A psychologist who has treated women with depression for 15 years shares her 6 most important pieces of advice
- Depression is nearly twice as common in women, likely because of unique social and hormonal factors.
- Many women don't recognize key signs of depression, which can make it harder to get timely support.
Dr. Carla Marie Manly, a clinical psychologist in private practice, has treated women with depression for 15 years.
According to Manly, one major misbelief about depression is that it's a "normal part of being a woman." This notion may be rooted in the fact that depression commonly affects women.
About one in eight American women will develop clinical depression during their lifetime. Moreover, women are almost twice as likely as men to experience symptoms of depression, which may be due to certain societal, hormonal, and biological factors unique to women.
Here are six things Manly wants women living with depression to know.
1. The key signs aren't always obvious
Some signs of depression in women are easier to spot — like changes in appetite or sleeping habits, irritability, or feelings of hopelessness.
But Manly says you and your loved ones may brush off or fail to notice other key symptoms. These symptoms include:
- Anhedonia: This symptom refers to an inability to get enjoyment out of activities that previously interested or uplifted you. "Given that many women struggle with feeling exhausted and overworked, this important sign of depression is often confused with burnout or lack of sleep," Manly says.
- Decreased interest in sexual activity: Low libido can relate to natural hormonal fluctuations, exhaustion, or stress, but it can also happen as a sign of depression, according to Manly.
- Drinking too much: Increased substance use can be both a cause and a coping mechanism when it comes to depression, Manly says. Drinking in excess can offer a way to mask or numb unwanted emotions. Plus, since society normalizes indulging in alcohol while socializing or relaxing, you may not immediately recognize when your drinking habits have changed.
- Isolation: Manly says both extroverts and introverts with depression may avoid even minor social engagements and start seeking out more solitary activities, like watching TV alone instead of participating in your weekly movie night with friends. "Although it's normal and healthy to pare back on activities when restorative time is needed, many women don't realize that depression may manifest through a gradual or sudden shift in the desire to engage with others," she says.
- Overspending: A 2015 study found making shopping choices can help alleviate sadness by restoring a sense of personal control over your environment. According to Manly, some women with depression may engage in compulsive shopping in an attempt to lift their mood.
2. It won't necessarily derail your life completely
"Many people assume that women who are depressed languish in bed or are largely unproductive," Manly says.
According to Manly, a lot of women have what's called "high-functioning depression," which can be more difficult to recognize. You can have depression, even if you can still perform at your job, take care of your kids, or put on a smile at social events.
"Many women who live with depression intentionally put on a mask of cheerfulness and remain very busy," Manly says.
3. Depression triggers may relate to your circumstances
While depression doesn't always have a specific cause, a wide range of issues — physical, emotional, and social or societal — can trigger depression in women, according to Manly.
For example, women are more likely to live in poverty, which can cause feelings of uncertainty, lack of control, and low self-esteem that contribute to depression.
Other common triggers of depression in women include:
- Relationship conflict
- Unresolved trauma, such as sexual abuse, childhood abuse, domestic abuse
- Stress, especially for single mothers and women working multiple jobs or caring for ill family members
- Family dysfunction
- Political issues, such as changing abortion rulings or the threat of war
- Environmental concerns, such as climate change or natural disasters
- Ongoing health issues
- Low self-esteem
- Social isolation or lack of friendships
- Unemployment
- Retirement
- "Empty-nesting," or adjusting to life at home after kids move out
- Excessive social media use
- Perfectionism
4. Depression can set in during certain life stages
Certain types of depression can occur at different stages of your life, often in response to specific physical changes.
Premenstrual dysphoric disorder
It's common to experience some sadness and even crying spells in the week or two leading up to your period as part of premenstrual syndrome (PMS).
But between 5% and 10% of people who menstruate experience a more severe form known as premenstrual dysphoric disorder (PMDD), which can cause a more severe depressed mood, feelings of despair, and suicidal thoughts.
Prenatal depression
Uncomfortable bodily changes, hormonal shifts, and intense planning that come with pregnancy can be overwhelming for expecting mothers — particularly if you add in relationship problems, work changes, a lack of social support, or other life stressors.
Prenatal depression tends to affect women right before having a child, but it can set in at any point during pregnancy — and it can make it difficult to care for yourself or others.
Self-care is especially important during pregnancy. Finding a support network for expecting parents and asking your doctor for treatment recommendations can help you manage and cope with symptoms of prenatal depression.
Postpartum depression
Around one in seven women develop postpartum depression (PPD), which tends to last longer than prenatal depression and involves more severe symptoms, from guilt or low self-esteem about your capabilities to suicidal thoughts.
Important: If you're having thoughts of suicide, help is available right now. You can get free, confidential support from compassionate crisis counselors by calling 988 to reach the Suicide and Crisis Lifeline or texting "HOME" to 741741 to reach the Crisis Text Line.
PDD often goes undiagnosed because many women don't want to disclose their depression to family members due to stigma, along with a general fear of abandonment or losing support. But without treatment, symptoms may get worse and affect your bond with your baby.
Risk factors for PPD include:
- A personal or family history of mood and anxiety disorders
- Infant or childbirth complications
- Lack of social support
Perimenopausal depression
Perimenopause, the transition into menopause, is when hormone levels tend to fluctuate the most. Many women going through perimenopause experience rapid changes in mood, depression, and anxiety.
You're more likely to experience perimenopausal depression if you go through menopause at a younger age, or if your ovaries are surgically removed.
5. Changing habits that fuel depression can be challenging
Manly says one of the main challenges in helping women with depression relates to changing the habits perpetuating their depression. This is because depression can negatively affect your energy and motivation.
"While a woman with depression may very much want to heal, it's often incredibly difficult for her to find the energy and drive to embrace mood-boosting habits," Manly says. "She may come to understand precisely what would help her manage her depression — like leaving a toxic workplace or even exercising more — but such tasks often feel overwhelming."
Anxiety or fear can also play a role in keeping women stuck. For example, Manly says a woman may realize her relationship with a difficult or abusive partner lies at the root of her depression, but hesitate to leave the relationship due to fear of change or loneliness.
Other reasons for staying in an abusive relationship might include financial insecurity, dependence on a partner due to a physical disability, and concerns about keeping the family unit together — factors that might also play a part in depression.
6. Depression is highly treatable
Manly's top piece of advice for women who have or believe they may have depression is to seek support from a licensed therapist.
She also suggests finding a local depression support group for women. Support groups not only provide a safe space to share your emotional experiences, but they can also serve as an important reminder that you aren't alone.
But when it comes to antidepressants, Manly advises managing your expectations: These medications may ease depression, but they likely won't erase it entirely. They can also take weeks to start working.
"If depression feels like a 100-pound weight, taking an antidepressant may make the weight feel more like a 60-pound weight," Manly says.
Important: Keep in mind that while antidepressants can help relieve some symptoms of depression, they don't help you address any underlying root causes of depression. That's why a combination of psychotherapy and medications may prove more effective than either treatment on its own.
You can find a therapist who treats depression by using any of the following searchable databases:
Insider's takeaway
Depression is more common in women, due to both biological factors and societal issues.
Big events like pregnancy, divorce, menopause, or the death of a loved one can all trigger depression, but this mental health condition can also stem from other everyday life stressors, or happen without a specific trigger.
Severity and symptoms can range widely from person to person, and some signs — like drinking a little more alcohol, spending more money, or seeking out more alone time — may be easy to miss.
"No matter what, remember that you are not broken if you struggle with depression," Manly says. "Many people have struggled with, and successfully overcome or learned to manage, the gloomy cloud. So, don't give up — because depression is a mental health issue that can be healed."