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Women's Health

The Many Faces of Depression Is it really just the blues? By Dr. Tara Yuan Published: October, 2007

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Is it really just the blues? Everyone gets the blues now and then, often prompted by life’s setbacks. Your kids sass you. The husband forgets your birthday. You’re passed over for a promotion. Some event gets you down. That’s normal. But if you continue to feel down, or during a 2-week period you experience 5 or more of these symptoms, you may have major depressive disorder (MDD): > Impairment in social and/or job functioning > Loss of interest or pleasure in most activities > Feelings of worthlessness or guilt > Difficulty falling or staying asleep, or sleeping more than usual > Change in appetite or weight > Behavior that is agitated or slowed down > Fatigue > Indecision or inability to concentrate > Thoughts of death or suicide THE GENDER GAP MDD, often called clinical depression, affects upwards of 25% of women of child-bearing age, as compared with 10-15% of men in their mid-teens to early 40s. This gender disparity is due to hormone fluctuations in women, the stresses women are under to have successful careers and be good moms and wives, and the greater willingness of women to admit they have a problem. Also, men are taught from boyhood on that to show sadness is a sign of weakness, and so they tend to mask depression as irritability, anxiety and anger. POSTPARTUM BLUES VS. DEPRESSION   Just like the regular blues, postpartum blues are common, affecting about 85% of new mothers. It’s normal to feel sad, moody, irritable and hypersensitive after delivery. These symptoms resolve within a few weeks and don’t significantly interfere with either the mother’s or the infant’s well-being. Up to 20% of women with postpartum blues see symptoms worsen and evolve into postpartum depression, a serious, but treatable, condition that impairs a mother’s ability to care for herself and newborn. Women with a depression history, those who have experienced emotional swings with their menstrual cycles or with previous pregnancies, and those under increased emotional stress due to marital problems, lack of partner or family support, are especially vulnerable to the “baby blues.” WARNING SIGNS Red flags for postpartum depression include: severe anxiety, feelings of incompetence or worthlessness, problems concentrating or making decisions, feeling physically exhausted despite plenty of sleep, or difficulty sleeping even though you’re tired, and thoughts of death, suicide or infanticide. If you’re experiencing any of these symptoms, see a doctor. The health and safety of not only the mother is at stake, but also that of the newborn, since women with postpartum depression may be unable or unwilling to care for their infants. Children of depressed mothers are also at risk for delayed and abnormal social, emotional and behavioral development. STEPS YOU CAN TAKE Ways to help you prevent or curb an onslaught of depression: • Exercise regularly. • Reduce or eliminate alcohol and caffeine. • Eat healthy foods. • Drink plenty of water. • Get 8 hours of sleep. • Spend time with those who care about you. If your blues persist or symptoms worsen, get professional help. Lifestyle changes and counseling can often cure mild depression. But moderate to severe cases may require medication or hospitalization. Treated promptly, postpartum depression and major depressive disorder have a good prognosis. Dr. Tara Yuan is a board-certified psychiatrist practicing at UC Irvine Healthcare’s Neuropsychiatric Center in Orange.

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