Source: Marina Khrapova on Unsplash

Depression is a common mental disease in both sexes that can impact every area of one’s life – family, social interactions, relationships, career and what not. However, rates of depression in women are twice as high as they are in men. According to the National Mental Health Association, in USA about one in every eight women develops depression at some point time in her life. This is partly due to hormonal changes which are reflected as premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), postpartum depression, and peri-menopausal depression, and partly rather greatly due to social setup that puts more stress on women. The proportion may vary, but the fact of women being more susceptible to depression remains unaltered in developing and under developed countries too.

Signs and Symptoms of Depression in women:

The symptoms of depression in women are similar to those in men in case of major depression. Common complaints include:

  • Morrows mood
  • Losing interest or pleasure in activities she usually enjoys
  • Feelings of guilt, hopelessness and worthlessness
  • Suicidal thoughts or recurrent death wish
  • Sleep disorder i.e. sleeping more or less than normal
  • Change in appetite i.e. Loss of Appetite or Over Eating
  • Lack of Concentration
  • Fatigue or lack of energy to do work

Differences between Male and Female depression:

Though signs and symptoms of depression in men and women are more or less similar, but women are more likely to experience pronounced feelings of guilt, sleep disorder, eating disorder and suicidal thoughts. Women are also more likely to suffer from Seasonal Affective Disorder i.e. depression in a cyclical manner. For example, feeling more depressed during winter months due to lower levels of sunlight. Again a woman may feel depressed and suffer from anxiety in the morning since work pressure of a family is usually vested on her where male folks are likely to complain instead of cooperating.

Also, women are more likely to experience the symptoms of Atypical Depression wherein instead of sleeping less, eating less and losing weight, the opposite symptoms are seen, i.e. sleeping excessively, eating more (especially carbohydrates) and thereby gaining weight. Women also have higher cases of thyroid problems, especially hypothyroidism, which can also cause lethargy and depression.

The difference between male and female depression can be summarized as follows:

Women tend to

Men tend to

1. Blame themselves and feel
2. Remain sad feeling apathetic
and worthless. Become tensed
and scared which often lead to
anxiety disorder.
3. Try to avoid conflicts with others at any costs.
4. Get slowed down out of nervousness and lack of confidence.
5. Become reluctant and loosen control over people or situation
6. Suffer from self-confidence and despair and express self-doubts.
7. Ruminate i.e. cry to relieve
tension, share problems with
friends. It aggravates the

1. Blame others while justify
2. Remain angry and irritable and
feel ego-inflated.
3. Become suspicious and skeptic about people around them.
4. Create or initiate conflicts with
others. Go restless and agitated.
5. Seek control on whomever
available under them and demand
others’ submission.
6. Try to hide self-doubt or despair and express arrogance.
7. Distract themselves from their
problems which give somewhat
relief to their depressive

Adapted from: Male Menopause by Jed Diamond

Causes of Depression in Women

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The reason that women are more prone to develop depression than men lies across ethnic, racial, socio-religious and economic divides. In fact, significant gender difference in rates of depression is found in most of the countries in the globe. Theories attempting to explain the higher incidence of depression in women find many factors have been implicated including biological, psychological and social & environmental factors.

Biological Factors

Biological factors farther include genetic and hormonal reasons.

1. Genetics:

This is true for both male and female i.e. having a family history of depression puts one at higher risk of developing the illness. However, this rule is not binding, especially for women. A woman without family history may suffer from depression whereas one having family history of may not develop depression symptoms themselves. Genetics research reveals that the risk for developing depression involves combination of multiple genes with environmental or other biological factors.

2. Chemical and Hormonal variation throughout the Female Reproductive Cycle: 

Modern brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people suffering from depression look different from brains of those without depression. But these images do not detect the reason of depression. Brain chemistry seems to play a significant role on Depressive Disorders due to which the portion of brain responsible for regulating mood, thinking process, sleep, appetite and behavior cannot function normally. Besides imbalance in the important neurotransmitters used by the brain cells for communication also affect mood.

On studying the influence of female hormones, which go on changing throughout life, researchers have shown direct correlation between those hormones with the brain chemistry controlling emotions and mood. Hormone fluctuations throughout the reproductive cycle can profoundly influence a woman’s mood. Hormonal and mental state varies largely during puberty, before menstrual periods, before, during and just after pregnancy (postpartum) and just prior to and during menopause (peri-menopause). All of these milestones in the reproductive cycle can influence mood and trigger depression. Apart from these birth control medications and hormone replacement therapy to which only women can be exposed to also have mood-related side effects.

Puberty and Adolescence:

Before adolescence, girls and boys experience depression at about the same frequency. After puberty, depression rates in females are found to be higher than in males. Since girls normally attain puberty before boys do, and that too with a radical hormonal change, they're more likely to develop depression at an earlier age than boys. Unfortunately this depression gender gap lasts until and after menopause, which itself again becomes depressive for most of the women. Hormone change during puberty is held primarily responsible for mood fluctuations. However, temporary mood swings due hormonal change during puberty are normal which alone don't cause depression. Some other factors happen to play more important role, such as:

  • Emerging sexuality, body dissatisfaction and identity crisis.
  • Conflicts with parents
  • Gender discrimination in terms of food, education or liberty within family by parents
  • Increasing pressure to achieve in school, sports or other spheres of life
  • Bullying by peers and/or problem in socialization
  • Sexual abuse by adults or even friends

Premenstrual Problems (Premenstrual Dysphoric Disorder):

As compared to other days of a month experiencing irritability, mood swings, tensed and/or feeling down during or week before menstruation is quite normal for most of the women. These are called Premenstrual Symptoms (PMS). But some women may experience these symptoms in such a way that interferes with their normal functioning. Such situation is called Premenstrual Dysphoric Disorder (PMDD).

For most females PMS actually involves physical problems like abdominal bloating, breast tenderness, and headache which invite anxiety, irritability and mood swing. Heavy flow of bleeding and sharp abdominal pain cause physical impairment which restricts socialization which in turn affects the behavioral pattern too. In most women these symptoms of anxiety, irritability and a blue mood are minor and short-lived. But some females, though not in majority, may have severe and disabling symptoms that disrupt their studies, jobs, relationships or other areas of their lives. At that point, PMS cross the borderline to become Premenstrual Dysphoric Disorder (PMDD) — a type of depression that generally requires treatment.

Women affected by PMDD do not necessarily have unusual hormone changes, but their system respond differently to the normal changes that take place during mestruation. Women having a history of other mood disorders are more sensitive to menstruation-related hormone changes and as such more prone to develop PMDD. Inherited traits thus can also play a role. Scientific explorations are yet to tress exactly how the cyclical rise and fall of female hormones affect the neurotransmitters associated with depressive illness. It’s believed that cyclical changes in oestrogen, progesterone and other hormones can possibly disrupt the function of brain chemicals like serotonin that control mood.

However, life experiences and other social factors seem to become vital for a woman in this phallus-centric world.


Dramatic hormonal changes occur during pregnancy which can greatly affect mood. There may some other factors which can also increase the risk of developing female depression during pregnancy or during attempts to become pregnant, such as:

  • Lifestyle or work changes
  • Relationship problems
  • Previous episodes of depression, postpartum depression or PMDD
  • Lack of social support
  • Mixed feelings about being pregnant
  • Unwanted pregnancy
  • Miscarriage
  • Infertility
  • Stopping use of antidepressant medications

Postpartum depression: All members expels a few

Pregnancy, though very common, is a very big event in a woman’s life which involves not only hormonal and physical changes but the new responsibility of caring for a newborn can also be overwhelming. Women are particularly vulnerable to depression after delivery. Many new mothers find themselves feeling sad, angry, irritable and prone to tears soon after giving birth. A brief episode of mild mood fluctuations, referred as "baby blues", is normal and generally subside within a week or two. But some may suffer from more severe and prolonged depression which is then identified as Postpartum Depression, and requires prompt treatment as well as emotional support from near ones. It occurs in about 10 to 25 percent of women. Typical symptoms include:

  • Low self-esteem
  • Anxiety
  • Agitation
  • Inability to care for her baby
  • Thoughts of harming own baby
  • Thoughts of committing suicide
  • It's thought to be associated with major hormonal fluctuations that influence mood, predisposition to mood and anxiety disorders, birth complications and poor social support.

A study found that women after child birth are at higher risk towards developing several mental disorders, depression being one of them, for several months after delivery.8 Women who experience postpartum depression often found to have had prior depressive episodes. Some may feel depressed during their pregnancies, but their problems often remain undetected. Thorough medical check-up can help women screening for depression both during pregnancy and in the postpartum period.

However, repeated visit to doctors for both physical and mental check-ups may be done in first world countries. But in under developed and developing countries where women are mostly forced to conceive, sometimes forced to abort and sometimes even forced or convinced to kill their girl children, are subject to more severe trauma, but remain unattended. Where females do not receive even basic physical care during pregnancy and postpartum tenure, care for their mental health is often viewed as nothing but luxury in the society at large. Women in Africa, West Asia and other Muslim countries often undergo a horrific experience of genital mutilation which itself is unimaginably painful and traumatic throughout the life. No doubt depressive cases prior, during or post pregnancy, hardly get registered in such apathetic society.

Besides infertility or inability to become pregnant coupled with family and social compulsion, alienation or punishment kills the moral and self-esteem of women totally. This is more serious than depressive disorder due to physiological causes. The same is true for the just reverse cases of unwanted pregnancy which not only cause physical and hormonal changes but also becomes a source of social shame and/or punishment in most of the societies. This area is also difficult to cover under pregnancy related depression.


Fluctuation in reproductive hormones increases during the transition between pre-menopause to menopause. While some women may transit to menopause comparatively smoothly without much mood swing, many women are prone to develop mood fluctuation and depression. This may happen even among women without having any history of depression. However, depression seems to be less common during the post-menopause period.

3. Psychological causes of Depression in Women:

  • Getting stuck to Negative Feelings: Women are more likely to ruminate when depressed. This includes crying to relieve their emotional pressure, introspecting to figure out the reason of their depression or sharing their depressive sufferings with friends and acquaintance. This rumination itself has been found to retain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
  • Overwhelming Stress at work, school or home: Studies show that stress has more impact on women than men in developing depression. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do. Moreover, female sex hormone progesterone prevents the stress hormone system from turning itself off while male sex hormone testosterone help switching off the functioning of stress hormone.
  • Body Image issues: The gender difference in depression begins in adolescence. The emergence of sex differences during puberty is likely to play a role. Some researchers hold body dissatisfaction responsible in developing depression which increases in girls during the sexual development of puberty.
  • Health problems: Chronic illness, serious injury or any kind of disability are expected to lead to depression in women. The same is true for crash dieting or quitting smoking.
  • Shocks due to more Emotion: Evidence suggests that women respond differently to the life events than men, making them more prone to depression. Death or departure of loved ones psychologically affects women more than men. Their response to their feelings of stress is also more than men which again in turn increases the risk for depression. However, propensity to develop depression under similar challenging and stressful condition varies from woman to woman and the exact reason behind it is not clear.

Social causes of depression in women

Social factors play more vital role in female than in men along with lifestyle, adaptability and relationships. These may include:

  • Marital or relationship problems: These not only include balancing the pressures of career and family life, but also conjugal sexual life with the partner. Women who have to participate in improper sex act e.g. oral or anal sex are bound to develop depression, low moral as well as several sexually transmitted diseases. A woman abominates to perform orally and remains completely dissatisfied. Men, on the other hand, are often found to get exited while performing orally and sometimes attain orgasm with ejaculation even though their genitals are not involved. But in many cases (much more than confessed) the female partner has to act against her will without receiving any pleasure at all. The process in long run turns her into a masochist who needs to pretend to enjoy for the most distasteful degrading and painful exercises. To escape the physical and tremendous mental trauma sex workers often indulge or rather resort to help of dangerous drugs. Women in relationship – marital or else, if need to fulfill similar demand of their partners are also subject to severe and chronic depression which may permanently affect their behavior.

  • Family responsibilities such as caring for children, spouse or aging parents primarily rest on women which put them in additional pressure.

  • Experiencing Gender Discrimination at work place is another major cause of depression in women. Gender discrimination may involve sexual abuse in one hand while deprivation from recognition on the other. Pressure of reaching goals, threat of losing job, instability in changing job, retirement, or embarking on military service – all these remain similar or more stressful for a woman than man since family responsibilities often interfere more with a woman’s career. These pressures are multiplied by gender discrimination and non-compassionate behavior at work.

  • Monitory independence makes a woman feel psychologically better. But in many cases especially in South Asian and African countries monitory independence of women is restricted or simply denied. Depression due to career frustration is multiplied if access to husband’s earning is farther denied, a condition typical in many Indian family. However, social pressure of earning is vested more on males than females.

  • Our social norms compel women to part from their parents which itself is traumatic. If in-laws are compassionate by chance women adapts easily; but they are if not, the case may go anywhere from depression to suicide. Domestic violence against women which is very common problem worldwide, especially in Indian subcontinent and world of women’s mental health is yet another topic which itself can make a book.

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