Depression remains one of the most common mental health disorders in India. The National Mental Health Survey has highlighted that women are three times more likely to experience depression in their lifetime. To tackle this mental health disorder, it is vital to identify the early warning signs and take timely action. A major treatment gap that exists in the treatment of depression is a lack of access to adequate care. About 79.1% of individuals lack access to mental health services needed for treating depression and the resulting disorders.

The National Mental Health Survey has flagged that depression is common among women, middle-aged adults, and urban residents, as well as low-income population groups. Even postpartum depression affects approximately 22% of Indian mothers, which is considered higher than global estimates.

What Is Depression?

According to the World Health Organization (WHO, depression can be defined through symptoms that last for more than two weeks. These symptoms are having a depressed mood or diminished interest or pleasure in all activities (anhedonia). The main condition that classifies depression is that the mood or lack of interest causes effects in social, occupational, or other important areas of functioning. These conditions shouldn't be linked to the use of substances, medical conditions, or having a history of hypomanic episodes. 

Debolina Roy, Consulting Clinical Psychologist, explains, "Depression does not always show up as sadness or tears. Sometimes, the first signs are changes in how a woman functions, engages with people, or experiences the things that usually bring her happiness."

Note: There is a clear difference between experiencing a period of depressive sadness and a major depressive disorder.

10 Early Warning Signs Of Depression In Women

The Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, has classified depression as when a person experiences at least 5 symptoms for 2 weeks. Debolina Roy adds, " She may find herself feeling irritated or emotionally numb for a prolonged period, losing interest in things she once enjoyed, feeling less hopeful about the future, or developing a persistent sense of helplessness or unworthiness."

1. Persistent Sadness Or Low Mood

Experiencing persistent sadness or a low mood is a sign of depression. The mental health impact of sadness can involve feeling hopeless or empty most of the day.

2. Loss Of Interest In Activities Once Enjoyed

When the hobbies that sparked joy turn into mundane daily routines and don't feel rewarding, then it could be a sign of depression. Those who are actively avoiding social interactions, even when they should, could be tied to having a depressive disorder.

3. Constant Fatigue And Low Energy

If you are feeling constant fatigue and have low energy levels despite getting adequate amounts of rest daily, then it could be tied to depression. Women tend to discount their constant fatigue from being overworked at home or at work, but their mental health could also be causing an issue.

4. Changes In Sleep Patterns

When your daily sleep patterns become disrupted, and you tend to experience insomnia or sudden early morning waking, then depression could be behind it. Another change is excessive sleeping that lasts for hours during the day when your body and brain haven't been overworked.

5. Appetite And Weight Changes

Sudden changes in appetite and weight changes could be a sign that depression has taken hold of your mental state. If your appetite changes suddenly, wherein you eat too much or too little, or you gain or lose weight due to an unexplained reason, then depression could be behind these changes.

6. Difficulty Concentrating

A lack of concentration, brain fog, forgetfulness, or reduced productivity could be linked to depression. But the underlying biological causes, such as nutritional deficiencies and brain health issues, should not be behind these issues, as the symptoms can mimic each other.

7. Increased Irritability Or Anxiety

When an individual is depressed, they tend to become irritable or experience anxiety, which can all point to depression. Being overtly emotional or developing extreme reactions to common happenings in your surroundings could point to an altered mental state.

8. Feelings Of Worthlessness Or Excessive Guilt

Depression in women could be characterised by excessive self-blame for what happens to them, as well as a constant stream of negative self-talk, which is common. But most people can talk to their family, friends, or trusted medical specialists to seek the right counsel.

9. Physical Symptoms Without A Clear Cause

Physical manifestations of depression can range from simple headaches that can get triggered due to a particular happening in your daily life to serious digestive issues. There are even impacts on your pain threshold, as those with depression tend to experience more unexplained body pain in the form of chronic aches and fatigue.

Note: If you are doubtful of your physical symptoms that have started suddenly, then it is best to consult a medical specialist to rule out physical health issues first. Then, proceed to your mental health state, as most of the time, people are not aware of their nutritional deficiencies that may be causing mental health issues.

10. Thoughts Of Self-Harm Or Suicide

This is a serious symptom, as people who are depressed and have no one to talk to tend to develop an altered mental state wherein they start imagining that the world is better off without them. In this case, it is important to seek medical help and make use of available mental health resources before it is too late.

Note: They are actual cases of depression wherein people regret making extreme decisions as their mental state was irrational.

Why Depression Is More Common in Women

Women are three times more likely to be depressed due to multiple factors that have a direct effect on their cognition. These factors need to be considered with the seriousness of any health issue, as mental health is not taken seriously until visible signs become evident. "It is also easy to mistake these changes for an ordinary mood shift. While the two can coexist, depression tends to have a more persistent effect on how a person experiences everyday life, " explains Debolina Roy.

Hormonal Factors

Hormonal fluctuations in progesterone, testosterone, and oestrogen could be behind depression or depressive periods. These fluctuations, as per the Psychology Journal, mention that these changes tend to affect women a lot more than men as they go through different stages wherein extreme physical and mental changes occur. These effects contribute to a rise in depression as women go through:

  • Puberty
  • Menstrual cycle changes
  • Pregnancy
  • Postpartum period
  • Perimenopause and menopause

Biological Factors

Depression could also be attributed to the brain's neurotransmitters misfiring. Genetic changes to your brain could make it more vulnerable to developing depression if certain conditions act as a trigger.

Social And Lifestyle Factors

Depression can also be triggered in women who are dealing with:

  • Caregiving responsibilities that can't be humanely executed.
  • Unmanaged workplace stress.
  • Relationship stress can also act as a trigger for depression.
  • Gender-based violence and trauma can further push people to a mentally challenging state.

Physical Symptoms Of Depression In Women Often Overlooked

Depression can also cause physical symptoms, especially in women, and most people choose to ignore it until they spiral to unmanageable levels and serious help becomes necessary. Symptoms such as:

  • Chronic fatigue
  • Digestive discomfort
  • Frequent headaches
  • Body aches
  • Sleep disturbances
  • Sexual health changes

Depression Across Different Life Stages

A woman goes through multiple stages in her life that could make it easy for depression to strike. The Lancet Journal points to reasons behind why young women tend to become depressed, and it can be linked to a rise in risk factors. Debolina Roy highlights " A woman may start withdrawing socially, often saying that she is 'busy' and using it as a reason to avoid people, even when she knows she is not particularly occupied. She may continue laughing at jokes, attending work, and managing responsibilities, while feeling disconnected internally."

Depression In Teenage Girls

Teenage girls are soft targets, as their sense of identity is developing, and are susceptible to the effects of bullying, social peer pressure, and family history, as well as stressful life events. In recent years, depression rates among teenage girls have increased due to social media usage, negative body image issues, and low self-esteem.

Depression During Pregnancy

Depression can occur during pregnancy, as risk factors such as previous depression, domestic violence, poor social support systems, unplanned pregnancy, and financial stress can act as triggers. If depression during pregnancy is left untreated, then both the mother and the infant are at risk.

Postpartum Depression

About 10% to 20% of women suffer from perinatal depression that can occur during pregnancy, after delivery, or both. The symptoms of this kind of depression are persistent sadness, fatigue, sleep disturbance, anxiety, guilt, loss of interest in daily activities, and suicidal thoughts.

Note: Postpartum depression is a serious mental health condition that requires treatment, as it can affect the mother and the infant.

Depression During Perimenopause And Menopause

Menopause tends to cause massive upheaval in a woman's life, as hormone fluctuations occur in stages, and those who have had depression in the past tend to be at higher risk. Physical factors such as hot flashes, night sweats, sleep disruption, and fatigue occur alongside depression episodes that can last for weeks on end.

Depression In Older Women

The Frontiers in Psychiatry points to depression in older women that happens after age 60-65 years, as they are vulnerable to chronic illness. When hormonal changes and reproductive changes tend to collectively take a toll on the mental state of older women, then depression becomes common.

Risk Factors That Increase The Chances Of Depression

Several risk factors can increase the chances of depression in women, which need to be considered, as they can become possible triggers:

  • Family history
  • Chronic illness
  • Thyroid disorders
  • Diabetes
  • Obesity
  • Loneliness
  • Stressful life events
  • Substance misuse

When Should Women Seek Professional Help?

Women should not wait if they experience a combination of symptoms, as depression tends to affect the mental state in stages. If it is caught early and treated timely, then pulling the individual out of depression becomes easier. Here are the conditions wherein women should consult a professional for help:

  • Symptoms lasting more than two weeks that seem to get worse as time passes.
  • Difficulty functioning at work or home is a sign that your mental state is affecting your daily life.
  • Severe anxiety is a byproduct of depression.
  • Social withdrawal is also a sign that depression is forcing you to cut off social connections.
  • Suicidal thoughts are a severe sign that your depression is turning into self-harm.

Indian women need to prioritise their mental health by taking the proven lifestyle measures. If they are feeling the symptoms, then they need to refocus their efforts on safeguarding their mental health. She concludes, " Decision-making can also start feeling unusually difficult, which can add to frustration and lead to more frequent conflicts with family members. One of the important things to notice is a sustained change from her usual self. Someone can appear to be functioning normally on the outside while struggling considerably on the inside, and recognising that difference can be an important first step towards seeking support."

Also Read: Can Vitamin B12 Deficiency Cause Anxiety? Link Decoded



Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.