According to the latest data from the National Center for Health Statistics, one in five women aged 40 to 59 and one in four women age 60 and older used an antidepressant in the past 30 days during 2015 to 2018. . Among women ages 18 to 39, the figure was one in 10. Among men, 8.4% of those aged 40 to 59 and those 60 and older had used antidepressants in the past 30 days, according to NCHS data.
The statistics are attracting the attention of scientists and doctors. Many are concerned about how high depression rates among midlife women were even before the pandemic, now that the past two years have exacerbated mental-health issues for many Americans. And some doctors are also concerned that antidepressants are being over-prescribed for menopausal symptoms.
In general, according to scientific research, women have higher rates of depression than men throughout their lives. The risk is greatest in midlife, up to menopause and during the years immediately following. The dramatic fluctuations in hormones that cause the most commonly known symptoms of hot flashes and night sweats can also wreak havoc on mood.
“Estrogen and progesterone are fluctuating a lot,” says Lucy Hutner, a fertility psychiatrist in New York City. “It can be difficult to take those changes into our minds.”
Scientists are working to understand how hormones can drive depression, but receptors for estrogen and progesterone are found throughout the brain, including those involved in movement, cognition and mood regulation, according to Psychiatry at Brigham and Women’s Hospital and Harvard Medical. Professor Haddin Joffe says. School in Boston.
New treatments for depression in middle-aged women may be on the horizon. For example, scientists at the National Institute of Mental Health are studying a drug that acts on the estrogen receptor in the brain. The hope is that, unlike typical antidepressants, it will directly target symptoms of depression related to estrogen withdrawal, but without the side effects of conventional hormone therapy commonly used for menopausal symptoms, says NIMH’s Intramural Research Program in Behavioral Endocrinology. Branch head Peter Schmidt notes.
Studies have found that the risk of women having an episode of major depression is two to four times higher around menopause than at other times in their lives; This is even more so for women who have had a previous episode of depression. Menopause is defined to occur one year after a woman’s last menstrual period. The average age of menopause in the US is 51.
Doctors also note that midlife is often a time of marked stress for women—and stress can increase the risk of depression. Many women are juggling careers, raising children and taking care of elderly parents. “You have a lot on your shoulders, and not a lot of room to take time for yourself,” says Dr. Hutner. Women may be more likely than men to seek care for a mental-health problem, which may lead to higher rates of diagnosis and treatment.
Valerie DeMartin, 59, says she fell into depression in 2020. She was dealing with sleep problems, the stress of the pandemic, and a family longtime move to California with two teenagers from Texas. An avid exerciser, she says she felt sad to see her body change in ways she felt she couldn’t control.
“I went through a life-changing step my kids were angry with me, middle age and covid and my body has to deal with changes,” says Ms. DeMartin, who works at Home Remodeling in Frisco, Texas.
Ms DeMartin says she did not seek medical attention or take antidepressants. She says she has coped by reaching out to friends and staying busy with work. She also plans to try hormone-replacement therapy. “Hopefully I’ll have a little more energy and sleep better,” she says.
Researchers at NIMH, who have been following 90 women since 1988, have found that the incidence of women’s median depression is concentrated in the two years before and after the last menstrual period, Dr. says Schmidt. Doctor. Women’s quality of life depression is also different, says Schmidt, often involving intense anxiety, irritability, and sleep problems, as well as more general sadness and loss of pleasure in one-time activities.
Doctors speculate that the reluctance of women to use hormone-replacement therapy for menopausal symptoms in recent decades is driving antidepressant use among middle-aged women — and many of their physicians. In 2002, a large study, the Women’s Health Initiative, was halted after women taking hormone therapy had an increased risk of breast cancer, heart attack and stroke. Subsequent analyzes found that the risks were largely concentrated in women who were older at the time of starting hormone therapy. For women in their 50s, hormone therapy actually reduced the risk of heart disease and death from any cause.
According to the North American Menopause Society and the American College of Obstetricians and Gynecologists, hormone therapy, either estrogen alone or combined with progestogen, is the most effective treatment for hot flashes and night sweats. Some research has found that it can also improve mood.
Still, many women and doctors are exploring alternatives. “People are so afraid of prescribing hormones,” says Stephanie Faubian, MD, medical director of the North American Menopause Society and director of Mayo Clinic Women’s Health. “A lot of women, unfortunately, who are going to their doctors because of hot flashes and night sweats are being slapped on antidepressants.”
Research has shown that some antidepressants can reduce hot flashes and night sweats. But Dr. Faubian says they are much less effective than hormones. The higher rates of antidepressant use among women 60 and older may be partly as a result of those women being left on when they were younger, during this earlier period of mental-health vulnerability, and then by default. Given, Dr. Hutner says.
This story has been published without modification to the text from a wire agency feed
download
The app will get 14 days of unlimited access to Mint Premium absolutely free!