exercise◦ Avoid substances—drugs, alcohol, MJ, smoking
Prevention?Modification?
Get help early◦ More treatable◦ Less impact on job/family/relationships
Vicious cycle◦ Recognize stressful times as susceptible times
Increase social support network◦ ASK for help◦ If young children in home, especially important
Prevention?Modification?
