Understanding Depression in Women

At Francesca’s Salon in Wilmington, owner Francesca Powell consults with clients about their hair. Sometimes, women also talk about what is going on inside their heads. For Kari Gormley, a young mother having her hair styled, the topic was postpartum depression. “She talked about being depressed and how she got through it,” Powell recalls. “I could relate because I was depressed, too.”

Women are 70 percent more likely than men to experience depression during the course of their lifetimes, according to the National Institute of Mental Health (NIMH), the largest scientific organization dedicated to the understanding and treatment of mental illness.

For many, it’s a disorder shrouded in silence and isolation. But a growing number of people are talking openly about depression, sharing their experiences and their successes in dealing with the disease. “The more we talk about this the less stigma there is around depression,” Gormley says.

Research indicates that women are more prone to depression than men due to hormones. The risk of depression rises for women during menstruation and during menopause. As many as one in 10 women suffers from depression after childbirth.

Women also are more likely to seek help for depression and be diagnosed. That accounts, in part, for the higher numbers, says Dr. Kate Weymouth, a psychiatrist in Centreville. “It is not a feminine condition. Men get depressed, too,” she says.

Fighting SAD

Gormley, who lives in North Wilmington, learned that she was prone to seasonal affective disorder or SAD when she lived in Sweden, which gets only five hours of daylight a day during the dead of winter.

Research indicates that people who are susceptible to SAD produce too much melatonin, a hormone associated with sleep, in the winter when light levels are lower. At the same time, their bodies make less serotonin, a naturally occurring chemical in the brain that is associated with mood.

She was able to keep the blues away through light therapy and regular exercise. Working out helps to relieve symptoms of depression because it triggers the release of endorphins, or neurotransmitters that relieve pain and stress, creating a positive feeling in the body.

In 2007, Gormley and her husband moved to Delaware from the Washington, D.C., area. She was seven months pregnant and was diagnosed with preeclampsia, a dangerous complication characterized by high blood pressure. “It was the perfect storm,” she recalls. “My husband had a great job, but we had moved away from my in-laws and had no support system here. And then I had a difficult pregnancy.”

Gormley was diagnosed with postpartum depression two days after delivery and was connected with a psychologist. “I had extreme anxiety,” she says. “I thought I had to do everything perfectly.”

Making healthy choices

Over the years, she has adopted a multi-pronged approach to coping with depression. That includes cornerstone habits that establish a sound foundation for positive living. Meditation gets the day off to a good start. “When you start meditating, you focus on breathing and being gentle with yourself,” she says.

Gormley also practices yoga and is an advocate of rigorous exercise. So far, she has run in three marathons. She says her desire to run better and for longer has led her to make healthier choices all around, including a focus on nutrition.

She has stuck with counseling, “sometimes, it’s just a checkup.” She has benefited from medication. And she started a business called The Running Lifestyle, which supports others in their quests to improve their lives over the long run.

She also learned to tap into the power of group energy. “It is hard to get out and run in January when it’s 20 degrees outside—but it’s easier to do when you do it with 20 other people,” she says.

Even seemingly small changes make a difference. She got a mouth guard to prevent her from grinding her teeth. “Now I get a good night’s sleep.”

Gormley also avoids negative influences. That includes what she watches, reads or listens to, in addition to the company she keeps. “Be mindful of the people and the media that you surround yourself with,” she says. “I don’t need to watch ‘Real Housewives’ or Fox News. I look for the positive.”

Through years of contemplation, Gormley has learned to accept herself as she is. “I am a ‘good-enough’ wife and mother,” she says. “I’m not perfect. I do the best I can.”

Powell’s struggle with depression and anxiety began when she was a young girl. She didn’t know it then, but the illness ran in the family. “When I was a child, I always had anxiety,” she recalls. “I would throw up on the way to school. I always wanted to be with my mom.”

By the time she was a young woman, she had developed a strong work ethic. But on her days off, she would stay in bed. She was successful yet would dwell on what she did not have. She was in her early 20s when she was diagnosed with depression. A doctor prescribed medication, which made a big improvement in her mood. “I started feeling happier, warm and fuzzy,” she recalls.

After the birth of her son, her demons came roaring back. “I had a beautiful baby and a wonderful husband, but I felt like I had weights on my arms and legs,” she says. “I was hollow inside.”

Powell’s mother took her to an endocrinologist. Tests revealed an extreme hormone imbalance and she began treatment. “Within the second dose, I was functioning,” she says.

When her baby was 18 months old, her mother died suddenly at 59. Soon after, her godfather and uncle died. He was 58. “I was surrounded by death,” she says. “I wanted to be in my coffin. I fought those feelings with all my might.”

When her son was 5, she got pregnant with her second child. After her daughter was born, she again experienced postpartum depression.

With prompt treatment, Powell recovered. She began to make lifestyle changes to help keep depression at bay. She began working out in earnest. She gets to bed early every night. She avoids refined sugar, caffeine and alcohol.

“I have a protein shake every day,” she says.  “Dinner is always chicken or fish with veggies.”

She also resolved not to hide her history of depression. She lost a few friends. But she gained personal freedom and the opportunity to help others. “Depression isn’t something anyone chooses,” she says. “It’s nobody’s fault.”

Powell and Gorman met at the salon in Trolley Square. Both women have discovered that depression is a malady shared by many people. “One day, I mentioned that I used to throw up before school,” Powell recalls. “And another woman said, ‘I did that, too.’” 

Searching for solutions

The Centers for Disease Control and Prevention reports that 3.4 percent of Americans suffer from major depression, defined as feelings of sadness, loss, anger or frustration that interfere with daily life for weeks or longer. That is the same rate as in Delaware. West Virginia is the bluest state, with a depression rate of 5.3 percent. Connecticut is the least-depressed state at 2 percent.

At her office, Weymouth tailors care to the individual patient’s circumstances. She notes that depression can be situational, as in a year of bereavement after the death of a loved one. “I normally tell folks that the seriousness of what they are going through matches the treatment,” she says. “Are they unable to work? Is their marriage threatened?”

Although family history is a risk factor, not everyone is aware of it. “It’s amazing how many bright, capable women come to me and have no idea what their mother’s menopause was like,” she says.

Talk therapy is helpful in many cases. Patients often are able to avoid medications through a regimen of exercise and other healthy practices. “Exercise can be as effective as any medication and without the adverse effects,” she says.

Weymouth suggests strengthening healthy habits when you feel well so that they are in place when you need them. That includes exercising, nutrition, getting enough sleep and mindfulness practices.

“These are the first things to go when we don’t feel well, and yet they are critical to fend off a depression, or bring us out of one,” she says.

Staying active socially is important, too. “Depression often leads us to isolate, which just makes matters worse,” Weymouth says. “Talk about how you feel with loved ones and your primary care physician.”

For some people, medication is a good option. In the past, it might have taken several attempts to come up with the right prescription and dosage. Now, doctors can take a cheek swab and send it off to the lab to determine which medication is best suited to the patient’s genetic profile.

The first step to finding relief is seeking treatment, Weymouth says. If you think you might be suffering from depression, you probably are. “Never worry alone,” she says. “Share it.”   

Signs of Depression in Women

• Persistent feelings of sadness, anxiety or emptiness.
• Losing interest or joy in activities you used to look forward to, including sex.
• Crying a lot.
• Feeling restless and irritable.
• Sleeping too much.
• Sleeping too little, especially waking up very early in the morning.
• Feeling worthless, hopeless and helpless.
• Losing your appetite and losing weight.
• Eating too much and gaining weight.
• Feeling tired and rundown.
• Difficulty concentrating, remembering or making decisions.
• Physical symptoms that don’t go away despite treatment, such as headaches, stomachaches and chronic pain.

Depression by the Numbers

• 15 million Americans suffer from depression.
• Two-thirds of depressed people in the U.S. are women.
• Less than 50 percent seek professional help.
• Depression is most prevalent in individuals age 45-64.
• 1 in 10 women experiences depression in the weeks after having a baby.
• Even though more women are depressed, men are four times more likely to commit suicide.

Where To Find Help

• Center for Women’s Emotional Wellness at Christiana Care, help before, during and after pregnancy: 733-6662.
• Mental Health Association in Delaware, 654-6833 or (800) 287-6423.
• Adult Crisis Intervention Services (Northern Delaware), (800) 652-2929; Crisis Intervention Services (Kent and Sussex counties), (800) 345-6785.
• Children & Adolescents Crisis Intervention, (800) 969-4357.
• Christiana Care Center for Comprehensive Behavioral Health, (302) 428-2100.
• National Alliance on Mental Illness Delaware, (302) 427-0787; NAMI Delaware HelpLine, (888) 427-2643,
• Mobile crisis intervention, (800) 652-2929 or (302) 577-2484