Depression in Women

Indigenous Women’s Reproductive Watch

Depression in Women

 by Anne Crabtree

What is Depression?

Feeling sad from time to time is part of human nature. Every person experiences sadness on some level on and off throughout his or her lifetime. However, when those sad feelings interfere with daily life and make it difficult for a person to work, form and maintain lasting, meaningful relationships, and simply enjoy life, this is depression.Many people experiencing symptoms of depression may also have symptoms of a generalized anxiety disorder as well. In 82% of cases, depression was found along with anxiety disorders. Depression is the most prevalent psychiatric disorder among Native women and is associated with urban residence & substance abuse. According to a study published in the American Journal of Public Health, “The amount of disability caused by depression has been found to be as great as or greater than the disability caused by common medical conditions such as hypertension, diabetes, arthritis, and gastrointestinal problems.” ²Depression is often recognized by its psychological symptoms, which include persistent sad feelings, loss of interest in regular activities and hobbies, trouble with concentration, feelings of worthlessness, and desires to commit suicide. However, about 45 to 95 percent of people living with depression only experience physical symptoms that do not go away, even if treated. These can include joint pain, neck pain, back pain, abdominal pain, fatigue, headaches, weakness, and insomnia. A combination of several of these symptoms is also common. 

Causes/Risks of Depression

There are multiple factors that put a person at risk of depression or depressive episodes. These include but are not limited to:

• lower self-esteem
• poor self-rated health or chronic physical illness
• debt
• low level of education
• family history of depression 
• domestic abuse ³

Ways to Manage Depression

Minor depression can be treated very effectively with medication and counseling, but there are alternative methods available as well. If you have a more severe form of depression, however, it is recommended that you consider medication and counseling in addition to these methods. These may not make your depression go away altogether, but may make it easier to live with, and are best used together as part of an overall healthy lifestyle:

• Exercise
  • Physical activity causes the brain to produce endorphins, which boost mood.
• Start and maintain a healthy, balanced diet
  • Eat plenty of fruits, vegetables, protein, whole grains, lean meats, and sources of Vitamins C, such as citrus fruits like oranges, and D, like milk
• Get enough sleep at night (an average of 7-9 hours a night)
•  Monitor your mood
  • Train yourself to pay attention and respond to your feelings. Through a system called H.A.L.T. (Hungry, Angry, Lonely, Tired), whenever you feel sad or down, check to see if you need to eat, are upset about something, need to talk to or spend time with someone, or just need to relax or take a nap.
• Set realistic goals for yourself, break up large tasks into smaller ones, and think positively
  • Do not take on too many projects or activities at once so that you don’t feel too overwhelmed or risk feeling like a failure if you can’t complete a large task ⁸
• Have a close support system, such as family and friends whom you trust and with whom you can be open     
• Stop smoking/smoke less, stop drinking/drink less
  • Drugs and alcohol may seem to help short-term with the pain of depression, but mental health problems and substance abuse were seen together in 80% of cases among Native peoples.⁴
• Reduce stress
  • If you have children, get someone to look after them, go to a place where you feel comfortable, safe, and calm, clear your mind, breathe slowly and deeply, think about the good things in your life, and rest.
• Go outside in the sunshine or use a lamp made for light therapy
  • Sunlight enhances Vitamin D intake, and natural light fights Seasonal Effective Disorder (SAD), a type of depression experienced mostly during winter and some spring and fall months due to a decrease in sunny days and hours of daylight. Suicide due to depression is more likely to occur during the spring and fall^{. 5}
• Cultivate your spiritual life
  • If you are a spiritual or religious person, you can draw strength from your spirituality through prayer and community worship services or ceremonies.
• Participate in your cultural traditions
  • The support of traditional culture and community may protect women from depression, especially certain features like spirituality, traditional healing practices and ceremonies, and a sense of group identity.⁶

Most importantly, remember that you are not alone. You are not the only person living with depression, and there are resources and support systems available to you. If ever you feel suicidal or are afraid you might hurt yourself, or know someone who might be suicidal and living with depression, these hotlines (at least) are here to help:

Suicide prevention hotlines:

-1-800-SAFE-TALK

 -1-800-273-TALK (8255)

-1-800-SUICIDE (1-800-784-2433)

For more information, check out these sources:

*-Women and Depression: Discovering Hope, a publication from the National Institute of Mental Health

*-Public Health Questionnaire 9 (PHQ 9), what physicians use to diagnose depression; can be found online and self-administered

Sources Cited

1. “What are the basic signs and symptoms of depression?” National Institute of Mental Health. 2011.

www.nimh.nih.gov/health/publications/depression/what-are-the-signs-and-symptoms-of-depression.shtml.

2. “Prevalence & correlates of mental disorders among Native American women in primary care.” B. Duran. American Journal of Public Health. 2004.www.ncbi.nlm.nih.gov/pmc/articles/PMC1449829/.

3. “Screening for Depression.” Douglas M. Maurer, D.O. Journal of the American Academy of Family Physicians. January 15, 2012. www.aafp.org/afp/2012/0115/.

4. “Reconceptualizing Native Women’s Health.” Karina L. Walters, PhD, and Jane Simoni, PhD. American Journal of Public Health. 2002. www.ncbi.nlm.nih.gov/pmc/articles/PMC1447108/.

5. “Tribes Take on Youth Suicide With Skits, Ceremonies and Mustangs.” Stephanie Woodard. Indian Country Today Media Network.  January 9, 2013.indiancountrytodaymedianetwork.com/2013/01/09/tribes-take-youth-suicide-skits-ceremonies-and-mustangs-146834.

6 “Substance use among American Indian and Alaska natives: incorporating culture in an “indigenist” stress-coping paradigm.” Karina L. Walters, Jane M. Simoni, and Teresa Evans-Campbell. Public Health Reports. 2002. www.ncbi.nlm.nih.gov/pmc/articles/PMC1913706/.

7. South Dakota Suicide & Crisis Hotlines. Meadow Lark Press. 2011.www.suicidehotlines.com/southdakota.html.

8. Women and Depression: Discovering Hope. National Institute of Mental Health.www.nimh.nih.gov/health/publications/women-and-depression-discovering-hope/index.shtml.