Most of us have experienced difficult times throughout the past few years, and feeling sad is a normal reaction. In many cases, the sadness fades in a few days or when difficult circumstances have resolved.

Clinical depression is different. The National Institute for Mental Health describes it as a common but serious mood disorder that can impact how you think, feel, and handle daily activities such as working, sleeping, and eating.

Depression is more common among women than men, likely due to certain biological, hormonal and social factors that are unique to women. A study by the Centers for Disease Control illustrates that 1 in 10 women in the United States reported symptoms consistent with an episode of major depression in the last year, roughly twice the rate as men. CDC research also suggests that approximately 1 in 8 women experience postpartum depression or depression during the pregnancy.

It is important to recognize the signs and symptoms of depression. This article will address signs and symptoms of depression, particularly in women, and encourages women experiencing these symptoms to reach out for help. It is important to note that depression is not a sign of weakness or a character flaw, but is rather a common yet serious mental health concern.

What to look for

While many symptoms of depression are consistent with both men and women, research suggests that women are more likely to report symptoms of depression, including:

• Persistent sad, anxious, or listless mood

• Loss of interest or pleasure in activities or hobbies

• Feelings of guilt, worthlessness, or hopelessness

• Changes in appetite, either increase or decrease

• Changes in weight, either increase or decrease

• Changes in sleep, either increase or decrease

• Emotional lability or increased crying

• Decreased energy and fatigue

• Thoughts of death or suicide

• Persistent physical symptoms, such as headaches, digestive issues, or chronic pain not responding to treatment

Depression presents differently to different people. Some women may experience many symptoms, while others may experience only a few. The intensity, frequency, and length of time symptoms last varies depending on the individual and the severity of the illness, according to the National Institute for Mental Health.

Perinatal and perimenopause depression

In addressing depression in women, it is important to address perinatal depression- depression both during and after pregnancy- and perimenopausal depression. In addition to grappling with morning sickness, body changes, and mood swings during pregnancy, then after delivery caring for an infant, pregnant and postpartum women also endure major changes in hormones that greatly impact their mood. Hormones play a huge role in a women’s mood, and the hormone fluctuations around pregnancy and menopause can contribute to depression.

Perinatal depression, which encompasses both pre-and postnatal depression, occurs during pregnancy or in the first year after childbirth. This occurs in women of all ages, race, income, culture, or education. The symptoms of perinatal depression are similar to symptoms of depression unrelated to pregnancy, as previously listed. Others signs and symptoms of perinatal depression include:

• concern about one’s ability to care for the infant

• lack of interest in the infant’s activities

• depressed mood for at least 2 weeks

• lack of response to emotional support

• using alcohol, tobacco, or illicit substances

• in extreme cases, thoughts of harming self or infant

Women also have an increased risk for depression as they transition to menopause. Depression is more likely to occur before menopause, in a period known as “perimenopause,” due to hormone fluctuations. The decline in estrogen levels in perimenopausal women is believed to play a major role in perimenopausal depression.

Treatment

Fortunately, there are many treatments for depression, including medication, therapy, and lifestyle changes. For some, lifestyle changes, such as eating nutritious foods, increasing time outside with sun exposure, increasing exercise, and improving sleep habits can drastically improve symptoms of depression. Therapy is another way in which individuals can address their depression and learn skills to manage and mitigate the symptoms. For many, medication management with antidepressants is an effective treatment.

For those with depression that does not respond to medication management, therapy, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT) are alternative treatments.

If you are suffering from depression, it is important to know that you are not alone. Depression is common, but not normal. The first step to seeking treatment is to talk to your healthcare provider. If needed, you may be referred to a mental health provider. Seeking help for depression can be scary, but is an important step in improving your quality of life.