Depression in children is a problem that is now being taken more seriously than ever. While it was once believed children didn't experience depression, we now know children with depression may complain of illnesses, refuse to go to school, cling to a caregiver and create behavioral patterns that can be detrimental going into the next stages of their lives. (read more about: Child Depression Symptoms)

Depression in youth appears to be common as the following estimates of depression show:¹

• 0.9% in preschool-aged children experience depression
• 1.9% in school-aged children experience depression
• 4.7% in adolescents experience depression

Pre-puberty, depression occurs in equal amount across genders. During and after puberty, more women experience depression than do men.

The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) makes very little distinction between depression in kids and adults. However, diagnostically, depressed children may have more of an irritable mood than a depressed one and a depressed child may fail to gain the appropriate amount of weight, rather than lose weight, which is common in adults.

Causes of Depression in Children

The causes of depression in children have not yet been pinpointed, but factors are thought to be genetic, physiological and psychological. Over time, the diagnosis of depression in kids is being seen at younger and younger ages. Poor psychosocial, school and family functioning all appear to contribute to the causes of depression in children.

Dysfunctions in the brain are one of the causes of depression in children. In one study, youth (under 18 years) hospitalized for depression were found to have unusual frontal lobe and lateral ventricular volumes in the brain. In other words, some parts of the brain appear to be underdeveloped while others appear to be overdeveloped in depressed children.

Other causes of depression in children appear to include:

• Sexual or physical abuse or neglect
• A mentally ill parent
• The more mental illness in a family, the younger depression tends to develop
• Possibly a lack of involvement by the father and overprotection by the mother

Treatment for Depression in Children

For mild-to-moderate depression in children, treatment does not typically involve antidepressant medications. Often changes in the home, school and personal life of the depressed child is the most effective form of depression treatment.

Cognitive behavioral therapy has been shown effective in treating childhood depression. For more severe cases of depression in children, therapy plus and antidepressant is the most effective form of treatment. You can get comprehensive information about antidepressants for children here.

It's important to remember that approximately 1-out-of-100,000 children ages 10-14 dies of suicide², so early assessment and treatment of childhood depression is critical. Go here to learn how to help a depressed child.

article references

Women experience depression twice as often as men. According to the National Mental Health Association:

• Approximately 12 million women in the United States experience clinical depression each year.
• About one in every eight women can expect to develop clinical depression during their lifetime.

The diagnostic criteria for depression in women is the same as for men, but women with depression more frequently experience guilt, anxiety, increased appetite and sleep, weight gain and comorbid eating disorders.

Over the course of a lifetime, depression occurs in approximately 20% of women compared with 12% of men. Although the exact reason for this difference is not known, biological, life cycle and psychosocial factors may relate to the higher rate of depression in women.

Women and Depression – Effect of Hormones

Hormones and depression in women may also be linked. Researchers have shown hormones directly effects the brain chemistry controlling emotions and mood. For example, depression in women is particularly common after giving birth, when hormonal and physical changes, along with the new responsibility of caring for a newborn, can be overwhelming. About 10%-15% of women will develop postpartum depression, a serious condition that requires active treatment.

Some women may also be susceptible to a severe form of premenstrual syndrome (PMS) called premenstrual dysphoric disorder (PMDD). PMDD affects mood and is thought to occur due to the hormonal changes that happen around ovulation and before menstruation begins. The transition into menopause also seems to affect hormones and depression in women.

Risk Factors for Depression in Women

• Family or personal history of mood disorders
• Loss of a parent before the age of ten
• History of childhood physical or sexual abuse
• Use of an oral contraceptive, especially one with a high progesterone content
• Use of gonadotropin stimulants as part of infertility treatment
• Persistent psychosocial stressors (e.g., loss of job)
• Loss of social support system or the threat of such a loss

Diagnosis of Depression in Women

The diagnostic criteria for major depression, as established in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), are the same for women and men (Table below). The diagnosis of depression requires the presence of depressed mood or diminished pleasure (anhedonia), plus four other symptoms for at least two weeks.¹

Diagnostic Criteria for Major Depression

• Depressed mood
• Diminished interest or loss of pleasure in almost all activities (anhedonia)
• Significant weight change or appetite disturbance
• Sleep disturbance (insomnia or hypersomnia)
• Psychomotor agitation or retardation
• Fatigue or loss of energy
• Feelings of worthlessness
• Diminished ability to think or concentrate; indecisiveness
• Recurrent thoughts of death, suicidal
• A pattern of long-standing interpersonal rejection ideation, suicide attempt, or specific plan for suicide

Additional depression diagnosis criteria are as follows:

• The symptoms must cause significant distress or impairment of functioning in social, occupational, or other important areas.
• Depression should not have been precipitated by the direct action of a substance or a general medical condition.
• Symptoms should not meet criteria for a mixed episode (ie, for both manic and depressive episode).
• Symptoms are not better accounted for by bereavement (ie, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation).
• A major depressive episode should not be superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or a psychotic disorder not otherwise specified (NOS).

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder, Text Revision. 4th Edition. Washington, DC: American Psychiatric Association; 2000.

The presentation and course of depression in women is sometimes different to that of men (Table below). Seasonal depression is more common in women as are the symptoms of atypical depression (i.e., hypersomnia, hyperphagia, carbohydrate craving, weight gain, a heavy feeling in the arms and legs, evening mood exacerbations and initial insomnia). In addition, women more frequently have symptoms of anxiety, panic, phobia and eating disorders. Women also have a higher incidence of hypothyroidism, a condition that is one of the causes of depression in women. Finally, exogenous and endogenous gonadal steroids may have a greater impact on depression in women than depression in men.

---

---

---

Depression in Women vs. Depression in Men

	Women vs. Men
Lifetime prevalence	20% of women vs. 12% of men
20% of women vs. 12% of men	Earlier in women
Seasonal affect on mood	Greater in women
Association with stressful social events	More common in women
Atypical symptoms (such as oversleeping or overeating)	More common in women
Feelings of guilt and anxiety	More common in women
Suicidality	Women attempt suicide more frequently while men successfully commit suicide more often.
Association with eating disorders	More common in women
Association with substance use	Less common in women
Association with thyroid disease, migraines	More common in women
Association of antisocial, narcissistic and obsessive-compulsive personalities	Less common in women
Effect of exogenous and endogenous gonadal steroids on mood	Effect of exogenous and endogenous gonadal steroids on mood

Depression in Women and Suicide

Depression is a significant risk factor for suicidal behavior in both sexes. Depressed women more often attempt suicide, whereas men more often complete suicide. In fact, the male-to-female ratio for completed suicides is greater than four-to-one, possibly because women with depression frequently choose less lethal methods like poisoning. Significant risk factors for suicide by depressed women are listed below. (in-depth information on suicide, suicide hotline phone numbers 1-800-273-8255)

High-Risk Factors for Suicidal Behavior in Women

Risk for suicide attempts²

• Age less than 35 years
• Threatened loss of intimate relationship; separation or divorce
• Current psychosocial stressors (e.g., recent loss of job)
• Substance abuse
• Diagnosis of a mental illness like depression or a personality disorder
• History of physical or sexual abuse
• Incarceration
• Exposure to suicidal behavior of others
• Family history of suicide
• Severe anxiety and/or panic attacks
• Insomnia
• Recent diagnosis of a life-threatening illness

Risk for completed suicide³

• Severe clinical depression, especially with psychosis
• Substance abuse
• History of suicide attempts
• Current active suicidal ideation or plan
• One or more active, chronic, often deteriorating medical illnesses
• Feelings of hopelessness
• Severe anxiety or panic especially if mixed with depression
• Access to a firearm

During the initial visit, every depressed woman should be screened for suicidal thoughts, intent and plan, as well as the availability and lethality of a method for committing suicide. This screening may provide an opportunity for lifesaving intervention for women in depression.

Poisoning is the method employed in 70% of all suicide attempts by women; so initially, women with depression may only be prescribed one week of antidepressants at a time. When treating women and depression it is also important to enlist at least one of the patient's family members or friends to monitor intake of the prescribed antidepressant so the patient does not hoard the medication for use in a suicide attempt.

Hospitalization is necessary for women with severe depression, psychosis, substance abuse, severe hopelessness or limited social support. Women with depression should also be hospitalized if they articulate or display a strong urge to act on suicidal thoughts or if they have a specific suicide plan that is likely to be successful.

Sources:

• Blehar MC, Oren DA. Gender differences in depression. Medscape Women's Health, 1997;2:3. Revised from: Women's increased vulnerability to mood disorders: Integrating psychobiology and epidemiology. Depression, 1995;3:3-12.
• Rubinow DR, Schmidt PJ, Roca CA. Estrogen-serotonin interactions: implications for affective regulation. Biological Psychiatry, 1998; 44(9): 839-850.
• NIMH, Depression publication. Last updated April 2008.

(Get trusted, comprehensive depression treatment information)

See Also:

• Loving Someone with Depression: 5 Things You Should Know
• How to Deal with a Depressed Wife: Will She Ever Get Over This?
• How to Deal with a Depressed Girlfriend: I’m Scared for Her

article references

Depression is an illness that affects both men and women. But people working in mental health services see far fewer men with depression. It seems likely men suffer from depression just as often as women, but they are less likely to ask for help. Male depression is treatable and best treated as early as possible. Men need to know answers to: what is depression and how to get effective help.

Depression in Men is Different

Men think of themselves differently than women and this can be quite unhelpful. Compared with women, they tend to be far more concerned with being competitive, powerful and successful. Most men don't like to admit they feel fragile or vulnerable, and so are less likely to talk about their feelings with their friends, loved ones or their doctors. This may be the reason depressed men often don't ask for help. Men tend to feel they should rely only on themselves and it is somehow weak to have to depend on someone else, even for a short time.

This traditional view of how men should be - always tough and self-reliant - is also held by some women. Some depressed men actually find their partner rejects them because of their depression. Even professionals sometimes share this view, and may not diagnose depression in men when they should.

Symptoms of Depression in Men

• Feeling sad or unhappy
• High levels of anxiety
• Low energy
• Difficulties concentrating
• Feeling worthless or hopeless
• Losing interest in activities or people
• Weight loss
• Loss of appetite
• Loss of sex drive
• Lapses in personal hygiene, such as not bathing or shaving as regularly
• Thoughts of suicide

The symptoms for some types of male depression may also include extreme opposites of those listed above; for example, unusually high or prolonged levels of energy, significant weight gain and so on.

Other people may notice:

• You are performing less well at work
• You seem unusually quiet, unable to talk about things
• You're worrying about things more than usual
• You're more irritable than usual
• You're complaining more about vague physical problems

Read more comprehensive information about male depression symptoms.

How Depressed Men Cope

Instead of talking about how they feel, depressed men may try to make themselves feel better by using alcohol or drugs. This will usually make things worse in the long run. Their work will suffer and alcohol often leads to irresponsible, unpleasant or dangerous behavior. Men with depression also tend to give their work a higher priority than their home life, which produces conflicts with their wives or partners. All of these things have been shown to make depression more likely.

Depressed Men and Relationships

For married men, research has shown trouble in a marriage is the single most common problem connected with depression. Depressed men can't cope with disagreements as well as women. Arguments actually make men feel very physically uncomfortable. So, they try to avoid arguments or difficult discussions. Depression in men often leads to the situation where a man's partner will want to talk about a problem, but he will not and will do his best to avoid talking about it. The partner feels they are being ignored and tries to talk about it more, which makes the depressed man feel he is being nagged. So, he withdraws even more, which makes his partner feel even more that they are being ignored . . . and so on. This vicious circle in male depression can quite easily destroy a relationship.

Male Depression and Separation / Divorce

Men have traditionally seen themselves as being the leaders in their family lives. However, the process of separation and divorce is most often started by women. Of all men, those who are divorced are most likely to kill themselves, probably because depression is more common and more severe in this group. This may be because, as well as losing their main relationship, depressed men often lose touch with their children, may have to move to live in a different place, and often find themselves hard-up for money. These are stressful events in themselves, quite apart from the stress of the break-up, and are likely to bring on male depression.

Depressed Men and Sex

Depressed men feel less good about their bodies and less sexy than when they're not depressed. Many just go off sex completely. Several recent studies suggest that, in spite of this, men who are depressed have intercourse just as often, but they don't feel as satisfied as usual. A few depressed men actually report increased sexual drive and intercourse, possibly as a way of trying to make themselves feel better. Another problem in male depression may be that some antidepressant drugs reduce sex-drive in a small number of men who take them.¹

However, the good news is that, as the depression improves, so will your sexual desire, performance and satisfaction.

It's worth remembering that it can happen the other way round. Impotence (difficulty in getting or keeping an erection) can be a cause of depression in men. Again, this is a problem for which it is usually possible to find effective help.

Pregnancy and Children and Depression in Men

We have known for many years some mothers feel severely depressed after having a child. It is only recently we have realized more than 1 in 10 men also suffer depression during this time. This shouldn't really be surprising. We know that major events in people's lives, even good ones like moving house, can bring about a period of depression in men and women. And this particular event changes your life more than any other. Suddenly, you have to spend much more of your time looking after your partner, and the children.

On an intimate level, new mothers tend to be less interested in sex for a number of months. Simple tiredness is the main problem, although men may take it personally and feel they are being rejected. Men may have to adjust, perhaps for the first time, to taking second place in your partner's affections. Men also find they have to spend less time at work. Paternity leave is still quite unusual in most parts of the world.

Depression in new fathers is more common if their partner is depressed, if they aren't getting along with their partner, or if they are unemployed. This isn't important just from the father's point of view. Male depression will affect the mother and may have an important impact on how the baby grows and develops in the first few months. (more information about: postpartum depression in men).

Unemployment and retirement can be stressful times for men and be one of the causes of depression in men. Leaving work, for any reason, can be stressful. Research has shown up to 1 in 7 men will become depressed in the six months following unemployment. This rate of male depression is much more than would be expected in employed men. In fact, after relationship difficulties, unemployment is the most likely cause of depression in men. This isn't surprising, as work is often the main thing that gives a man his sense of worth and self-esteem. You may lose symbols of your success, such as the company car. You may have to adjust to looking after the home and children, while your wife or partner becomes the bread-winner. From a position of being in control, you may face a future over which you have little control, especially if it takes a long time to find another job.

Depression in men is more likely to happen if they are shy, don't have a close relationship or don't manage to find another job. Of course, if men get depressed, they may well find it harder to get another job, which may make the depression worse.

Retiring from paid employment may be a cause of depression in men, especially if their partner continues to work. It may take some time to get used to losing the structure of your day and contact with workmates.

Gay Men and Depression

On the whole, gay men do not suffer from depression any more than straight men. However, it seems gay teenagers and young adults are more likely to become depressed, possibly due to the stresses associated with coming out.

Depressed Men and Suicide

Depressed men are more than four times more likely to kill themselves than women.² Suicide is most common amongst depressed men who are separated, widowed or divorced and is more likely if someone is a heavy drinker.

We do know two-out-of-three people who kill themselves have seen their family doctor in the previous four weeks and nearly one-in-two will have done so in the week before they kill themselves. We also know about two-out-of-three people who kill themselves will have talked about it to friends or family.

Asking if a depressed man is feeling suicidal will not put the idea into his head or make it more likely he will kill himself. So, although some men with depression may not be very good at talking about how they are feeling, it is important to ask if you have any suspicion - and to take such ideas seriously. For a depressed man who feels suicidal, there is nothing more demoralizing than to feel others do not take him seriously. Men with depression often have taken some time to pluck up the courage to tell anybody about it. If you do find yourself feeling so bad that you have thought about suicide, it can be a great relief to tell someone.

Male Depression and Violence

Some studies have shown male depression is linked to violence.³ However, we don't know if the depression makes violence more likely, or if it's just the way they lead their lives.

Helping Men with Depression

Many depressed men find it difficult to ask for help - it can feel unmanly and weak. It may be easier for men to ask for help if those who give that help take into account men's special needs.

Men with depression are more likely to talk about the physical symptoms of their depression rather than the emotional and psychological ones. This may be one reason why doctors sometimes don't diagnose male depression. If you are feeling wretched, don't hold back - tell your doctor.

It can help to be reminded depression is a result of chemical changes in the brain. Depression in men is nothing to do with being weak or unmanly, and it can easily be helped. Antidepressants are often an important part of getting better - and it's important to remember this sort of medication is not addictive.

If a depressed man is married, or in a steady relationship, his partner should be involved so she can understand what is happening. This will make it less likely for the male depression to cause permanent problems in their relationship.

Some men don't feel comfortable talking about themselves and so may be reluctant to consider psychotherapy. However, it is very powerful and works well for many men with depression.

Male Depression Self-Help

• Don't bottle things up - If you've had a major upset in your life, try to tell someone how you feel about it.
• Keep Active - Get out of doors and get some exercise, even if it's only a walk. This will help to keep you physically fit and you will sleep better. It can also help you not to dwell unhelpfully on painful thoughts and feelings.
• Eat properly – a man with depression may not feel very hungry, but you should eat a balanced diet, with lots of fruit and vegetables. It's easy to lose weight and run low on vitamins when you are depressed.
• Avoid alcohol and drugs – Men with depression may find alcohol makes them feel better for a couple of hours, but it will make the depressed man more depressed in the long run. The same goes for street drugs, particularly amphetamines and ecstasy.
• Don't get upset if you can't sleep - Do something restful that you enjoy, like listening to the radio or watching television. (depression and sleep)
• Use relaxation techniques - If you feel tense all the time there are many ways of helping yourself to relax. These include exercises, audio-tapes, yoga, massage, aromatherapy etc.
• Do something you enjoy - Set some time aside regularly each week to do something you really enjoy - exercise, reading, a hobby.
• Check out your lifestyle - A lot of men with depression are perfectionists and tend to drive themselves too hard. You may need to set yourself more realistic targets and reduce your workload.
• Take a break - This may be easier said than done, but it can be really helpful to get away and out of your normal routine for a few days. Even a few hours can be helpful.
• Read about depression - There are now many books about male depression. They can help you to cope, but can also help friends and relatives to understand what you are going through.

Remember, in the long run, this depression might be helpful - It's unpleasant to have it, but some men with depression find it to be a useful experience, and some people emerge stronger and coping better than before. You may see situations and relationships more clearly and may now have the strength and wisdom to make important decisions and changes that you were avoiding before.

Getting More Help with Male Depression

The best place to start is your general practitioner / family doctor. He or she will be able to assess a man for depression and discuss the options for treatment of depression. It is true many depressed men are concerned the information held by their family doctors may need to be given in medical reports, and so may damage their chances in work. In spite of this, your family doctor is the best person to approach. Male depression may be due to physical illness, so it is important you have a proper physical check-up. If you are already receiving treatment for some physical disorder, your doctor will need to know because of the possible interactions between drugs. Any worries about confidentiality should be discussed with your doctor.

If you really feel you can't talk about it with anyone you know, look in the phone book for a 24-hour telephone service (crisis or suicide hotline 1-800-273-8255) which can give any man with depression the opportunity to discuss things anonymously.

Depression in men can be as much of an illness as pneumonia or breaking your leg. We really shouldn't feel embarrassed or ashamed about it. The most important thing to remember is to ask for the help you need, when you need it. If you need more information on male depression, or to talk to somebody confidentially, the following lists of publications and other organizations may be helpful.

Remember - depression is easily treatable and you are entitled to the help you need.

See Also:

• Loving Someone with Depression: 5 Things You Should Know
• How to Help a Depressed Husband, Wife When They Don’t Want It
• How to Deal with a Depressed Husband: 3 Things You Must Know
• My Depressed Partner Blames Me for Everything. Should I Put Up with It?

article references

Depression is a treatable, mental illness characterized by long periods of low, or depressed, mood that can occur at any stage of life. Recognizing the signs and symptoms of depression in teens and children can be a challenge though. It can be difficult to tell the difference between major depressive disorder symptoms and normal, moody behavior. Because children may not display the typical symptoms of depression, this article on what a depressed child looks like in real life may be helpful to you.

It is hard to estimate the number of teens and children with depression as not all doctors agree on diagnostic criteria. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) makes few distinctions between depression symptoms in teens and children versus adults. Depression in children and teens is not rare though. One estimate is between 0.9% - 4.7% preschool-age to adolescent youths meet the criteria for depression.¹

Symptoms of Depression in Teens

Depression symptoms in teenagers can potentially lead to very serious consequences – suicide is the second leading cause of death in adolescents. The pressures of school, peers, bullies and changing bodies can all add to the challenges of dealing with teenage depression.

The DSM-IV-TR diagnoses depressive disorders in teens almost identically to adults. However, the diagnostic symptoms of depression in teens include the possibility of an irritable mood, rather than a depressed one. Depression symptoms in teens often co-occur with other mental health issues like attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, substance abuse and behavioral problems. (take depression test for teenagers)

While most symptoms of depression in teens match that of adults, some depression symptoms are seen specifically in teenagers. These include:²

• Disruptive, behavioral problems, often in boys
• Preoccupation with body image and performance, often in girls
• Anxiety, often in girls
• Poor school performance
• School absenteeism
• Talk/threats of running away

Child Depression Symptoms

Similar to teens, the DSM-IV-TR makes little distinction between adult and child depression symptoms. Differences in diagnostic symptoms of depression in children include:

• Mood may be irritable rather than depressed
• Weight and appetite changes may include failure to gain expected weight

It's important to look at all surrounding mental health issues as they may include post-traumatic stress disorder or sleep disorders. Child-onset depression is also thought to be a common precursor to bipolar disorder, so symptoms of even brief mania or hypomania should be carefully evaluated.

Information on treatment of depression in children.

article references

Depression is a common, treatable mental illness that affects approximately one-in-ten men at some point in their lives. Depression can affect how a man functions at home, work and in his social life. The enduring low (depressed) mood experienced during depression manifests itself both physically and mentally. While some men do not want to admit they have a problem, it's important to remember depression in men does get better with treatment.

It's critical to treat depression in men because four-and-a-half times more men die of suicide than women.¹

Depression Risk Factors in Men

Many depression risk factors are shared across men and women. For example, any major life stressor such as a divorce or death can put either gender at greater risk for depression. There are a couple of key risk factors of depression that do occur frequently in men:

• Work stress – While stress at work can affect either gender, men often have more of their identity wrapped up in their work life than women. Men often feel a personal sense of failure if there are problems at work.
• Postpartum depression – much is known about postpartum depression in women but what has only recently been recognized is childbirth is a depression risk factor for men too. Approximately one-in-ten men experience postpartum depression. This is likely due to changing family dynamics and adjusting to the new role the man may take on at home.
• Low testosterone levels in later life can increase the risk of depression symptoms in men.

Hiding Male Depression Symptoms

Women are diagnosed with depression more frequently than men. This may be, in part, because of how men cope with depression symptoms. While women may externalize and talk about their sadness, a man may choose to cover it up by working more and disconnecting from others. Depression symptoms in men can be hard to spot because often the man wants to hide the symptoms so as not to appear weak.

However, depression is a treatable illness and not a form of moral or character weakness. Depression is not something a person can just "tough out."

Depression Symptoms in Men

According to the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) symptoms used to diagnose depression in men are the same as those for women. However, the visible signs and symptoms of depression in men tend to be slightly different. (take free online depression test)

With depression, men feel sadness and a loss of pleasure or interest and other symptoms often occur in an attempt to hide the depression. Common depression symptoms in men include:²

• Overworking, spending more time at the office
• Drinking or using other substances
• Spending more time alone and away from the family
• Controlling, violent or abusive behavior
• Anger
• Risky behavior
• Inappropriate sexual relationships, infidelity

article references

 

The symptoms of depression in women can severely impact social and occupational functioning as well as impair a woman's ability to care for a child (learn about postpartum depression). Depression is a debilitating illness that one-in-eight women can expect to experience in their lifetime and is characterized by prolonged periods of a low, or depressed, mood. It's important to remember, however, that depression is a very treatable mental illness.

Symptoms of Depression in Women

Female depression symptoms meet the same diagnostic criteria as those for men according to the Diagnostic and Statistical Manual of Mental Illness. However, there is a common cluster of depression symptoms women tend to experience. General symptoms of depression include:

• Depressed or low mood
• Lack of interest in previously enjoyed activities
• Worthlessness, hopelessness, guilt
• Sleep disturbance
• Appetite and weight changes
• Difficulty in memory and decision-making
• Fatigue
• Recurring thoughts of death

While these symptoms are common across genders, women tend to experience some depression symptoms more than others. For example, symptoms of depression in women tend to include more feelings of guilt than men and are more likely to be those known as "atypical" depression symptoms. Atypical depression symptoms in women include:

• Increase in appetite, particularly for carbohydrates
• Weight gain
• Increased need for sleep

A type of depression known as seasonal affect disorder (SAD) is seen in women more often than men. Women experience depressive symptoms according to the time of year (season) in this disorder. Women are also more likely to have thyroid problems and this can contribute to, or mimic, depression symptoms.

Almost twice as many women are diagnosed with depression as men (take online depression quiz). It's unknown as to whether this number reflects a predisposition in women to seek treatment for depression, but it's likely explained, at least in part, by the hormonal changes that happen throughout a woman's life. This increase in a woman's risk of depression is seen across other countries such as Iceland, Canada, Japan and Switzerland.¹

Depression Risk Factors in Women

There are many known risk factors in women for developing depression. Many risk factors affect both genders equally such as extreme stress, genetic predisposition or a co-existing illness. Some depression risk factors only apply, or are much more common in, women.

A major depression risk factor for women is childbirth. Postpartum, 85% of women experience emotional upset and 10%-15% go on to experience clinical depression. The drop in hormones, blood volume, blood pressure and other major physical systems puts women at a dramatically increased risk of depression. Having to adapt to, and care for, a new child is also a major life stressor and a risk factor of depression.

Other depression risk factors commonly seen in women include:²

• History of abuse, sexual abuse
• Use of an oral contraceptive, particularly those with a high progesterone content
• Use of gonadotropin stimulants as part of infertility treatment
• Loss of social supports, or the threat of this loss
• Lack of intimacy and marital discord
• Miscarriage or unwanted pregnancy
• Infertility
• Premenstrual problems
• Perimenopause and menopause

article references

The "winter blues" are a sluggish and low mood that appears over the winter months. While sometimes seasonal affective disorder (SAD) is referred to as the winter blues, SAD is a formal major depression diagnosis and the winter blues is not. The symptoms of the winter blues do not rise to the level of a mental illness, but can still be unpleasant and somewhat impairing for people. In some northern climates, full-blown SAD is experienced by 10% of people while another 30% experience the winter blues.¹

Symptoms of the Winter Blues

The symptoms of the winter blues are similar to depression but are milder. Symptoms of the winter blues include a low or sad mood as well as:

• Irritability
• Decreased energy, fatigue
• Change in appetite
• Lack of motivation

If low mood symptoms continue for more than two weeks, and are significantly impairing day-to-day functioning, a doctor should be seen for a full depression screening (take our free online depression test).

Beating the Winter Blues – Diet and Exercise

Beating the winter blues involves mostly lifestyle changes in diet, exercise and sleep patterns but light therapy and psychotherapy may also be helpful.

Diet and exercise are tied into how our whole body works. A diet with too many sugars (simple carbohydrates), saturated fats or alcohol will bring down mood. Having a sugary treat may feel good at the moment, but will leave you feeling tired soon after. A healthy diet will keep energy levels up and prevent any winter weight gain. Getting a full eight hours of sleep every night also helps energy during the day.

Exercise has been shown to be a powerful antidepressant in those with depression and can help those with the winter blues too. Not only can exercise improve your mood and combat stress but, combined with a healthy diet, can boost energy throughout the day. Exercise with a friend is particularly useful as it combines the benefits of exercise with the benefits of socializing with others.

Beating the Winter Blues – Therapy and Light

It's known that those with seasonal affective disorder do significantly better when treated with cognitive behavioral therapy (CBT) and light therapy together. This therapy may be useful for the winter blues as well. CBT focuses on understanding one's own thought processes and learning to use tools to alter those thoughts.

Light therapy is frequently used in the treatment of seasonal affective disorder as the reduction of light available in the winter appears to evoke depressive symptoms in some people. Additional light for the winter blues can also be helpful. This does not mean turning on every light in the house, however. This means getting more natural sunlight and the addition of more natural light in the home can also help. Ways to get light for the winter blues include:

• Spending more time outdoors; for example, frequent trips to the ski slopes or going for walks everyday.
• Switch indoor lights to full-spectrum or 4100 Kelvin bulbs.
• Use a seasonal affective disorder light box.

article references

Seasonal affective disorder is a form of major depression with episodes that correlate to the time of year. Seasonal depression is most commonly seen during the winter, suggesting the decreased hours of sunlight are a factor in producing the symptoms of seasonal affective disorder. One effective SAD treatment combats this: light therapy.

Seasonal affective disorder (SAD) light therapy has been repeatedly shown as beneficial over multiple studies and multiple years and is now an accepted treatment. Most people using light therapy for SAD show improvement one week after starting treatment.¹ One study of 100 people with SAD showed light therapy was equal in effectiveness to treatment with fluoxetine (Prozac), with light therapy producing results slightly faster.²

Light Therapy for Seasonal Affective Disorder (SAD)

Light therapy involves exposing the patient to a SAD light which emits a powerful, full-spectrum light, similar to the sun. This specialized seasonal depression light appears to create changes in the brain that effect mood.³ The seasonal affective disorder lamp is placed approximately 1 – 2 feet from the patient's eyes and angled so the light is coming from above the patient (those who do not have the light shining downwards do not respond as well to treatment²). SAD lights are used 15 – 30 minutes a day, typically in the morning; however, a doctor should decide on the best use of lights for SAD.

A complete understanding of how light therapy for SAD works is unknown, but it appears to be tied to the body's daily rhythm (circadian rhythm). Scientists have found a part of the eye that is not used for vision and instead delivers light information directly to the center of the brain, in the hypothalamus. This area is known to be the location of the "biological clock" in humans. Without enough light to this part of the brain, the circadian rhythm is altered, possibly producing depressive symptoms in some people.⁴

What to Look for in Seasonal Depression Lights

Lights for SAD come in many sizes and strengths. It's important to know what kind of light box to buy. A doctor should always be consulted before starting light therapy or buying a SAD lamp. Here some things to keep in mind about specific seasonal depression lights:⁵

• Evidence – is the light specifically designed for light therapy for SAD? Some lights have studies supporting their effectiveness while many do not.
• Intensity – it's critical to know how much light a SAD light is producing. Light intensity is measured in a unit called "lux." Patients typically want to receive 10,000 lux of light during treatment. However, each seasonal depression lamp can only produce a specific intensity at a given distance. For example, the patient may get 10,000 lux of light when sitting 18 inches away from the light, but will receive less if sitting farther away.
• UV light – UV light emitted should be minimized due to eye and skin damage risks.
• Blue light – there is some evidence to suggest that SAD lights emitting blue light are more effective; however, blue light may also pose a greater risk of harm to the eye.
• Design – can the light be positioned at the correct distance at a downward angle?

Cost can vary widely from $50 to $200. Often the cost is associated with SAD lamp quality and supporting evidence. Some of the options for SAD lights include:²

Zadro	About $50 from Target, Walmart	Some Reports of quality problems
goLITE BLU energy light	$30 - 120 from Walmart, Costco, Amazon	10,000 lux, proven effective
Sunlight Jr.	$200+ from Sunbox.com	10,000 lux, a well-known and recognized company

article references

Seasonal affective disorder symptoms are typically seen during the winter months but variations of the disorder cause different mood patterns and some people experience SAD symptoms during other times of the year.

Seasonal affective disorder, often referred to as "SAD," is a type of mental illness and is very common - with estimates of between 1.4% - 9.7% of the population experiencing some degree of SAD symptoms.¹ The likelihood of seasonal affective disorder is partly due to climate, with people in New Hampshire being approximately six times more likely to develop symptoms of seasonal affective disorder than people in Florida.

Seasonal Affective Disorder Symptoms

Seasonal affective disorder requires depressive episodes be tied to a particular time of year. The Mayo Clinic recognizes three subtypes of seasonal affective disorder: fall and winter; spring and summer; and reverse.²

The most common pattern of symptoms in seasonal affective disorder has the onset of depression in the late fall. The full depressive episode is seen in the winter and remits during spring and summer. Winter seasonal depression disorder symptoms include typical major depression symptoms like a low mood and hopelessness as well as:

• Anxiety
• Loss of energy, fatigue
• Withdrawal from family and friends
• Hypersomnia (oversleeping)
• Loss of interest in previously-pleasurable activities
• Overeating, weight gain
• Difficulty in cognitive processing and concentrating

Winter seasonal affective disorder symptoms focus on low energy symptoms whereas summer seasonal affective disorder symptoms are more centered on agitation and irritability related symptoms. Summer SAD appears in the late spring, is most severe in summer and remits during the fall and winter. Other typical summer seasonal affective depression symptoms include:

• Anxiety
• Insomnia
• Lack of appetite, weight loss
• Increased interest in sex

There is a third, less common form of SAD disorder known as reverse SAD. Instead of a season bringing about depressive symptoms, seasons, generally spring and summer, bring about manic or hypomanic symptoms. This type of SAD is related to bipolar disorder. Reverse SAD symptoms include:

• Elevated mood
• Agitation
• Rapid thoughts and speech
• Increased social activity
• Hyperactivity
• Unbridled, unreasonable enthusiasm

It's important to note while reverse SAD is a type of seasonal affective disorder, light therapy, commonly used in SAD treatment, may not be indicated and may further destabilize mood in bipolar disorder.³

Risk Factors for Seasonal Affective Disorder

The direct cause of the disorder, SAD, is not known, but it is thought to be a biochemical problem with genetic and environmental components. Risk factors for developing seasonal affective disorder include:

• Gender – females are most often diagnosed with SAD
• Location – the further a person is from the equator, the greater the risk for SAD
• Family history – as with other types of depression, SAD tends to run in families
• Bipolar disorder – people with reverse SAD have bipolar disorder

article references

Seasonal depression is a type of depression that occurs at the same time every year. Seasonal depression disorder, also known as seasonal affective disorder (SAD), can be serious and crippling each year. In that way, it is different than the milder "winter blues." Most commonly, seasonal depression is in the winter in North America, as that is when there are fewer hours of sunlight.

There is no known cause of seasonal affective disorder but researchers currently think it may be related to:

• Changes in biological clock as the seasons change
• A disruption in the hormone melatonin
• A drop in the neurotransmitter serotonin, possibly due to reduced sunlight

Seasonal Depression Symptoms

Seasonal depression can be related to the summer or winter months, each with their own seasonal depression symptoms. Fall and winter seasonal affective disorder symptoms include:¹

• Depression, hopelessness
• Anxiety
• Loss of energy
• Social withdrawal
• Oversleeping
• Loss of interest in once-pleasurable activities
• Overeating, weight gain
• Difficulty thinking and concentrating

Seasonal depression in the summer is somewhat different. Rather than experiencing the marked low mood of depression, more irritable characteristics may come out. Typical spring and summer seasonal depression symptoms include:

• Anxiety
• Trouble sleeping
• Irritability, agitation
• Lack of appetite, weight loss
• Increased sex drive

Seasonal Depression Treatment

While some people think they have to "tough out" seasonal depression, there is no need for this as there are effective seasonal depression treatments available. Treatments for seasonal affective disorder include psychotherapy, antidepressant medication and SAD bright light therapy.

While seasonal depression is thought to be related to biological factors, psychotherapy is still a treatment option. Therapy for seasonal depression disorder can both teach the patient about their illness as well as support the patient through depressive episodes. Psychotherapy can also treat any underlying condition that may be contributing to the seasonal depression.

Medications are also used in seasonal depression treatment, particularly if the symptoms are severe. Medications typically used in seasonal depression treatment include:

• Antidepressants – selective serotonin reuptake inhibitors (SSRIs) like paroxetine (Paxil), , fluoxetine (Prozac, Sarafem) and venlafaxine (Effexor) are common. bupropion (Wellbutrin XL) is a similar antidepressant that is thought to prevent future seasonal depressive episodes.
• Modafinil (Provigil) – there is preliminary data suggesting a wakefulness-promoting agent may be used to prevent fatigue during the day as well as decrease depressive symptoms.²

Bright light therapy is the most common seasonal depression disorder treatment. Bright light therapy attempts to increase the amount of "sunlight" received via a specialized light box. Patients spend a set period of time per day in front of their light box to treat seasonal depression. The way in which bright light therapy works, however, is unclear.

article references