Why is it depression is more common in women than men? Why is it that twice as many women are prescribed antidepressants and tranquillisers than men? Perhaps it is the extra stress of life as a woman coping with family, work, husband and with the added social problems of divorce, poor job prospects and general frustration of life at home. This is the feminist point of view, but it does not really explain why life should be more stressful or depressing for a woman than it may be for a man. However, there is a belief that at times of anxiety and stress, women complain and men misbehave. That means that women go to their doctors and are prescribed antidepressants and men go out drinking and worse.
It is clear that this excess of depression in women starts at puberty and is no longer present in the 6th and 7th decade. The peaks of depression occur at times of hormonal fluctuation in 1) the premenstrual phase, 2) the postpartum phase and 3) the climacteric perimenopausal phase, particularly in the one or two years before the periods cease. This triad of hormone responsive mood disorders, (HRMD) often occur in the same vulnerable woman.
Postnatal depression is another example of depression being caused by fluctuations of sex hormones and having the potential to be effectively treated by hormones. It is a common condition which affects 10-15% of women following childbirth and may persist for over one year in 40% of those affected. There does seem to be a lack of any overall influence of psychosocial background factors in determining vulnerability to this postpartum disorder although it can be recurrent.
Postnatal depression is severe and more prolonged in women who are lactating and lower oestradiol levels are found in depressed women following delivery than with controls. It is probable that the low oestradiol levels with breast feeding and the higher incidence of depression are related in a causative way.