Depression in Women

Understanding depression in women

Depression can impact every area of a woman’s life—including your physical health, social life, relationships, career, and sense of self-worth—and is complicated by factors such as reproductive hormones, social pressures, and the unique female response to stress. However, it’s important to know that you’re not alone. Women are about twice as likely as men to suffer from depression but depression is treatable and there are plenty of things you can do to make yourself feel better.

Of course, the Catch-22 of depression is that feeling better requires action but taking action when you’re depressed is difficult. However, while you may not have much energy, you probably have enough to take a short walk around the block or pick up the phone to call a loved one, for example—and that can be a great start to boosting your mood and improving your outlook. It’s important to also learn about the factors that cause depression in women so you can tackle the condition head on, treat your depression most effectively, and help prevent it from coming back.

Signs and symptoms of depression in women

The symptoms of depression in women vary from mild to severe (major depression) and are distinguished by the impact they have on your ability to function. Common signs of depression include:

• Feelings of helplessness and hopelessness. You feel as if nothing will ever get better and there’s nothing you can do to improve your situation.
• You don’t care anymore about former hobbies, pastimes, and social activities you used to enjoy.
• Appetite changes often leading to significant weight loss or weight gain.
• Changes in your sleep pattern.
• Feeling angry, agitated, restless.
• Feeling fatigued, sluggish, and drained of energy.
• Trouble concentrating, making decisions, or remembering things.
• Increase in aches and pains, including headaches, cramps, breast tenderness, or bloating.
• Suicidal thoughts.

Women also tend to experience certain depression symptoms more often than men. These include:

• Depression in the winter months (seasonal affective disorder) due to lower levels of sunlight.
• Symptoms of atypical depression, where rather than sleeping less, eating less, and losing weight, you experience the opposite: sleeping excessively, eating more (especially refined carbohydrates), and gaining weight.
• Strong feelings of guilt and worthlessness. You harshly criticize yourself for perceived faults and mistakes.

Causes of depression in women

Women report experiencing depression at much higher rates than men. This gender disparity may be explained by a number of social, biological, and hormonal factors that are specific to women.

Premenstrual problems. Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For some women, symptoms are severe and disabling and may warrant a diagnosis of premenstrual dysphoric disorder (PMDD). PMDD is characterized by severe depression, irritability, and other mood disturbances beginning about 10 to 14 days before your period and improving within a few days of its start.

Pregnancy and infertility. The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.

Postpartum depression. It's not uncommon for new mothers to experience the “baby blues.” This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is called postpartum depression and is thought to be influenced, at least in part, by hormonal fluctuations.

Menopause and perimenopause. Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.

The female physiological response to stress. Women produce more stress hormones than men, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men. This can make women more susceptible to developing depression triggered by stress.

Body image issues which increase in girls during the sexual development of puberty may contribute to depression in adolescence.

Thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician.

Medication side effects from birth control medication or hormone replacement therapy.

Health problems. Chronic illness, injury, or disability can lead to depression in women, as can crash dieting or quitting smoking.

Other common causes of depression include:

• Loneliness and isolation; a lack of social support.
• Family history of depression.
• Early childhood trauma or abuse.
• Alcohol or drug abuse.
• Marital or relationship problems; balancing the pressures of career and home life.
• Family responsibilities such as caring for children, spouse, or aging parents.
• Experiencing discrimination at work or not reaching important goals, losing or changing a job, retirement, or embarking on military service.
• Persistent money problems.
• Death of a loved one or other stressful life event that leaves you feeling useless, helpless, alone, or profoundly sad.

Compensating for biological and hormonal causes of depression

Because biology and hormone fluctuations can play such a prominent role in affecting a women's depression, it may be helpful to make use of more coping strategies at hormonal low points during the month. Try keeping a log of where you are in your menstrual cycle and how you are feeling—physically and emotionally. This way you will be able to better anticipate when you need to compensate for the hormonal lows and reduce or avoid the resulting symptoms.

It is important to remember that depression, at any stage in life and for any reason, is serious and should be taken seriously. Just because you've been told that your symptoms are a “normal” part of being a woman does not mean you have to suffer in silence. There are many things you can do to treat your depression and feel better.

How to feel better tip 1: Reach out for social support

You can make a huge dent in your depression with simple but powerful self-help steps. Feeling better takes time and effort when you don’t feel like making an effort. But you can get there if you make positive choices for yourself each day and draw on the support of others.

Getting support from people who care about you plays an essential role in overcoming depression. On your own, it can be difficult to maintain a healthy perspective and sustain the effort required to beat depression. At the same time, the very nature of depression makes it difficult to reach out for help. When you’re depressed, the tendency is to withdraw and isolate, while an irritable mood brought on by depression can cause you to lash out over situations that wouldn’t normally bother you, further distancing you from others.

Ask for the help and support you need and share what you’re going through with the people you love and trust. You may have neglected your most treasured relationships, but they can get you through this tough time. If you don't feel that you have anyone to confide in, you can find help to build new friendships—even if you're shy or introverted.

How to reach out for support

Look for support from people who make you feel safe and cared for. The person you talk to doesn't have to be able to fix you; they just need to be a good listener—someone who'll listen attentively and compassionately without being distracted or judging you.

Make face-time a priority. Phone calls, social media, and texting are great ways to stay in touch, but they don't replace good old-fashioned in-person quality time. The simple act of talking to someone face to face about how you feel can play a big role in relieving depression and keeping it away.

Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed it feels more comfortable to retreat into your shell, but being around other people will make you feel less depressed.

Find ways to support others. It’s nice to receive support, but research shows you get an even bigger mood boost from providing support yourself. So, find ways—both big and small—to help others: volunteer, be a listening ear for a friend, do something nice for somebody.

Join a support group for depression. Being with others dealing with depression can go a long way in reducing your sense of isolation. You can also encourage each other, give and receive advice on how to cope, and share your experiences.

Tip 2: Support your health

In order to overcome depression, you have to do things that relax and energize you. This includes following a healthy lifestyle, learning how to better manage stress, setting limits on what you're able to do, and scheduling fun activities into your day.

Aim for eight hours of sleep. Depression typically involves sleep problems; whether you're sleeping too little or too much, your mood suffers. But you can get on a better sleep schedule by adopting healthy sleep habits.

Keep stress in check. Not only does stress prolong and worsen depression, but it can also trigger it. Figure out all the things in your life that stress you out, such as work overload, money problems, or unsupportive relationships, and find ways to relieve the pressure and regain control.

Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give you a sense of being needed—both powerful antidotes to depression.

Do things you enjoy (or used to). While you can't force yourself to have fun or experience pleasure, you can push yourself to do things, even when you don't feel like it. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to a museum, the mountains, or the ballpark.

Develop a “wellness toolbox” to deal with depression

Come up with a list of things that you can do for a quick mood boost. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even if you're feeling good.

1. Spend some time in nature.
2. List what you like about yourself.
3. Read a good book.
4. Watch a funny movie or TV show.
5. Take a long, hot bath.
6. Take care of a few small tasks.
7. Play with a pet.
8. Talk to friends or family face-to-face.
9. Listen to music.
10. Do something spontaneous.

Tip 3: Get up and get moving

When you're depressed, just getting out of bed can seem like a daunting task, let alone working out! But exercise is a powerful depression fighter—and one of the most important tools for depression recovery.

Studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue. You don't even have to hit the gym. A 30-minute walk each day will give you a much-needed boost. And if you can't manage 30 minutes, three 10-minute bursts of movement throughout the day are just as effective.

Exercise is something you can do right now to boost your mood

Your fatigue will improve if you stick with it. Starting to exercise can be difficult when you're depressed and feeling exhausted. But research shows that your energy levels will improve if you keep with it. Exercise will help you to feel energized and less fatigued, not more.

Find exercises that are continuous and rhythmic. The most benefits for depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.

Add a mindfulness element, especially if your depression is rooted in unresolved trauma or fed by obsessive, negative thoughts. Focus on how your body feels as you move—such as the sensation of your feet hitting the ground, or the feeling of the wind on your skin, or the rhythm of your breathing.

Pair up with an exercise partner. Not only does working out with others enable you to spend time socializing, it can also help to keep you motivated. Try joining a running club, taking a water aerobics or dance class, seeking out tennis partners, or enrolling in a soccer or volleyball league.

Walk a dog. If you don't own a dog, you can volunteer to walk homeless dogs for an animal shelter or rescue group. You'll not only be helping yourself but also be helping to socialize and exercise the dogs, making them more adoptable.

Tip 4: Eat a healthy, depression-fighting diet

What you eat has a direct impact on the way you feel. Some women find dietary modifications, nutritional supplements and herbal remedies can help aid in the relief of depression symptoms. These include:

Cutting back on salt, unhealthy fats, caffeine, sugar/refined carbs, and alcohol can help improve depression symptoms.

Not skipping meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.

Boosting your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To increase your intake, eat more citrus fruit, leafy greens, beans, chicken, and eggs. Vitamin B-6 along with calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit women suffering from PMDD.

Eating foods with Omega-3 fatty acids. Omega-3 fatty acids play an essential role in stabilizing mood. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, sardines, and tuna, or vegetarian options such as seaweed, flaxseed, and walnuts.

Making sure you’re getting enough iron. Low iron levels can produce common depression symptoms like irritability, fatigue, and difficulty concentrating. Iron rich foods to add to your diet include red meat, beans, leafy greens and dried fruit.

Adding herbal supplements may be helpful. Primrose oil and chaste tree berry have both been found to be effective in the treatment of PMDD.

Tip 5: Get a daily dose of sunlight

Sunlight can help boost serotonin levels and improve your mood. Aim for at least 15 minutes of sunlight a day. Remove sunglasses (but never stare directly at the sun) and use sunscreen as needed.

• Take a walk on your lunch break, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or spend time gardening.
• Double up on the benefits of sunlight by exercising outside. Try hiking, walking in a local park, or playing golf or tennis with a friend.
• Increase the amount of natural light in your home and workplace by opening blinds and drapes and sitting near windows.
• If you live somewhere with little winter sunshine, try using a light therapy box.

Dealing with the winter blues

The reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). Women are diagnosed with SAD at four times the rate of men. SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love. No matter how bad you feel, though, there are plenty of things you can do to keep your mood stable throughout the year.

Tip 6: Challenge negative thinking

Depression puts a negative spin on everything, including the way you see yourself and your expectations for the future. When these types of thoughts overwhelm you, it’s important to remember that this is a symptom of your depression and these irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic.

Women also tend to ruminate when we’re depressed, perhaps spending hours trying to figure out why we're feeling this way. However, rumination can maintain depression or even make it worse. You can’t break out of this pessimistic mind frame by just telling yourself to “think positive.” Often, it’s part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it.

You can develop a more balanced way of thinking by identifying the type of negative thoughts that are contributing to your depression, and then learning to replace them with a more balanced way of thinking.

Negative, unrealistic ways of thinking that fuel depression

All-or-nothing thinking. Looking at things in black-or-white categories, with no middle ground (“If I fall short of perfection, I'm a total failure.”)

Overgeneralization. Generalizing from a single negative experience, expecting it to hold true forever (“I can't do anything right.”)

The mental filter. Ignoring positive events and focusing on the negative. Noticing the one thing that went wrong, rather than all the things that went right.

Diminishing the positive. Coming up with reasons why positive events don't count (“He said he had a good time on our date, but I think he was just being nice.”)

Jumping to conclusions. Making negative interpretations without actual evidence. You act like a mind reader (“She must think I'm pathetic”) or a fortune teller (“I'll be stuck in this dead-end job forever.”)

Emotional reasoning. Believing that the way you feel reflects reality (“I feel like such a loser. I really am no good!”)

‘Shoulds' and ‘should-nots.' Holding yourself to a strict list of what you should and shouldn't do, and beating yourself up if you don't live up to your rules.

Labeling. Classifying yourself based on mistakes and perceived shortcomings (“I'm a failure; an idiot; a loser.”)

Challenge your negative thinking

Once you identify the destructive thought patterns that contribute to your depression, you can start to challenge them with questions such as:

• “What's the evidence that this thought is true? Not true?”
• “What would I tell a friend who had this thought?”
• “Is there another way of looking at the situation or an alternate explanation?”
• “How might I look at this situation if I didn't have depression?”

As you cross-examine your negative thoughts, you may be surprised at how quickly they crumble. For example, the negative thought: “My boss hates me. He gave me this difficult report to complete,” could be replaced with: “My boss must have a lot of faith in me to give me so much responsibility.” In the process of challenging negative thoughts, you’ll develop a more balanced perspective and help to relieve your depression.

Get professional help if needed

If you don't benefit sufficiently from self-help treatments, seek help from a mental health professional. While women suffering from depression respond to the same types of treatment as men, specific aspects of treatment are often modified for women. Women are also more likely to require simultaneous treatment for other conditions such as anxiety or eating disorders.

Therapy. Talk therapy is an extremely effective treatment for depression. It can provide you with the skills and insight to relieve depression symptoms and help prevent depression from coming back. One of the most important things to consider when choosing a therapist is your connection with this person. The right therapist will be a caring and supportive partner in your depression treatment and recovery.

Medication. Antidepressant medication may help relieve some symptoms of depression in women, but it won't cure the underlying problem. Because of female biological differences, women are generally started on lower doses of antidepressants than men. Women are also more likely to experience side effects, so any medication use should be closely monitored. Don't rely on a doctor who is not trained in mental health for guidance on medication, and remember that medication works best when you make healthy lifestyle changes as well.

Last updated or reviewed on March 21, 2023