depression and anxiety

Why Women Are More Prone to Depression and Anxiety

Depression and anxiety are two of the most common mental health disorders in the United States. While both men and women can experience these mood-altering conditions, they are much more prevalent in women.

What is depression?

Depression (sometimes referred to as major depressive disorder or clinical depression) is a prevalent yet severe mood condition characterized by a persistent, all-encompassing feeling of sadness that interferes with how you feel, think, and perform daily activities such as sleeping, eating, and working. It is the most common mental disorder in the United States affecting an estimated 300 million people.

There are many types and levels of depression. It can be short-lived, lasting just a few days, or continue for months or years. It can occur as a response to a setback or failure, such as a romantic breakup or loss of a job, or it can permeate your mind and body for no discernible reason, significantly interfering with your day-to-day life. The latter is known as “clinical depression” or “major depressive disorder.”

Symptoms of depression

Symptoms of depression can include:

  • Restlessness
  • Irritability
  • Persistent feelings of sadness or anxiousness
  • Ongoing feeling of emptiness
  • Loss of interest in activities that once brought pleasure
  • Feelings of guilt, shame, or worthlessness
  • Sleep disturbances, i.e., insomnia, oversleeping or interrupted sleep
  • Difficulty focusing on tasks or making decisions
  • Overeating or lack of appetite
  • Thoughts of suicide or suicidal attempts

Types of depression

Below are the most common types of depression.

  • Major depression: This type is all-consuming and crippling, causing severe behavioral/mood changes and loss of interest in activities. It can lead to suicidal thoughts or attempts.
  • Persistent depressive disorder: Characterized by a low mood that lasts at least two years but is not as acute as major depression. People with this disorder are usually functional, but they feel “down” much of the time with no capacity for joy.
  • Bipolar disorder: Formerly called manic depressive disorder, this type is characterized by periods of severe depression interspersed by periods of mania, such as intense energy, racing thoughts, and extreme excitement.
  • Seasonal Affective Disorder (SAD): Triggered by seasonal changes, particularly in the fall and winter.

In addition, women are at risk for two types of depression associated with childbirth and menstruation: postpartum depression (perinatal depression) that occurs during pregnancy or within 12 months of delivery, and premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome.

Women and depression

How common is depression among women?

Statistics show that women are more likely to experience depressive symptoms of any intensity than men. (1) For example, in 2019, 21.8% of women experienced depression symptoms in a two-week period compared to 15.0% of men. (2)

Women are also more likely to experience a major depressive episode, the most crippling and dangerous type of depression. For example, in 2017, the prevalence of major depression among women was 8.7% compared to 5.3% for men. (3)

What is anxiety?

The American Psychological Association defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.” (4)

Everyone feels anxious from time to time. After all, it is a typical reaction to unfamiliar environments/situations or perceived threats. Uncontrolled anxiety, however, can turn into a distressing and often crippling anxiety disorder.

Symptoms of anxiety

Anxiety symptoms vary widely and are often mistaken for a physical condition, such as a heart attack.

There are several categories of anxiety, so including a comprehensive listing here is impossible. Below is a general list of mental and physical symptoms of anxiety that, if experienced frequently, might be a sign of an anxiety disorder.

  • Persistent, uncontrollable worry
  • Nervousness
  • Trembling
  • Sweating
  • Racing heart or palpitations
  • Dizziness
  • Feeling unsteady
  • Breathing rapidly (hyperventilation)
  • Sleep issues, i.e., trouble falling asleep or staying asleep throughout the night
  • Fatigue
  • Avoidance of things and places that trigger anxiety

As many symptoms of anxiety could be signs of a medical condition, you must see your healthcare provider for a proper diagnosis. 

Types of anxiety disorders

According to the Anxiety & Depression Association of America, an estimated 40 million adults in the U.S. experience anxiety disorder every year. That’s 18.1% of the population. (5)

The most common anxiety disorders include:

  • Generalized Anxiety Disorder (GAD): Chronic, excessive worry about daily life situations.
  • Social Anxiety Disorder: Extreme fear of social interactions.
  • Panic Disorder: Sudden intense feelings of terror that usually happen repeatedly and include physical symptoms — such as chest pain, shortness of breath, and dizziness — that often make the person feel like they’re dying.
  • Agoraphobia: A specific fear of places and situations where the person previously suffered a panic attack or severe anxiety. This can result in extreme avoidance and social isolation.
  • Simple Phobia: Irrational fear of certain places, events, or objects.
  • Post-Traumatic Stress Disorder (PTSD): The result of experiencing or witnessing a traumatic event, PTSD is characterized by severe anxiety, uncontrollable thoughts or “flashbacks” about the event, and avoidance of places and situations that reminds them of the original incident.

Women and anxiety

In a systemic review of studies on people with anxiety worldwide, the University of Cambridge researchers discovered that women are nearly twice as likely to suffer from anxiety disorders as men. (6)

Depression and anxiety comorbidities

When two or more illnesses are simultaneously present in a patient, those illnesses are called “comorbid”. For example, obesity and diabetes are comorbidities when they are present in the same patient. Similarly, depression and anxiety are common comorbidities. 

According to the National Alliance on Mental Illness, “Some estimates show that 60% of those with anxiety will also have symptoms of depression, and the numbers are similar for those with depression also experiencing anxiety.” (7)

The exact reason for the frequent coexistence of these conditions is unknown, but researchers theorize that similar processes in the brain cause them. In addition, certain types of depression and anxiety can have similar symptoms, such as sleep disturbances, that meet the diagnostic criteria for both conditions.

Dangers of depression and anxiety

Depression and anxiety can cause more than emotional and physical distress; they can be dangerous for your health.

For example, anxiety or depression can increase blood pressure and lead to cardiovascular disease (CVD). Research shows that major depressive disorder is the second leading cause of disability and contributes to ischemic heart disease. (7a) It also significantly increases the risk of suicide.

These research results were so compelling that they persuaded the American Heart Association to officially list depression as a heart disease risk factor in 2014. (7b)

Why Are women more likely to experience depression and anxiety?

There are several reasons why women are more prone to depression and anxiety.

Differences in brain chemistry

A growing body of research suggests that women respond differently to stress than men and that this could be due to differences in brain chemistry.

For example, early studies indicate that a woman’s fight-or-flight response is triggered earlier and lasts longer than a man’s. This can arouse bodily sensations similar to anxiety, and if it happens often enough with no actual danger present, it can progress into an anxiety disorder. (8)

Researchers also found that depressed women show differences in the brain area that involve mood regulation and the integration of emotions compared to non-depressed women. (9)

Hormonal shifts

Women are subject to numerous hormonal shifts throughout their lives — puberty, the menstrual cycle, pregnancy, postpartum period, perimenopause, menopause — that can contribute to depression.

One reason for this effect appears to be estrogen, the primary female hormone. Studies show that estrogen has an impact on mood. For example, estrogen helps increase serotonin in the brain. Serotonin is a neurotransmitter that some consider a hormone, and it is necessary for a happy and contented mood. Estrogen also regulates the production of endorphins, a class of “feel good” hormones. (10)

Interestingly, new research by Harvard and Emory University neuroscientists found that low estrogen levels can also trigger anxiety in women. (Lower than normal estrogen levels can occur with hormonal fluctuations during the menstrual cycle, pregnancy, the postpartum period, menopause, etc.) (11)

Societal factors

Societal factors may also play a significant role in women’s higher risk of depression and anxiety.

For example, a large percentage of women are the primary caregiver of children and other family members. According to Michigan State University, “66 percent of caregivers are women. Men also provide care, but women may spend as much as 50 percent or more time caregiving than men.” Many female caregivers also work outside of the home, which increases their stress levels and feelings of failure when they cannot perform every task perfectly. (12)

In addition, many women experience unequal treatment and wages at work, pressures to meet society’s expectations of beauty, and the need to juggle their careers and caregiving responsibilities perfectly.

These factors create stress that can lead to depression and anxiety.

depression in women

Treating depression and anxiety

The good news is there are several treatments for depression and anxiety. Below are just a few of them that you can use alone or in combination.

Seek medical treatment

If your anxiety or depression is severe, you should seek medical treatment immediately. Your medical doctor can often prescribe medication that can help with your symptoms.

Find a good mental health therapist

Cognitive-behavioral therapy (CBT) has proven to be especially effective at treating depression and anxiety and is most often recommended. CBT is a solutions-oriented form of talk therapy that focuses on identifying and challenging dysfunctional beliefs, thoughts, and feelings that cause problems in your life.  Mindfulness-based treatments like mindfulness-based cognitive therapy (MBCT) and Acceptance and Commitment Therapy (ACT) have also proven quite effective, especially for depression.

If you carry health insurance, consult your provider directory for a therapist specializing in treating depression and anxiety. You can also ask your family doctor for a referral.

Learn yoga

Yoga is an ancient mind/body/spirit practice that can reduce your anxious or depressed feelings.

It combines breathing exercises, meditation, and bodily poses (asanas) to encourage relaxation, improve mood, and reduce stress.

You can learn yoga by reading books and watching videos. Still, it’s best if you attend an in-person class to receive group or individual instruction from a certified yoga instructor.

Practice meditation

Like yoga, meditation is an ancient practice that has been shown to improve mood and reduce anxiety.

There are many forms of meditation, but most involve concentrating on one thing, such as breathing. This trains the mind to focus, which relaxes the mind and body, instilling calmness and reducing depressed or anxious feelings.

Meditation is easy to learn, but it takes a lot of practice to see physical and emotional results. You can learn meditation by reading a book, searching for instructions online, or practicing with a guided meditation video.

REFERENCES

References

1- Centers for Disease Control. Symptoms of Depression Among Adults: United States, 2019. Page last reviewed: Sep 23, 2020. Accessed Sep 22, 2021. https://www.cdc.gov/nchs/products/databriefs/db379.htm

2- Villarroel MA, Terlizzi EP. Symptoms of Depression Among Adults: United States, 2019. Centers for Disease Control and Prevention. Sep 2020. Accessed Sep 22, 2021. https://www.cdc.gov/nchs/products/databriefs/db379.htm

3- National Institute of Mental Health. Major Depression. NIMH. Accessed Sep 23, 2021. https://www.nimh.nih.gov/health/statistics/major-depression

4- American Psychological Association. Anxiety. APA. Accessed Sep 23, 2021. https://www.apa.org/topics/anxiety/

5- Anxiety & Depression Association of America. Facts & Statistics. ADAA. Accessed Sep 23, 2021. https://adaa.org/understanding-anxiety/facts-statistics

6- Remes O. Why Women Suffer From Anxiety More Than Men, Leading To Increased Risk For Depression And Suicide. Medical Daily. Sep 27, 2016. Accessed Sep 23, 2021. https://www.medicaldaily.com/why-women-suffer-anxiety-more-men-leading-increased-risk-depression-and-399120

7- Salcedo B. The Comorbidity of Anxiety and Depression. NAMI. Jan 19, 2018. Accessed Sep 23, 2021. https://nami.org/Blogs/NAMI-Blog/January-2018/The-Comorbidity-of-Anxiety-and-Depression

7a- Brooks M. Depression Now World’s Second Leading Cause of Disability. Medscape. Nov 6, 2013. Accessed Sep 23, 2021. https://www.medscape.com/viewarticle/813896

7b- Brauser D. List Depression as Official Heart Disease Risk Factor, AHA Panel Says. Medscape. Feb 28, 2014. Accessed Sep 23, 2021. https://www.medscape.com/viewarticle/821253

8- Thriving Center of Psychology. Why Women are More Prone to Depression and Anxiety and What You Can Do About It. Accessed Sep 23, 2021. https://www.thrivingcenterofpsych.com/blog/why-women-are-more-prone-to-depression-and-anxiety-and-what-you-can-do-about-it

9- University of Michigan Health System. “New Brain-chemistry Differences Found In Depressed Women.” ScienceDaily. ScienceDaily, 8 November 2006. <www.sciencedaily.com/releases/2006/11/061106164718.htm>.

10- Hoffman M. Estrogen and Women’s Emotions. WebMD. Jul 23, 2019. Accessed Sep 23, 2021. https://www.webmd.com/women/guide/estrogen-and-womens-emotions

11- The Harvard Gazette. Estrogen and female anxiety. Accessed Sep 23, 2021. https://news.harvard.edu/gazette/story/2012/08/estrogen-and-female-anxiety/