WOMEN are not just struggling to close the gender pay gap – they have to deal with the depression gap too.
Even allowing for the fact that women are more likely to seek help, they are still twice as likely to experience a serious low mood for a mix of biological and social reasons, according to a range of research.
So why do double the number of women – about one in eight during their lifetime – struggle with depression, compared with men, and what can we do about it?
1. Women have bigger hormone swings
Men’s levels of their main sex hormone testosterone don’t change much over their lifetimes.
After puberty, it stays the same day in day out, only dropping off gradually at a rate of one to two per cent a year after the age of 40.
However, as soon as they start their periods, girls have big fluctuations of the female sex hormones oestrogen and progesterone, over the course of every month as part of the menstrual cycle.
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This may help explain why until puberty, boys and girls have similar rates of depression, according to a 2017 study in the journal Psychological Bulletin. After that, girls’ depression rates double.
One reason is that oestrogen doesn’t just affect what happens in the ovaries.
It’s also critical to the workings of the female brain. In women, it helps make feel-good brain chemicals, like serotonin.
This explains why men can have as much as 52 per cent more of this mood-booster, according to a study in the Proceedings of the National Academy of Sciences (1997).
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Shifts in female sex hormones during and after pregnancy also help explain why women suffer more hormone-related mental health issues, like the baby blues.
In the first year after giving birth, up to 15 to 20 percent of new mums will have depression according to the UK’s National Institute for Health and Care Excellence.
WHAT YOU CAN DO
Tracking your hormones is one way to start feeling in better control of your mental health, says hormone expert Gabrielle Lichterman, author of 28 Days: What your cycle reveals about your moods, health and potential.
“Writing down how you feel as your cycle progresses will help you start to see how the rise and fall of hormones like oestrogen will help you understand why you may feel down at certain times,” says Gabrielle.
“This means that you can predict when your hormones will be likely to prompt certain moods, including sadness and irritability.
“It will help to know your feelings could just be due to hormones, these feelings will pass and in just a few days you’ll be feeling optimistic again.”
2. Menopause means a drop in feel-good hormones
At menopause, women’s levels of oestrogen start to rollercoaster and then stop completely when their periods stop, also sparking a big drop-off in the levels of mood-boosting hormones until their brains can readjust.
And there’s one more reason that up to 20 per cent of women in menopause report bouts of depression.
In the run-up to this change, women have higher levels of a brain protein called monoamine oxidase.
This breaks down levels of feel-good chemical serotonin, which makes it more difficult to keep up your mood.
Dr Ferhat Uddin is a GP who specialises in menopause care via Liberty Health Clinics which she set up to help women going through this phase.
“All the time, women tell me they've just lost their zest for life but can't quite put their finger on it because they know they should be happy because they've got everything set up.
“And yet, they just don't enjoy things anymore. Many end up blaming themselves, not realising there’s a biological reason.”
WHAT YOU CAN DO
While it’s not for everyone, studies have found Hormone Replacement Therapy (HRT) – which can top up your oestrogen and progesterone levels – can help lift how you feel.
According to the NHS, benefits include ‘relieving mood swings.’
But if you don’t fancy HRT, supplements containing ingredients that have been found to lift mood in clinical trials can also make you feel better.
The latest option is Holland & Barrett’s Day and Night Peri and Menopause Support, which contains a new blend of herbal ingredients found to improve mood in menopause.
3. Women are FOUR times as likely to get ‘winter blues’
It’s autumn and the days are getting shorter,
Around six in 100 people get seasonal depression – or ‘winter blues’ when it gets darker during the winter months – and it's four times more common in women than men.
One possible reason is that sunlight helps the production of feel-good chemicals serotonin, which is already lower in females.
WHAT YOU CAN DO
The good news is that you will feel much better if you deliberately aim to get out into the daylight, says Dr Kat Lederle, a chronobiologist at drkatsleep.com who studies the effect of light on health and sleep,
Dr Lederle says: “Make sure you spend time outdoors every day, ideally in the morning when light levels are highest.”
4. Women don’t sleep as well
Is your male partner peacefully sleeping soundly beside you while you lie awake worrying? If so, you are not alone.
Women are up to 40 per cent more likely to get insomnia than men, according to a review in the journal, Philosophical Transactions of the Royal Society of London.
They also don’t sleep as well when they do and are more likely to wake up during the night.
Reasons include the ups and down in female hormones, snoring partners and children who wake up during the night.
But women feel more than just tired if they lose out on sleep. Over time, it can add up to low mood.
In one study of 10,000 adults, people with insomnia were five times more likely to develop depression.
WHAT YOU CAN DO
If your partner snores, you’re likely to lose an hour of sleep a night, according to a study in the Mayo Clinic Proceedings by scientists at the University of Utah.
And once your partner moves in their sleep, there’s a 50 per cent chance you will shift position too, and your sleep will be disturbed without even realising it.
Neuroscientist Professor Russell Foster, author of Life Time: The New Science of the Body Clock, and How It Can Revolutionize Your Sleep and Health says: “The partner lying next to you in bed may be messing up your sleep without you even realising it.
“If they are big snorers, get them tested for obstructive sleep apnoea (when the muscles in the back of the throat relax, obstructing the airways and causing gasping, snorting, or choking noises).
“Think too about separate bedrooms. Sleeping together is not an indicator of the strength of your relationship and it may be bad for your sleep.”
5. Women are more likely to experience burnout
Feel burnt out by juggling work and family commitments?
Nearly as many women as men now work in the UK. But despite the fact that more women work full or part time than ever, most are ‘double jobbing’ and bearing the same amount of responsibility for childcare and housework as they did before.
Research has also found that as women tend to have less power at work, this can also lead to feelings of frustration and helplessness that are also the hallmarks of burnout, according to a 2018 study by the University of Montreal.
WHAT YOU CAN DO
Harvard stress expert Dr Joan Borysenko, author of the book Fried: Why You Burnout and How to Revive says that simple awareness can be the best protection.
Joan says: “Create a sliding scale in your head. At one end, the number one means ‘I’m feeling really good’, and ten is ‘I’m feeling burnt out.’
“Keep drawing a hatch line between those two points to work out where you stand.
“If it gets to an eight – and you’re feeling like you can’t stand it anymore – it’s time to take a moment to relieve the situation.”
She also advises giving yourself permission to cut out time-sapping people or activities and to practise ways of politely saying no to more tasks.
If you have kids, make sure you are a genuine team with your co-parent.
Make a list of all the things you have to do on a weekly basis and make sure the workload is evenly divided.
6. Women get more inflammation
We all know how our skin flares up due to a bite – or joints can swell due to arthritis.
But it’s less known that parts of the brain can also become inflamed – and this can contribute to depression.
One cause of inflammation can be the foods we eat.
Heavily processed foods containing refined flours, cheap oils and fats, sugars and starches, now make up 50 percent of the foods we eat in the UK.
Crucially women are more affected by brain inflammation than men, according to a study in the journal Current Psychiatry Reports.
WHAT YOU CAN DO
Choose food not only on the basis of what’s nice to eat, but also what will boost your mood.
Cut your junk food intake and eat more fibre which can help calm inflammation and help keep your gut lining strong.
This helps stop toxins passing through it and causing an immune system reaction which also affects your brain function.
Women’s health Dr Uddin recommends ‘eating the rainbow’ of colours of fruits and veg.
“This can also make all the difference to the production of feel-good hormones.”
7. Women worry and blame themselves more
It’s not your imagination. Men really don’t fret as much as women do.
Research has found that while men tend to look outward when they feel bad and try to problem-solve, women tend to internalise their worries.
They are also far more likely to blame themselves and ruminate – or mull over things – both habits which have been found to be key factors in depression.
WHAT YOU CAN DO
Researchers say it helps women to learn coping skills and ways to stop rumination turning into depression and worry.
This includes listening out for an inner voice which is telling you situations are worse than they are or you are to blame when things go wrong.
One study by Penn State researchers found that 91 per cent of things that people worry about never happen.
So ‘fact-check’ your anxieties – and recognise when the same thoughts are going around and around in your mind.
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Instead, establish “worry periods” — or specific times when you’re allowed to worry for ten minutes. But then decide you have done enough and move on.
If you are worried about your mental health or feel you may have symptoms of depression, you are not alone, speak to your GP.
If you are affected by any of the issues raised in this article, please call the Samaritans for free on 116123.
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