Women and depression in Eagle County | VailDaily.com

Women and depression in Eagle County

Brenda Himelfarb
Vail CO, Colorado
AE depression illustration KA 12-09-07

EAGLE COUNTY, Colorado ” Karyn raced through the day going from one chore, one place to another without even thinking about what she was doing. She spent hours appeasing everyone. Since the mere utterance of the words, “I can’t” made her feel guilty, she never said “No.” She was a full-time mom, working part-time, chairing the school carnival, constantly juggling. She was hassled. She was spent. She was angry. It was every day, and never-ending.

Terry, on the other hand, faced each day differently. Each morning she’d awake with a start and a pounding in her chest that reverberated throughout her body. Random thoughts flashed through her head as though she was watching a music video. If she did this, she could fix that, she thought. She was always tired and listless; everything became an effort.

The consummate extrovert, Terry began to withdraw. She didn’t care about going out at all. She’d have splashes of feeling terrific, but they didn’t last long. Soon, everything became an effort. And then Terry was no longer willing to make the effort.

Alone in the house, Terry would sit in the middle of her bed, in her pajamas, unable to even answer the telephone. Her tears flowed for no obvious reason, so there she sat. Crying and staring.

Almost everyone knows a woman who has suffered a bout of depression, and the symptoms do differ. According to the National Institute of Health, about 19 million people ” one in 10 adults ” experience depression each year.

And women experience depression at roughly twice the rate of men. Although the specific cause of depression in women remain unclear, a variety of factors unique to women’s lives are suspected. Those include hormones, reproduction, genetic or geological factors as well as abuse, oppression and other interpersonal factors. The list goes on.

“I see women from late adolescence to those into their 80s,” says psychiatrist Joan Bornstein, who practices in Avon. “Women have different psycho-socio stresses than men. These days, in addition to family stresses, many women are in the work force. So not only do they wonder, ‘how does my family view me?’ but also, ‘how am I viewed at work?”

Age, Bornstein says, also has its effects.

“Older women have other issues,” she says. “Life changes like retirement can trigger depression. They question who they are and how valuable they still are. They might face health problems of an aging spouse. Additionally, women in second marriages encounter adjustment problems like blending new families.”

According to Dr. Carl Mueller, who teaches psychopharmacology at Yale, there are many nuances related to female depression. There is a genetic component to depression, but doctors are also identifying estrogen as one of the primary initiators of a lifelong proclivity to depressions.

“Up until about 10 years ago, it was viewed that it didn’t really matter if you were a man or a woman: someone is in a physiological depression,” Mueller says. “End of story. They’re treated all the same. Not true. Women are different from men.”

“Depression that adolescents have is very different between girls and boys,” Mueller continues. “Frequently the testosterone will make the depression more physically aggressive. Boys will be more agitated. They get into trouble with the law. They get into fights. Girls will be more withdrawn, emotionally vulnerable, extremely sensitive and will feel more rejection.”

Gay Cotter, a licensed psychotherapist and former Vail resident now living in Boulder, agrees. “Girls traditionally tend to be more sedentary; boys more physically active. Boys move and might work out their affected condition on the football or soccer field. Girls are more emotive. Their brains operate differently than boys.

“Teens are very vulnerable, at any moment, to be influenced by the status of what’s going on around them,” Cotter says. “So, for instance, if their parents are involved in a seasonal income and are stressed out because, say, it’s off-season and the cash flow isn’t there, a teenager is going to pick up on that.”

Cotter points out, however, that if you think your child is depressed, you should be looking at the “physical” first. Did he suffer a head injury while playing sports? If you have a child who is “all over the place,” is he or she indulging in alcohol or tobacco, which are considered to be depressants?

“Check sleep patterns,” advises Cotter. “Check their diet. “Is your child getting enough protein? I think we use the term ‘depressed’ too often. It’s very important to get that baseline. What is their normal reaction to things?”

The strain of adolescence is only the first of many stresses that women may experience. And it is thought that the high incidence of their depression is actually due, in part, to particular stresses that countless women face, as Dr. Bornstein has suggested, like single parenthood, or the constant juggling of working and motherhood. The quality of a marriage may also contribute significantly to depression ” like lack of intimacy in the relationship or constant bickering. In fact, rates of depression are shown to be highest among unhappily married women.

In his book, “Understanding Depression,” Dr. J. Raymond DePaulo, Director Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, maintains that depression is worse than mere sadness or being in a “bad mood.” The indicator of severe depression, he says is “an inclination to despair,” and the inability to feel any emotion.

Joanne, too, was a victim of severe depression.

“When you have a depression, you know those signs so well,” she says. “And sometimes even with the medication, it’s still there. And, I think, ‘if I weren’t on anything, what would life be like?’ I have spurts of fabulous. But my downs are very down and I don’t know how I would handle a blue day without medication. There is no color. And there’s no reaching out.”

If help is offered, she says, the tendency is to shy away from it.

“You do not want to take the hand,” she says. “You don’t want to pull out, you’re not sure why, but you just know you can’t. You’re lonely. You’re sad. It’s a purgatory of some sort. You can’t go back, you can’t go forward, you can’t get out of your own way. There’s no control. It’s very deep. I take life day by day.”

Despite such depths, even severe depression can be highly responsive to treatment. Often, part of the hopelessness that accompanies serious depression is having the belief that it is incurable. So doctors say it’s important that individuals not only get information about the effectiveness of treatments but also get treatment as soon as the symptoms of depression begin.

“Sometimes people don’t realize that they are depressed,” Bornstein says. “A family member or someone close has to point it out. You have to differentiate it from everyday ‘blues.’ It has to go on for a couple of weeks pretty consistently before you could call it ‘depression.'”

Adds Cotter: “Sometimes a women sits in front of you, smiling from ear to ear, telling you that the love of her life walked out on her four weeks ago. And yet, she is smiling. It’s not congruent. The situation that’s impacted her and the affect she’s giving you is mismatched. She needs to go to a knowledgeable, awake physician who will catch that.”

E-mail questions or comments about this story to cschnell@vaildaily.com.

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