Almost anyone can attest to the fact that men and women are different in many ways. Scores of books – which have achieved varying degrees of success and acclaim – have been published that attempt to quantify and explain the differences.
In the field of psychiatry, gender differences are an important phenomenon as men and women not only experience different disorders, they experience the same disorders differently.
The best example of this occurs in mood disorders such as depression and bipolar disorder. Women experience a higher incidence of these conditions and manifest different symptoms across their lifespan than men.
To begin with, women are twice as likely as men to experience a mood disorder. This difference in incidence is not fully understood, but there seems to be a connection between female mental health and the hormonal system.
For instance, there is no difference in incidence among pre-pubescent children or among seniors. Gender difference seems to be confined to the reproductive years, which suggests that hormones such as estrogen play a role.
Not only are women more likely to have a mood disorder, but women experience different symptoms than men. Women are much more likely to have a seasonal pattern to their depression and are more likely to have an increased appetite and need for sleep compared to the classic symptoms of insomnia and lack of appetite.
Women with mood disorders are also much more likely than men to suffer with a co-existing anxiety disorder and also tend to experience their disorder as a chronic illness across their lifespan rather than an isolated incident.
It seems that during the reproductive years women are at a much higher risk with their mood disorders than they are in their early years or after menopause. Hormonal events such as pregnancy or the period of menopause tend to increase recurrences and symptoms of mood disorders.
For example, women are more likely to present bipolar symptoms for the first time after a reproductive event. Also, 70 per cent of women with existing mood disorders will relapse during pregnancy.
The post-partum period is widely known to be a risky time for women in terms of mood symptoms and many women experience either post partum blues or the more serious depression. In fact, as many as 80 per cent of women experience the mild blues after giving birth – not a disorder, but some mild depression and anxiety that dissipate quickly.
The more serious postpartum depression affects 10 to 15 per cent of women and only a very few suffer from the psychiatric emergency of postpartum psychosis.
Menopause brings hormonal instability that appears to be linked to an increased frequency of depressive symptoms and women with a history of mood disorder are at a much higher risk of recurrence during this period.
Indeed, the female hormonal system appears to affect her mental health, while on the other hand, mood disorders themselves may affect the timing of some reproductive or hormonal events. For example, menopause seems to occur earlier than average in women with a history of depression.
With an increasing understanding of the relationship between a woman’s reproductive cycles and her mental health, there will be possibilities for gender specific treatments and treatments designed to suit the hormonal landscape of a specific time of life.
In the mean time, it is important to get treatment if you experience a mood disorder. Depression and bipolar disorder are serious illnesses with many health consequences and should not be ignored.
If you have a mood disorder and are considering pregnancy, talk with your doctor about your options.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.
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