Monday, December 26th, 2011
Depression is a common disorder. Who is at highest risk? Women of child bearing (and rearing) age. How common is it? Some studies suggest that 1 in 3 women may experience depression at some point in their life. Given this, I am writing a three-part series on moms and depression (in the near future I will do a similar series on dads and depression) – starting with the fundamental questions of why moms are at high risk, and which moms are at highest risk.
Let’s start with the first question: why do so many moms get depressed? A first reason is that women in general are at higher risk for depression than men (or technically speaking, higher risk for being diagnosed with depression). This gender difference becomes evident during adolescence (the most typical developmental period for the first onset of depression) and women are around twice as likely as men to experience depression. It’s not entirely clear why this is the case. There has been of course lots of research on female hormones and how they might partly explain this phenomenon, but to date the specifics remain elusive. That said, the bottom line is that being a female increases your risk of developing depression, starting during the teen years.
A second reason is the very real phenomenon of postpartum depression. Although the reported rates of postpartum depression can vary widely across studies, it is clear that a significant number of women experience some level of depressive symptoms after birth, and many (somewhere between 5% and 20%) experience some form of detectable postpartum depression.
A third reason is that the stress of being a mom can also increase the risk of depression. The sources of stress can be many and include physical stresses – for example, lack of sleep. Many women take on a number of new tasks and responsibilities with a new baby (whether they are working or not) and depression often results from accumulating stresses.
These are three basic reasons why many moms experience symptoms of depression. But what about the next question: why do some moms get depressed when others don’t?
One of the key factors is genetics. Although it’s not possible to screen for genetic risk for depression – especially since it is assumed that many genes contribute to risk for depression – some of the most persuasive work over the past decade has shown that specific “candidate” genes exert their influence during times of stress. So even though every mom has a lot of stress, one’s genetic make-up makes some women more likely to be susceptible to feeling depressed in the face of stress. Embedded in this risk is the very strong effect of having grown up with a depressed mom, which substantially increases the risk of developing depression, especially depression with an early onset (in the teen years).
A second important factor is the history of depression prior to becoming a mom. One of the features of depression is that it is likely to recur – each episode of depression increases the risk for a future episode (which often times is more severe than the last one). So if a woman has suffered from depression prior to becoming a mom, she is at higher risk of having another episode sometime in the future – including the time period when she is raising a child.
To review, there are two key points for moms (or moms-to-be). First, if you are female, you have a higher risk for depression than males (which is important to keep in mind because depression is so common). So any mom is, in some sense, at elevated risk for developing depression. But moms who have a family history of depression (especially in their mom) and/or have experienced prior depressive episodes are at especially high risk. Given all this, my next post will focus on how to recognize the signs of depression – especially those that might not be that obvious.
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