December 2012 Women's Connection luncheon presentation on Women and Depression by Connie Marsh, MD, associate medical director of Via Christi Senior Behavioral Health.

1. Connie Marsh MD
University of Kansas School of Medicine-Wichita

2.  Importance of topic
 By 2020, depression will be the second
greatest cause of disability world wide

3.  In any given year, what percentage of
individuals will have depression?
a. 2%
b. 5%
c. 10%

4.  True or False
Women and men have the same rates of depression.

5.  What percentage of women, over a life time,
will have depression?
a. 7%
b. 13%
c. 21%

7.  Importance
◦ impact

8.  Impact
◦ Isolation
◦ Work problems
◦ Family problems
◦ Worsening medical problems
◦ Suicide attempt and completion
 15%

9.  Importance
◦ Impact on illness
 Greater disability and impairment
 Diabetes
 Lung disease
 High blood pressure
 Back problems
 Heart disease

10.  For most women, depression usually first
occurs
a. Age 15-24
b. Age 25-44
c. Age 45-55

11.  Neglected
◦ 60% detection by primary care doctor
◦ Less than 2/3 of people with depression seek
treatment
 Inadequate treatment is common

13.  What does depression look like?

14.  Mood
 Sleep
 Appetite
 Energy
 Interests
 Guilt
 Concentration
 Slowed down
 Thoughts of suicide

15.  Women more likely
◦ Seasonal component
◦ Excess eating
◦ Excess sleeping

17.  What does depression look like?

18.  Perception of mental illness
 Stigma
 Willingness to accept treatment
 Compliance to treatment
 Role expectations
 Immigration

19.  Rates of depression across races/ethnic
groups
◦ Globally
◦ Within US culture
 900 young women
 21% of whites
 28% of African Americans
 29% of Hispanics

21.  Male/female disparity

22.  Social
◦ Introspection encouraged in girls
 Socioeconomic
◦ Single parent
◦ Social isolation
 Psychological
◦ Increased rates of sexual/physical abuse in females

23.  Male/female disparity
◦ ENDOCRINE/neurotransmittors
ESTROGEN

25.  Puberty
 Premenstrual
 Pregnancy/lactation
 Postpartum
 Perimenopause

30.  What are risk factors for depression?

31.  For males and females
◦ Family history
◦ Personal history
◦ Serious medical illness
◦ Decreased social support
◦ Serious life stress
◦ Substance abuse, including alcohol, MJ, cigarettes

32.  For females
◦ Loss of parent before age 10
◦ Childhood sexual/physical abuse
◦ History of depression after pregnancy
◦ Single parent
◦ Unhappy/abusive marriage
◦ Presence of young children in home

33.  Psychotherapy
 Antidepressant medication
 Life style changes
◦ Exercise
◦ Nutrition
◦ Socialization

35.  If risk factors
◦ Recognize susceptibility
◦ Don’t ignore symptoms, including irritability
◦ Get therapy
 Stay healthy
◦ Exercise
◦ Avoid substances—drugs, alcohol, MJ, smoking

36.  Get help early
◦ More treatable
◦ Less impact on job/family/relationships
 Vicious cycle
◦ Recognize stressful times as susceptible times
 Increase social support network
◦ ASK for help
◦ If young children in home, especially important