Mar 12

Depression in Women: Three Recent Memoirs

Three recent memoirs by women living with depression. One brand new, the others from 2016 and 2017. One of the three, by the way, is an account by a psychiatrist—about herself.

I. Mary Cregan, The Scar: A Personal History of Depression and Recovery (March 2019)   

Although Cregan was first identified as suffering from severe clinical depression after the death of her infant daughter in 1983, she came to realize this wasn’t her first experience with the condition.

From Kirkus Reviews:

Moreover, depression had afflicted many members of her extended family, strong evidence of a genetic connection. As she discovered from research into the history of diagnosis and treatment, there has been much debate about whether the disorder arises from the mind or the body, whether it is a ‘maladaptive response’ to life circumstances or a biological mood disorder associated with chemical imbalances.

Cregan has benefited from therapy—including electroconvulsive therapy (ECT)—and medication, among other things.

II. Daphne Merkin, This Close to Happy: A Reckoning with Depression (2017) 

Merkin has experienced not one but three inpatient stays in her lifetime, starting in childhood. Despite lots of therapy and prescribed medications, depression is not something that completely goes away, Merkin has found.

She writes: “It was one thing to be depressed in your twenties or thirties, when the aspect of youth gave it an undeniable poignancy, a certain tattered charm; it was another thing entirely to be depressed in middle age, when you were supposed to have come to terms with life’s failings, as well as your own.”

III. Linda Gask, The Other Side of Silence: A Psychiatrist’s Memoir of Depression (2016)   

No longer in clinical practice, Gask does remain a psychiatry faculty member in the UK. In the following excerpt she questions the origins of her depressive condition:

Perhaps my depression coincided with the start of every academic year and the subsequent increase in my workload. Or maybe there was a more biological explanation linked to the fact that I, like many people with depressed mood, find the absence of light at these latitudes intolerable in the winter months. I didn’t know the answer – I still don’t. This is who I am. I cope most of the time; I am well for months, sometimes even for more than a year; but there are recurring periods in my life when the world seems a darker, more hostile and unforgiving place. I am a person who gets depressed.

An excerpt from Dr. Lilian Hickey‘s book review (Medical Humanities blog):

The professionals who make a difference to Gask are described candidly – the kind, the solid, the unreliable, the awkward and the wise. We are reminded that the right psychiatrist or therapist can be an astonishing lifeline on the edge of a mental abyss, and over the years her medical and psychotherapeutic relationships have been essential aspects of her own soul-rescuing in times of dread or confusion.

…There are different sorts of treatments and some have worked for Gask better than others. That things change – illness and the medical and psychological therapies which help, at different times in life – is a given.

May 05

What’s Special About Women and Depression?

Women and depression: we are twice as likely to be diagnosed than men. However, it’s not necessarily clear why or whether this statistic really reflects reality. As the Harvard Mental Health Letter stated in 2011:

Some experts believe that both genders are affected by depression in equal numbers, but women are more likely to be diagnosed with this disorder, in part because men are less likely to talk about feelings and seek help for mood problems. It also may be that depression shows up in different ways in men — for example, as substance abuse or violent behavior.

Others theorize that while both genders are biologically vulnerable to developing depression, women may be more susceptible to harm from life stresses and other environmental factors.

Neel Burton, MD, Psychology Today, proposes the following reasons for women’s more frequent presentation of depression, noting that the factors involved are biological, psychological, and sociocultural.

  1. Compared to men, women may have a stronger genetic predisposition to developing depression.
  2. Compared to men, women are much more subjected to fluctuating hormone levels…
  3. Women are more ruminative than men, that is, they tend to think about things more—which, though a very good thing, may also predispose them to developing depression. In contrast, men are more likely to react to difficult times with stoicism, anger, or substance misuse.
  4. Women are generally more invested in relationships than men. Relationship problems are likely to affect them more, and so they are more likely to develop depression.
  5. Women come under more stress than men. Not only do they have to go work just like men, but they may also be expected to bear the brunt of maintaining a home, bringing up children, caring for older relatives, and putting up with all the sexism!
  6. Women live longer than men. Extreme old age is often associated with bereavement, loneliness, poor physical health, and precarity—and so with depression.
  7. Women are more likely to seek out a diagnosis of depression. They are more likely to consult a physician and more likely to discuss their feelings with the physician. Conversely, physicians (whether male or female) may be more likely to make a diagnosis of depression in a woman.

Regardless of the possible causation, how can women heal from depression? Few resources focus specifically on women and depression, but a currently top-selling book on this topic is Dr. Kelly Brogan‘s 2016 A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives.

Antidepressant medication isn’t the best way to treat it, she believes, nor is there any proof for the theory that depression indicates a chemical imbalance in the brain. This is also the stance of such experts as Irving Kirsch, Andrew Weil, and James Davies. (Links will lead to my previous posts on their opinions.)

“Depression is an opportunity,” says Brogan. “It is a sign for us to stop and figure out what’s causing our imbalance.” Possible sources could be “your food, your gut, your thyroid, or even your go-to pain reliever.”

Nutrition is often the key to relieving depression, says Brogan. A free ebook obtainable by giving your email address at this link offers some of her basic prescriptions in this regard.

From reading the ebook as well as editorial and consumer reviews, it seems that Brogan’s approach is better suited to someone who can get totally on board with a holistic, the-food-you-eat-is-medicine-but-not-necessarily-fun-to-eat approach—something many resist.

Moreover, many do still believe that, for whatever unknown reason—placebo effect or otherwise— antidepressant medication not only works but also has saved lives. I’ve seen this too often myself to neglect to mention it here.

And don ‘t forget therapy, of course, as well as physical exercise—both proven to be effective.