Why are Women more Vulnerable to Depression?

About 1 in 5 women develop depression at some point in life. Women are nearly twice as likely as men to have depression. In her book “A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in Her Childbearing Years” Ruta Nonacs, M.D., Ph.D., wrote about this phenomenon.

Depression may strike at any time, but women appear to be particularly vulnerable during their childbearing years. Women are at highest risk for depression during pregnancy and shortly after delivery. One recent study indicated that as many as 25% of women suffer from depression during either pregnancy or postpartum period. Yet, in most of these women, the illness goes unrecognised and untreated.

Many have attributed this disparity to the various stresses women face as a result of their gender and the demands women face as they occupy multiple — and often conflicting — roles within the family, in the community, and at work. Over the last decade, researchers have also focused on the role of reproductive hormones, particularly estrogen. Women produce only one-half the amount of serotonin as men; however, estrogen in women multiplies the amount of serotonin to equal the level in men. The challenge occurs at three specific times—prior to a woman’s menstrual cycle, after childbirth, and around menopause—when estrogen levels drop, sometimes severely. If a woman’s estrogen level is not sufficient to multiply serotonin, she experiences a depletion of serotonin, which can cause depression.

When girls are between 11 and 13 years old there is a dramatic rise in the prevalence of depression, and by the age of fifteen females are twice as likely as males to suffer from depression. Adolescence is a time characterised by dramatic psychological and physical changes for women, and it is easy to imagine that this tumultuous transition may render adolescent girls more vulnerable to depression.

However, a woman’s risk for depression persists beyond puberty and she remains at higher risk for depressive illness than a man throughout her entire adult life. At no other point are women more vulnerable to depression than during their childbearing years. This is a time when she is faced with many life-changing and potentially stressful transforming events, which might be emotionally charged times. These years are also characterised by dramatic hormonal shifts related to reproductive functioning. Specialists in the field of women’s mental health said that it is the combination of psychological stressors and hormonal events that make women so vulnerable to depression during the childbearing years.

On top of this, many women experience constant hormonal fluctuations. … Experts believe that these hormonal shifts may act as a trigger for depression in some women and that women who have premenstrual mood changes may also be more vulnerable to depression at other times when exposed to significant hormonal fluctuations, such as after childbirth or during the transition to menopause.

While it is clear that certain women may be more vulnerable to these hormonal shifts, it is not clear whether hormonal factors increase vulnerability in all women. Some researchers think that these monthly hormonal changes act as a type of recurrent stressor, and with these repetitive insults, the underlying architecture of a woman’s brain is somehow altered so that is more susceptible to depression.