Women and Depression: Not Just An Hormonal Event
While it is truly wonderful that women’s moods, such as postpartum depression, from a biological perspective, are now being studied in more depth, I think the focus on maternal reproductive health as a by-product of a biological hormonal condition is too narrow. Janet. M. Stoppard. PhD, in her work, Understanding Depression, discusses the social and personal issues that also pressure women across the life-span, as they move from one reproductive stage to the next.
Women across the lifespan have a higher risk of depression than men. Dr. Samantha Meltzer-Brody, Director of Perinatal Psychiatry at the University of North Carolina, Chapel Hill, discusses depression, women and hormonal fluctuation. Research about women, complex hormonal fluctuation and reproductive maternal mental health is important and ground-breaking. Giving voice to women in research about depression is important, having women researchers work on the subject and also actually including as subjects in research studies, is important, This is as opposed to studying male subjects and then applying conclusions about male subjects to women.
As Dr. Meltzer-Brody points out, “Epidemiologic studies consistently demonstrate that women have a twofold increased prevalence of major depression disorder (MDD)throughout their reproductive life cycle,”, with the occurrences “becoming more evident after puberty.” The risk ” for developing mood disorders may be associated at least partly with female-specific reproductive events.”
As Dr. Stoppard discusses in her work, at puberty, girls are subjected to scrutiny of their bodies, increased pressure to be model-perfect, increased pressure to NOT rely on their academic achievements, and have a dilemma to integrate such as choosing a career that can integrate with child-rearing. Sexual assault, date rape, emotional abuse are all concerns a girl needs to integrate as she matures. The medicalization of pregnancy and birth are prominent facts in our culture, with deep emotions of fear, pain , and helplessness associated with these personal experiences. Once a women enters the workforce the very real salary gap is there, and the glass ceiling is encountered in the workforce. In the home, the division of household chores, even n two income homes, is still biased in favor of men. In divorce, women and children are more often plunged into poverty or into a lower standard of living.
I believe that as a culture, we need to recognize that there are many factors leading into depression in women, and that a biological focus alone lets us off the hook too easily. I find this issue often in couples counseling. As women become more hormonal, they express their forbidden, hidden feelings more easily, this creates new demands on the relationship and the relationship is asked to change, causing a strain. So, while clinicians should be aware of and be able to recognize and screen for the signs and symptoms of mood disorders throughout a woman’s reproductive life cycle, leave some room to note that there may be previously unexpressed, even unrecognized, dreams coming to the surface as emotionality is unleashed.