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Monday, August 29, 2011

depression in girls, women

Girls under 14 more stressed, suicide-prone
Bhavya Dore, Hindustan Times
Mumbai, August 27, 2011
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First Published: 01:28 IST(27/8/2011)
Last Updated: 01:32 IST(27/8/2011)
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Some indicative figures;

under 14 age group
year boys Girls
2009 5 9
2008 3 7
2007 4 9
2005 4 10

above 14 years

Year Girls Boys Total
2009 243 263 506
2008 253 275 528
2007 244 273 517
2005 280 307 567

A study conducted by the Tata Institute of Social Sciences (Tiss) on stress among city students has found that among children below 14 years, girls are more vulnerable to suicides. The report’s analysis of recent suicide statistics (from the National Crime Records Bureau) suggests that
while men have a higher rate of suicide compared to women, in the under 14 years age group, more girls compared to boys have committed suicide.

For instance, in 2009, in Maharashtra in the 15 to 29 years age group, 2,387 girls committed suicide compared to 2,901 boys. However, in the younger age group (under 14 years) 55 girls committed suicide compared to 48 boys in the same year.

“This indicates that young girls under the age of 14 years are either highly stressed in comparison to their male counterparts or are unable to cope with the stress,” said the report, while suggesting that further research was required in the area.

“Boys just have that chilled out attitude, it just happens, girls just don’t have it,” said Dristi Jain, 15, a college student.

The study report, which was submitted to the government last week, has recommended that the state government should develop a policy to prevent student suicides and make it mandatory for all schools to adopt it.

It recommends that all schools should have counsellors whom students can approach for their problems. “It is expensive for a school to have a full-time counsellor, but it is important to have someone for students to talk to,” said Katy Gandevia, a professor at Tiss Centre for Health and Mental Health.

“Children felt burdened under the expectations of their parents,” said the report. “During the interviews with the stakeholders, many identified family as the key source of stress. The stress from family might not be direct, but it can indirectly also cause a lot of friction in a student’s life.”

To combat student suicides the report recommends ;

Training teachers to identify warning signs and risk factors

Improving the student-teacher ratio in class

Training Peer cousellors

Full-time counsellors in all schools

mentorship programs

parent-teacher interactions on a regular basis should not be only about academics but also behaviour and attitudes

Hobby classes and recreational courses

Open discussions on depression, stress, tension and suicide


Depression in Women
Causes, Symptoms, and Treatment


Depression in Women: Causes, Symptoms, and Treatment

Depression is not "one size fits all," particularly when it comes to the genders. Not only are women more prone to depression than men, but the causes of female depression and even the pattern of symptoms are often different.

Many factors contribute to the unique picture of depression in women—from reproductive hormones to social pressures to the female response to stress. Learning about these factors can help you minimize your risk of depression and treat it more effectively.
In This Article:

Understanding depression in women
Causes of depression in women
Risks factors for depression in women
Treating depression in women
Premenstrual dysphoric disorder
Related links for depression in women

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Understanding depression in women

Depression is a serious condition that can impact every area of your life. It can affect your social life, your family relationships, your career, and your sense of self-worth and purpose. And for women in particular, depression is common.

If you’re feeling sad, guilty, tired, and just generally “down in the dumps,” you may be suffering from major depression. But the good news is that depression is treatable, and the more you understand about depression’s particular implications for and impact on women, the more equipped you will be to tackle the condition head on.
According to the National Mental Health Association:

Approximately 12 million women in the United States experience clinical depression each year.
About one in every eight women can expect to develop clinical depression during their lifetime.

Signs and symptoms of depression in women

The symptoms of depression in women are the same as those for major depression. Common complaints include:

Depressed mood
Loss of interest or pleasure in activities you used to enjoy
Feelings of guilt, hopelessness and worthlessness
Suicidal thoughts or recurrent thoughts of death
Sleep disturbance (sleeping more or sleeping less)
Appetite and weight changes
Difficulty concentrating
Lack of energy and fatigue

For more, see Understanding Depression: Spotting the Signs and Symptoms and Getting Help.
Differences between male and female depression

Although the signs and symptoms of depression are the same for both men and women, women tend to experience certain symptoms more often than men. For example, seasonal affective disorder—depression in the winter months due to lower levels of sunlight—is more common in women. Also, women are more likely to experience the symptoms of atypical depression.

In atypical depression, rather than sleeping less, eating less, and losing weight, the opposite is seen: sleeping excessively, eating more (especially carbohydrates), and gaining weight. Feelings of guilt associated with depression are also more prevalent and pronounced in women. Women also have a higher incidence of thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician in women who are depressed.
Causes of depression in women

Women are about twice as likely as men to suffer from depression. This two-to-one difference persists across racial, ethnic, and economic divides. In fact, this gender difference in rates of depression is found in most countries around the world. There are a number of theories which attempt to explain the higher incidence of depression in women. Many factors have been implicated, including biological, psychological, and social factors.
Biological causes of depression in women

Premenstrual problems - Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For many women, PMS is mild. But for some women, symptoms are severe enough to disrupt their lives and a diagnosis of premenstrual dysphoric disorder (PMDD) is made.

Pregnancy and infertility - The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.

Postpartum depression - Many new mothers experience the “baby blues.” This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is known as postpartum depression. Postpartum depression is believed to be influenced, at least in part, by hormonal fluctuations.

To learn more, see Postpartum Depression: Signs, Symptoms, and Help for New Moms.

Perimenopause and menopause - Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.
Social and cultural causes of depression in women

Role strain - Women often suffer from role strain over conflicting and overwhelming responsibilities in their life. The more roles a woman is expected to play (mother, wife, working woman), the more vulnerable she is to role strain and subsequent stress and depression. Depression is more common in women who receive little help with housework and child care. Single mothers are particularly at risk. Research indicates that single mothers are three times more likely than married mothers to experience an episode of major depression.
Unequal power and status - Women’s relative lack of power and status in our society may lead to feelings of helplessness. This sense of helplessness puts women at greater risk for depression. These feelings may be provoked by discrimination in the workplace leading to underemployment or unemployment. Low socioeconomic status is a risk factor for major depression. Another contributing factor is society’s emphasis on youth, beauty, and thinness in women, traits which to a large extent are out of their control.
Sexual and physical abuse - Sexual and physical abuse may play a role in depression in women. Girls are much more likely to be sexually abused than boys, and researchers have found that sexual abuse in childhood puts one at increased risk for depression in adulthood. Higher rates of depression are also found among victims of rape, a crime almost exclusively committed against women. Other common forms of abuse, including physical abuse and sexual harassment, may also contribute to depression.
Relationship dissatisfaction - While rates of depression are lower for the married than for the single and divorced, the benefits of marriage and its general contribution to well-being are greater for men than for women. Furthermore, the benefits disappear entirely for women whose marital satisfaction is low. Lack of intimacy and marital strife are linked to depression in women.
Poverty - Poverty is more common among women than men. Single mothers have the highest rates of poverty across all demographic groups. Poverty is a severe, chronic stressor than can lead to depression.

Psychological causes of depression in women

Coping mechanisms - Women are more likely to ruminate when they are depressed. This includes crying to relieve emotional tension, trying to figure out why you’re depressed, and talking to your friends about your depression. However, rumination has been found to maintain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
Stress response - Some studies show that women are more likely than men to develop depression under lower levels of stress. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men.
Puberty and body image - The gender difference in depression begins in adolescence. The emergence of sex differences during puberty likely plays a role. Some researchers point to body dissatisfaction, which increases in girls during the sexual development of puberty. Body image is closely linked to self-esteem in women, and low self-esteem is a risk factor for depression.

Risk factors for depression in women

There are a number of different, yet interrelated, risk factors for depression in women. Women of lower socioeconomic status are more likely to develop depression. This makes sense considering that the more sources of stress in a woman’s life, the more likely she is to develop depression. Women of low socioeconomic status are likely to struggle with financial problems, issues of unemployment or underemployment, discrimination, lack of education, and single parenthood. Additional risk factors include marital conflict and dissatisfaction, past sexual or physical abuse, and role strain.
Risk Factors for Depression in Women

Family history of mood disorders
Personal past history of mood disorders in early reproductive years
Loss of a parent before the age of 10 years
Childhood history of physical or sexual abuse
Use of an oral contraceptive, especially one with a high progesterone content

Use of gonadotropin stimulants as part of infertility treatment
Persistent psychosocial stressors (e.g., loss of job)
Loss of social support system or the threat of such a loss

Source: American Academy of Family Physicians
Treating depression in women

For the most part, women suffering from depression receive the same types of treatment as everyone else. The main treatment approaches are psychotherapy and antidepressant therapy. However, there are some special treatment considerations for depression in women.
Depression and the reproductive cycle

Hormone fluctuations related to the reproductive cycle can have a profound influence on a woman’s mood. In light of this possibility, you and your doctor should always look for connections between your depressive symptoms and the female reproductive cycle. Is your depression connected to your menstrual period and a possible effect of PMS? Are you pregnant and struggling with complications and concerns related to the vast changes you and your body are undergoing? Are you struggling with the baby blues after recently giving birth? Or are you approaching menopause and dealing with hormonal and emotional fluctuations? All of these milestones in the reproductive cycle can influence or trigger depression. It’s also important to consider mood-related side effects from birth control medication or hormone replacement therapy.
Relationship issues and role strain

Because of the special role that interpersonal issues and role strain plays in female depression, psychotherapy should address them directly. Interpersonal therapy and cognitive-behavior therapy are both effective in teaching new problem solving skills, improving interpersonal relationships, and reducing negative thinking and ineffective coping techniques.
Treatment modifications

Specific aspects of treatment must often be modified for women. Because of female biological differences, women should generally be started on lower doses of antidepressants than men. Women are also more likely to experience side effects, so any medication use should be closely monitored. Finally, women are more likely than men to require simultaneous treatment for other conditions such as anxiety disorders and eating disorders.
Premenstrual dysphoric disorder

Most women are all too familiar with premenstrual syndrome (PMS). Unwelcome symptoms of PMS such as bloating, moodiness, and fatigue appear and reappear each month at the same time in the menstrual cycle. For most women, these premenstrual symptoms are uncomfortable but not disabling. But for up to one out of ten women, symptoms are so distressing and disabling that they warrant a diagnosis of premenstrual dysphoric disorder (PMDD). PMDD is characterized by severe depression, irritability, and other mood disturbances. Symptoms begin about 10 to 14 days before your period and improve within a few days of its start.
Symptoms of Premenstrual Dysphoric Disorder

Feelings of sadness or hopelessness
Feelings of tension or anxiety
Panic attacks
Mood swings and tearfulness
Persistent irritability or anger
Disinterest in daily activities and relationships

Trouble concentrating
Fatigue or low energy
Food cravings or binge eating
Sleep disturbances
Feeling out of control
Physical symptoms (bloating, breast tenderness, headaches, muscle pain)

Self-help for PMDD

There are many steps you can take to improve PMDD symptoms. Many involve simple lifestyle adjustments.

Exercise - Regular aerobic exercise can reduce the symptoms of PMDD.
Dietary modifications - Changes to your diet may help reduce symptoms. Cutting back on salt, fatty foods, caffeine, and alcohol is recommended. Eating plenty of complex carbohydrates is also recommended.
Nutritional supplements - Vitamin B-6, calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit women suffering from PMDD.
Herbal remedies - Evening primrose oil and chaste tree berry are herbal supplements that have both been studied and found to be effective in the treatment of PMDD.
Stress reduction - Relaxation techniques and other strategies to reduce stress may help with PMDD symptoms. Yoga and meditation are particularly effective.

For more severe cases of PMDD, antidepressant therapy may be helpful. Serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, and Paxil can alleviate the emotional symptoms of PMDD. The medication may be taken consistently, or in some cases, it is only taken during the two weeks leading up to the onset of menstruation.

Postpartum DepressionPostpartum Depression and the Baby Blues
Symptoms, Treatment, and Support for New Moms

Postpartum Depression and the Baby Blues
Symptoms, Treatment, and Support for New Moms


Postpartum Depression:

Having a baby is stressful—no matter how much you've looked forward to it or how much you love your child. Giving birth puts you through a physical and emotional wringer. But your exhaustion has to take a backseat to the needs of your newborn. Considering the sleep deprivation, new responsibilities, and lack of time for yourself, it's only natural that a lot of new moms feel like they're on an emotional rollercoaster.

The baby blues are perfectly normal, but if your symptoms don’t dissipate after a few weeks or they start getting worse, you may be suffering from postpartum depression. Postpartum depression can interfere with your ability to take care of yourself and your newborn child. But with treatment, the support of your family, and attention to your own needs, you can get back on the road to healthy and happy motherhood. Learn about the signs and symptoms and how you can help yourself or your partner.
In This Article:

The baby blues
Signs and symptoms of postpartum depression
Postpartum depression causes and risk factors
How postpartum depression affects the baby
Treatment and help for postpartum depression
Coping with postpartum depression
Postpartum psychosis
Related links

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The baby blues

You’ve just had a baby. You expected to be basking in new mom bliss. You expected to be celebrating the arrival of your little one with your friends and family. But instead of celebrating, you feel like crying. You were prepared for joy and excitement, not exhaustion, anxiety, and weepiness. You may not have been expecting it, but mild depression and mood swings are common in new mothers—so common, in fact, that it has its own name: the baby blues. The vast majority of new mothers experience at least some symptoms: moodiness, sadness, difficulty sleeping, irritability, appetite changes, concentration problems. Symptoms of the baby blues typically show up within a few days of giving birth and last from several days to a couple of weeks.

The baby blues are a normal part of new motherhood—probably caused by the hormonal changes that occur following birth. If you have them, there is no cause for undue worry. The baby blues usually don’t last very long and will go away on their own once your hormones level out. Aside from the support of your loved ones and plenty of rest, no treatment is necessary. However, if your symptoms don’t go away within two to three weeks, or they are severe (such as suicidal thoughts or an inability to care for your newborn), you may be suffering from a more serious condition known as postpartum depression.
Signs and symptoms of postpartum depression

In the beginning, postpartum depression can look like the normal baby blues. In fact, they share many symptoms, including mood swings, crying jags, sadness, insomnia, and irritability. However, in postpartum depression, these symptoms are either longer lasting or more severe. Anxiety is also more prominent in postpartum depression. If you have postpartum depression, you may worry to excess over your baby’s health and well-being. In addition to obsessing over the safety of your newborn, you may be troubled by intrusive thoughts about harming your baby.

Signs and Symptoms of Postpartum Depression

Lack of interest in your baby
Negative feelings towards your baby
Worrying about hurting your baby
Lack of concern for yourself
Loss of pleasure

Lack of energy and motivation
Feelings of worthlessness and guilt
Changes in appetite or weight
Sleeping more or less than usual
Recurrent thoughts of death or suicide

Postpartum depression usually sets in soon after childbirth and develops gradually over a period of several months. But postpartum depression can also come on suddenly, and in some women, the first signs don’t appear until months after they’ve given birth. Because of the possibility of delayed onset, if you have a depressive episode within six months of having a baby, postpartum depression should be considered.

The Edinburgh Postnatal Depression Scale (EPDS) is a screening tool designed to detect postpartum depression. Fill it out for a more complete look at your emotional state. If you believe you have postpartum depression, it can be helpful to bring the completed form to your doctor or therapist.
Postpartum depression causes and risk factors

The exact reasons why some new mothers develop postpartum depression and others don’t are unknown. But a number of interrelated causes and risk factors are believed to contribute to the problem.

The rapid hormonal changes that accompany pregnancy and delivery may trigger depression. After childbirth, women experience a big drop in estrogen and progesterone hormone levels. Thyroid levels can also drop, which leads to fatigue and depression. These hormone dips—along with the changes in blood pressure, immune system functioning, and metabolism that new mothers experience—can all play a part in postpartum depression. It has been theorized that women who are more sensitive to these hormone imbalances develop postpartum depression.

Women who have just given birth are also dealing with numerous changes, both physical and emotional. They may still be coping with physical pain from the pregnancy and delivery. They may also have difficulties losing the baby weight, leading to insecurities about their physical and sexual attractiveness. In addition to changes to their body, they are also dealing with lifestyle changes. The lifestyle adjustment can be particularly difficult for first time moms, who must get used to an entirely new identity. The stress of caring for a newborn can also take a toll. New mothers are often sleep deprived. In addition, they may feel overwhelmed and anxious about their ability to properly care for their baby. All of these factors can contribute to and trigger postpartum depression.
Risk factors

Women with a previous history of depression are at an increased risk of experiencing postpartum depression. Your risk is also elevated if you have a history of severe PMS or premenstrual dysphoric disorder, if the pregnancy was unplanned, or if you had postpartum depression following a previous pregnancy. According to the National Institute of Mental Health, women with a prior history of postpartum depression have a 50% chance of recurrence.

Stressful events during pregnancy or birth also increase the odds of developing postpartum depression. Stressful events might include a difficult delivery, prenatal problems, premature birth, or illness during pregnancy. Finally, research has shown that women with marital difficulties or a general lack of social support have a greater chance of developing postpartum depression.

If you’ve recently given birth and have one or more of these risk factors, it is especially important to be on the lookout for any signs or symptoms of postpartum depression.
How postpartum depression affects the baby

Postpartum depression can interfere with your ability to function, including your ability to take care of yourself and your child. If you have postpartum depression, it doesn’t mean that you’re a bad mother. However, when you’re consumed with symptoms of depression such as fatigue, irritability, apathy, and tearfulness, it is difficult—if not impossible—to properly look after your newborn’s needs. Your baby will be affected if the depression is left untreated.
The Impact of Postpartum Depression on Children

Behavioral problems

Children of depressed mothers are more likely to develop behavioral problems down the line, including sleep problems, temper tantrums, aggression, and hyperactivity.

Delays in cognitive development

Development is often delayed in babies and children who have depressed mothers. They may learn to walk and talk later than other children. They may also have many other learning difficulties, including problems with school.

Social problems

Children of depressed mothers have difficulty establishing secure relationships. They may find it hard to make friends in school. They may be socially withdrawn, or they may act out in destructive ways.

Emotional problems

Studies have show that children of depressed mothers have lower self-esteem, are more anxious and fearful, are more passive, and are less independent.


The risk of developing major depression early in life is particularly high for the children of mothers with postpartum depression.

If you’re suffering from postpartum depression, there is no reason to feel guilty or ashamed. The symptoms of postpartum depression are outside your control, and they don’t make you a bad person or a bad parent. However, the choice to get treatment is in your control. Considering the impact depression has on both you and your child, it’s important to seek help right away.
Postpartum depression and attachment

Creating Secure Infant Attachment

Creating Secure Infant Attachment

Research has shown that depressed mothers interact less with their babies. Women with postpartum depression are less likely to breastfeed, play with, and read to their children. They may also be inconsistent in the way they care for their newborns. Depressed mothers can be loving and attentive at times, but at other times they may react negatively or they may not respond at all. This inconsistency disrupts the bonding process between mother and child. This emotional bonding process, known as attachment, is the most important task of infancy.

A secure attachment is formed when the mother responds warmly and consistently to her baby’s physical and emotional needs. When the baby cries, the mother quickly soothes him or her. If the baby laughs or smiles, the mother responds in kind. In essence, the mother and child are in synch. They recognize and respond to each other’s signals. But a depressed mother is less likely to pick up on and respond to her baby’s cues. This sets the stage for an insecure attachment. A child who is insecurely attached is at risk for multiple developmental difficulties and delays, including behavioral, emotional, and social problems.

To learn more about attachment and its impact, see Parenting: Attachment, Bonding and Reactive Attachment Disorder.
Treatment and help for postpartum depression

If you have postpartum depression, you should seek professional treatment. Left untreated, postpartum depression can last for a significant length of time—even up to a year or more. Postpartum depression responds to the same types of treatment as regular depression. Therapy, medication, and support groups can all be helpful.

Psychotherapy – Individual therapy or group therapy can be very effective in the treatment of postpartum depression. Psychotherapy is often the treatment of choice because of concerns over taking medication while breastfeeding. Interpersonal therapy (IPT), which focuses on interpersonal relationships and issues, is believed to be particularly effective for postpartum depression.
Hormone therapy – Estrogen replacement therapy sometimes helps with postpartum depression. Estrogen is often used in combination with an antidepressant. There are risks that go along with hormone therapy, so be sure to talk to your doctor about what is best—and safest—for you.
Marriage counseling – If you are experiencing martial difficulties or are feeling unsupported at home, marriage counseling could be very beneficial.
Antidepressants – For severe cases of postpartum depression where the mother is unable to care for herself or her baby, antidepressants may be an option. However, medication use should be accompanied by therapy, as well as close monitoring by a physician.

To learn more, see Antidepressants: Understanding Depression Medication.
Taking antidepressants while breastfeeding

If you’re considering the use of antidepressants, it’s important to know that your medication can be passed to your baby through your breast milk. Research suggests that in the case of tricyclic antidepressants and SSRIs, the levels of medication that reach the baby through breastfeeding are either low or undetectable. However, there have been rare reports of adverse reactions in nursing infants. Furthermore, the long-term effects of exposure—even to trace amounts of the medication—are unknown.
Coping with postpartum depression

The best thing you can do if you have postpartum depression is to take care of yourself. Be sure to get enough rest, get out in the sunshine each day, and eat a healthy diet. Set aside quality time for yourself to relax and take a break from your mom duties.
Self-help for postpartum depression

Find someone you can talk to about your feelings.
Find people who can help you with child care, housework, and errands so you can get some much needed rest.
Make time for yourself every day, even if it’s only for 15 minutes. Do something relaxing or that makes you feel good about yourself.
Keep a daily diary of your emotions and thoughts. This is a good way to let everything out and to keep track of your progress as you begin to feel better.
Give yourself credit for the things you’re able to accomplish, even if you only get one thing done in a day. If you aren’t able to get anything done, don’t be hard on yourself.
Give yourself permission to feel overwhelmed.
Remember that no one expects you to be supermom.
Be honest about how much you can do and ask others for help.
Join a support group.

Source: American Academy of Family Physicians

It’s also important to stay connected to family and friends. Don’t keep your feelings to yourself. Share them with your significant other or a close friend. Let your loved ones know what you need and how you’d like to be supported.
Helping a loved one with postpartum depression

If your loved one is experiencing postpartum depression, the best thing you can do is to offer support. Give her a break from her childcare duties, provide a listening ear, and be patient and understanding.
You also need to take care of yourself. Dealing with the needs of a new baby is hard for fathers as well as mothers. And if your significant other is depressed, you are dealing with two major stressors.
Postpartum psychosis

Postpartum psychosis is a rare, but extremely serious disorder that can develop after childbirth. It is characterized by loss of contact with reality. Postpartum psychosis should be considered a medical emergency. Because of the high risk for suicide or infanticide, hospitalization is usually required to keep the mother and the baby safe.

Postpartum psychosis develops suddenly, usually within the first two weeks after delivery, and sometimes within 48 hours. Symptoms include:

Hallucinations (seeing things that aren’t real or hearing voices)
Delusions (paranoid and irrational beliefs)
Extreme agitation and anxiety
Confusion and disorientation
Rapid mood swings
Bizarre behavior
Inability or refusal to eat or sleep
Suicidal thoughts or actions
Thoughts of harming or killing the baby

Early warning signs of postpartum psychosis include an inability to sleep for several nights, agitation, euphoria or irritability, and avoidance of the baby. 
Women with a history of bipolar disorder are at an increased risk of developing postpartum psychosis. In fact, postpartum psychosis resembles a manic episode. Women who have previously had postpartum psychosis are also highly likely to develop it again if they have another child.

Parenting & AttachmentParenting & Attachment
Advice For Bonding With Your Baby

Helping a Depressed PersonHelping a Depressed Person
Taking Care of Yourself While Supporting a Loved One
More Helpguide articles:

Dealing with Depression: Self-Help and Coping Tips
Depression Treatment: Therapy, Medication, and Lifestyle Changes That Can Help
Feeling Suicidal? Coping with Suicidal Thoughts and Help to Get You Through

Related Links
General Information about postpartum depression

Depression During and After Pregnancy – Article discusses depression during pregnancy and after childbirth, including possible causes. (The National Women's Health Information Center)

More than the Baby Blues – Learn about postpartum depression and postpartum psychosis, including the signs, symptoms, and causes. (HealthyPlace)
Treatment and help for postpartum depression

Postpartum Major Depression: Detection and Treatment – Take a comprehensive look at the treatment options and considerations for postpartum depression. (American Academy of Family Physicians)

Antidepressants and Breastfeeding - Provides an overview of the benefits and potential risks of breastfeeding while on medication. (HealthyPlace)
Support for postpartum depression

The Online PPD Support Group – Online discussion forum for women suffering from postpartum depression. (PPD Support Page)
Information for fathers

Postpartum Dads – Guide to getting through a partner’s postpartum depression. Includes advice on dealing with rejection from your partner and tips for staying healthy and together. (PostpartumDads)
Postpartum psychosis

One Mother's Story: Postpartum Psychosis – A personal look at postpartum psychosis, including the signs and symptoms. (National Public Radio)


Dealing with Depression

Dealing with Depression


Depression Self-Help: Living with Depression in Yourself and Others

Depression drains your energy, hope, and drive, making it difficult to do what you need to feel better. But while overcoming depression isn’t quick or easy, it’s far from impossible. You can’t beat it through sheer willpower, but you do have some control—even if your depression is severe and stubbornly persistent.

You can make a huge dent in your depression with simple lifestyle changes: exercising every day, avoiding the urge to isolate, challenging the negative voices in your head, eating healthy food instead of the junk you crave, and carving out time for rest and relaxation. Feeling better takes time, but you can get there if you make positive choices for yourself each day and draw on the support of others.
In This Article:

The road to recovery
Supportive relationships
Taking care of yourself
Healthy diet
Negative thinking
Emotional Intelligence
Getting additional help
Related links

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The road to depression recovery

Recovering from depression requires action. But taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can be exhausting.

It’s the Catch-22 of depression recovery. The things that help the most are the things that are most difficult to do. But there’s a difference between difficult and impossible.
Start small and stay focused

The key to depression recovery is to start with a few small goals and slowly build from there. Draw upon whatever resources you have. You may not have much energy, but you probably have enough to take a short walk around the block or pick up the phone to call a loved one.

Take things one day at a time and reward yourself for each accomplishment. The steps may seem small, but they’ll quickly add up. And for all the energy you put in to your depression recovery, you’ll get back much more in return.
Depression self-help tip 1: Cultivate supportive relationships
10 tips for reaching out and building relationships

Talk to one person about your feelings.
Help someone else by volunteering.
Have lunch or coffee with a friend.
Ask a loved one to check in with you regularly.
Accompany someone to the movies, a concert, or a small get-together.
Call or email an old friend.
Go for a walk with a workout buddy.
Schedule a weekly dinner date.
Meet new people by taking a class or joining a club.
Confide in a counselor, therapist, or clergy member.

Getting the support you need plays a big role in lifting the fog of depression and keeping it away. On your own, it can be difficult to maintain perspective and sustain the effort required to beat depression. But the very nature of depression makes it difficult to reach out for help. However, isolation and loneliness make depression even worse, so maintaining your close relationships and social activities are important.

The thought of reaching out to even close family members and friends can seem overwhelming. You may feel ashamed, too exhausted to talk, or guilty for neglecting the relationship. Remind yourself that this is the depression talking. You loved ones care about you and want to help.

Turn to trusted friends and family members. Share what you’re going through with the people you love and trust. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time.
Try to keep up with social activities even if you don’t feel like it. When you’re depressed, it feels more comfortable to retreat into your shell. But being around other people will make you feel less depressed.
Join a support group for depression. Being with others who are dealing with depression can go a long way in reducing your sense of isolation. You can also encourage each other, give and receive advice on how to cope, and share your experiences. To locate a depression support group in your area, use the Depression and Bipolar Support Alliance's Support Group Locator.

Therapeutic Benefits of PetsHow pets can make you happier and healthier

While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and you a sense of being needed—both powerful antidotes to depression. And the research backs it up. Studies show that pet owners are less likely to suffer from depression or get overwhelmed by stress.

Read: The Therapeutic Benefits of Pets: How Caring for a Pet Can Make You Happier and Healthier
Depression self-help tip 2: Take care of yourself

In order to overcome depression, you have to nurture yourself. This includes making time for things you enjoy, asking for help from others, setting limits on what you’re able to do, adopting healthy habits, and scheduling fun activities into your day.
Do things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can choose to do things that you used to enjoy. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out with friends. Take a day trip to a museum, the mountains, or the ballpark.
Develop a wellness toolbox

Come up with a list of things that you can do for a quick mood boost. Include any strategies, activities, or skills that have helped in the past. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even if you’re feeling good.

Spend some time in nature.
List what you like about yourself.
Read a good book.
Watch a funny movie or TV show.
Take a long, hot bath.

Listen to music.
Take care of a few small tasks.
Play with a pet.
Write in your journal.
Do something spontaneous.

Push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.
Adopt healthy lifestyle habits

Aim for 8 hours of sleep. Depression typically involves sleep problems. Whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
Expose yourself to a little sunlight every dayExpose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Make sure you’re getting enough. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden.
Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Fight depression by managing stress

Not only does stress prolong and worsen depression, but it can also trigger it. In order to get over depression and stay well, it’s essential to learn how to minimize and cope with stress.

Identify your stressors. Figure out all the things in your life that are stressing you out. Examples include: work overload, unsupportive relationships, substance abuse, taking on too much, or health problems. Once you’ve identified your stressors, you can make a plan to avoid them or minimize their impact.
Go easy on yourself. Many depressed people are perfectionists, holding themselves to impossibly high standards and then beating themselves up when they fail to meet them. Battle this source of self-imposed stress by challenging your negative ways of thinking.
Plan ahead. If you know your stress triggers and limits, you will be able to identify and avoid many landmines. If you sense trouble ahead, protect yourself by dipping into your wellness toolbox and saying “no” to added responsibility.

Depression self-help tip 3: Get regular exercise

Get regular exerciseWhen you’re depressed, exercising may be the last thing you feel like doing. But exercise is a powerful tool for dealing with depression. In fact, studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue.

Scientists haven’t figured out exactly why exercise is such a potent antidepressant, but evidence suggests that physical activity increases mood-enhancing neurotransmitters in the brain, raises endorphins, reduces stress, and relieves muscle tension – all things that can have a positive effect on depression.

To get the most benefit, aim for 30 minutes of exercise per day. But you can start small. Short 10-minute bursts of activity can have a positive effect on your mood. Here are a few easy ways to get moving:

Take the stairs rather than the elevator
Park your car in the farthest spot in the lot
Take your dog for a walk
Pair up with an exercise partner
Walk while you’re talking on the phone

As a next step, try incorporating walks or some other enjoyable, easy form of exercise into your daily routine. The key is to pick an activity you enjoy, so you’re more likely to keep up with it.
Exercise as an Antidepressant

The following exercise tips offer a powerful prescription for boosting mood:

Exercise now…and again. A 10-minute walk can improve your mood for two hours. The key to sustaining mood benefits is to exercise regularly.
Choose activities that are moderately intense. Aerobic exercise undoubtedly has mental health benefits, but you don't need to sweat strenuously to see results.
Find exercises that are continuous and rhythmic (rather than intermittent). Walking, swimming, dancing, stationery biking, and yoga are good choices.
Add a mind-body element. Activities such as yoga and tai chi rest your mind and pump up your energy. You can also add a meditative element to walking or swimming by repeating a mantra (a word or phrase) as you move.
Start slowly, and don't overdo it. More isn't better. Athletes who over train find their moods drop rather than lift.

Adapted from Johns Hopkins Health Alerts

For more exercise tips, read Exercise for Exercise Haters: Finding Ways to Tolerate (or Even Enjoy) Exercise.
Depression self-help tip 4: Eat a healthy, mood-boosting diet

Eat a healthy, mood-boosting dietWhat you eat has a direct impact on the way you feel. Aim for a balanced diet of protein, complex carbohydrates, fruits and vegetables.

Don’t neglect breakfast. A solid breakfast provides energy for the day.
Don’t skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every 3-4 hours.
Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or french fries. But these “feel-good” foods quickly lead to a crash in mood and energy.
Focus on complex carbohydrates. Foods such as baked potatoes, whole-wheat pasta, brown rice, oatmeal, whole grain breads, and bananas can boost serotonin levels without a crash.
Boost your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To get more, take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs.
Consider taking a chromium supplement. Some depression studies show that chromium picolinate reduces carbohydrate cravings, eases mood swings, and boosts energy. Supplementing with chromium picolinate is especially effective for people who tend to overeat and oversleep when depressed.
Practice mindful eating. Slow down and pay attention to the full experience of eating. Enjoy the taste of your food

Omega-3 fatty acids play an essential role in stabilizing mood.

Foods rich in certain omega-3 fats called EPA and DHA can give your mood a big boost. The best sources are fatty fish such as salmon, herring, mackerel, anchovies, sardines, and some cold water fish oil supplements. Canned albacore tuna and lake trout can also be good sources, depending on how the fish were raised and processed.
You may hear a lot about getting your omega-3’s from foods rich in ALA fatty acids. Main sources are vegetable oils and nuts (especially walnuts), flax, soybeans, and tofu. Be aware that our bodies generally convert very little ALA into EPA and DHA, so you may not see as big of a benefit.
Some people avoid seafood because they worry about mercury or other possible toxins. But most experts agree that the benefits of eating 2 servings a week of cold water fatty fish outweigh the risks.

Depression self-help tip 5: Challenge negative thinking

Depression puts a negative spin on everything, including the way you see yourself, the situations you encounter, and your expectations for the future.

But you can’t break out of this pessimistic mind frame by “just thinking positive.” Happy thoughts or wishful thinking won’t cut it. Rather, the trick is to replace negative thoughts with more balanced thoughts.
Ways to challenge negative thinking:

Think outside yourself. Ask yourself if you’d say what you’re thinking about yourself to someone else. If not, stop being so hard on yourself. Think about less harsh statements that offer more realistic descriptions.
Keep a “negative thought log." Whenever you experience a negative thought, jot down the thought and what triggered it in a notebook. Review your log when you’re in a good mood. Consider if the negativity was truly warranted. For a second opinion, you can also ask a friend or therapist to go over your log with you.
Replace negatives with positives. Review your negative thought log. Then, for each negative thought, write down something positive. For instance, “My boss hates me. She gave me this difficult report to complete” could be replaced with, “My boss must have a lot of faith in me to give me so much responsibility.”
Socialize with positive people. Notice how people who always look on the bright side deal with challenges, even minor ones, like not being able to find a parking space. Then consider how you would react in the same situation. Even if you have to pretend, try to adopt their optimism and persistence in the face of difficulty.

Depression self-help tip 6: Raise your emotional intelligence

Emotions are powerful. They can override thoughts and profoundly influence behavior. But if you are emotionally intelligent, you can harness the power of your emotions.

Emotional intelligence isn’t a safety net that protects you from life’s tragedies, frustrations, or disappointments. We all go through disappointments, loss, and change. And while these are normal parts of life, they can still cause sadness, anxiety, and stress. But emotional intelligence gives you the ability to cope and bounce back from adversity, trauma, and loss. In other words, emotional intelligence makes you resilient.
Emotional intelligence gives you the ability to:

Remain hopeful during challenging and difficult times
Manage strong feelings and impulses
Quickly rebound from frustration and disappointment
Ask for and get support when needed
Solve problems in positive, creative ways

Learn how to raise your emotional intelligence

Emotional intelligence gives you the tools for coping with difficult situations and maintaining a positive outlook. It helps you stay focused, flexible, and creative in bad times as well as good. The capacity to recognize your emotions and express them appropriately helps you avoid getting stuck in depression, anxiety, or other negative mood states.

Read: Emotional Intelligence: The Five Key Skills

Depression self-help tip 7: Know when to get additional help

If you find your depression getting worse and worse, seek professional help. Needing additional help doesn’t mean you’re weak. Sometimes the negative thinking in depression can make you feel like you’re a lost cause, but depression can be treated and you can feel better!

There are many effective treatment options for depression. To learn about them, see Depression Treatment and Therapy.

Don’t forget about these self-help tips, though. Even if you’re receiving professional help, these tips can be part of your treatment plan, speeding your recovery and preventing depression from returning.

Relaxation Techniques for Stress ReliefRelaxation Techniques for Stress Relief
Relaxation Exercises to Reduce Stress, Anxiety, and Depression

Improving Emotional HealthImproving Emotional Health
Strategies and Tips for Good Mental Health
More Helpguide articles:

Depression Treatment: Therapy, Medication, and Lifestyle Changes That Can Help
Antidepressant Medications: What You Need to Know About Depression Medications
Feeling Suicidal? Coping with Suicidal Thoughts and Help to Get You Through
Helping a Depressed Person: Taking Care of Yourself While Supporting a Loved One

Need More Help?
Use your senses to keep stress in checkBring Your Life Into Balance Toolkit

Feeling depressed, overwhelmed, helpless, or hopeless? This toolkit can help you regain your emotional balance.

Go to Toolkit »
Related links for depression self-help and recovery
Depression self-help and coping tips

A Case of Catch 22 – Learn how to get around the Catch-22 of depression, in which the things a person needs to do to get well are the very things the illness makes it difficult to do. (Psychology Today)

Recovery - A series of articles on depression recovery, covering topics such as meditation, healthy eating, sleep, and exercise. (McMan’s Depression and Bipolar Web)
Support Groups

Find Support – To locate a depression support group in your area, visit the (Depression and Bipolar Alliance)
Depression self-help tools

Back from the Bluez – Self-help modules for coping with and recovering from depression. Features advice on increasing activity levels, thinking more positively, and maintaining treatment progress. (The Government of Western Australia Department of Health)

Self-Care Depression Program (PDF) – Comprehensive self-help guide to depression recovery from the University of British Columbia. (National Electronic Library for Health)

Wellness Toolbox – A selection of tools for depression recovery, including a therapy worksheet, symptom checklist, trigger tracker, and a personal wellness checklist. (Depression and Bipolar Support Alliance)
Challenging negative thoughts

Depression Doing the Thinking – Learn about common cognitive distortions and how to change them (Psychology Today)
Healthy lifestyle habits and depression

Depression and Exercise – Learn how exercise improves depression and find tips for getting started. (Better Health Channel)

Omega-3 for Depression and Bipolar – Gives an overview of the Omega-3 fatty acids and their role in boosting mood and relieving depression symptoms. (McMan's Depression and Bipolar Web)

Bedfellows: Insomnia and Depression – Discover the connection between sleep and mood, including how lack of sleep can trigger depression. (Psychology Today)

Healthy eating and depression (PDF) – Learn how to change your diet to improve your mood and relieve symptoms of depression. (Mental Health Foundation)
Delving deeper into dealing with depression

Coping with Depression – Psychologist Jon G. Allen reviews the key concepts of depression self-help and recovery, such as minimizing stress, thinking more flexibly, and maintaining supportive relationships. (The Menninger Clinic)

Authors: Melinda Smith, M.A., and Joanna Saisan, Robert Segal, M.A., and Jeanne Segal, Ph.D. Last updated: June 2011


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