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The disease of our time

We all feel sadness or melancholy at one point or another in our lives, but these feelings are usually temporary and disappear within a few days. The severity of depression can only be explained by someone who has experienced it. When we suffer from depressive disorders, melancholy, anger or frustration overwhelm us, causing severe and prolonged sadness that affects our ability to relate to others, to work or even just to face our daily lives.

Depression is a common disease worldwide. An estimated 3.8 percent of the population is affected, including 5.0 percent of adults and 5.7 percent over the age of 60. Around the world, some 300 million people suffer from depression. This condition is different from normal mood swings and temporary emotional reactions to everyday problems. When recurrent and of moderate to severe intensity, depression can become a serious illness. It can cause great suffering and change the affected person’s work, school and family life. In the worst cases, depression can lead to suicide. Each year, more than 700,000 people die by suicide. Suicide is the fourth most common cause of death among 15-29 year olds.

Modern psychiatry tries to navigate the levels of neurotransmitters in the brain. Drugs such as prozac, zoloft and xanax work by increasing serotonin levels in the brain. However, several other factors are also linked to depression, such as certain nutritional deficiencies, medications, high alcohol or caffeine consumption, smoking, high sugar or protein intake. They all have in common the ability to reduce the conversion of tryptophan, an important amino acid, into serotonin in the brain. Hypoglycemic problems, hormonal imbalances and allergies can also be associated.

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Contributing factors. Treatment methods

Depression results from a complex interaction of social, psychological and biological factors. People who have experienced difficult events in their lives (unemployment, bereavement, trauma) are more likely to be depressed. Depression, in turn, can lead to more stress and dysfunction and worsen the situation for the affected person and the depression itself. There are interconnections between depression and physical health. For example, cardiovascular disease can lead to depression and vice versa.

Treatment of depression in adults is psychotherapy and prescription of antidepressants. Treatment varies depending on the severity of symptoms and the origin of depressive symptoms. It takes into account patient preferences. Antidepressants are essential for treating characteristic depression of moderate to severe intensity. Treatment of depression is a collaborative effort between the person with depression and his or her general practitioner, psychiatrist and possibly other health care professionals. Psychotherapy and, if necessary, drug treatment are tailored to each case. Hospitalization may be necessary.

As with any disease that evolves over time, the information provided to the patient, and sometimes to the patient’s loved ones (with the patient’s consent), allows the person with depression to understand the issue of treatment and adhere to it. During a depressive episode, treatment continues for at least four to six months after symptoms improve to consolidate positive results. Regular treatment is essential. Discontinuation of antidepressant treatment, if warranted, should be done gradually over several weeks, after 6 to 12 months of remission of depression, to prevent relapse. Early withdrawal of treatment results in a recurrence of depression. In severe forms of depression, treatment is sometimes extended for several years to avoid relapse.

Women more than men

The health of women and girls is influenced by biological differences related to gender and other social determinants. Women live longer than men. However, it is women who experience greater morbidity and are more likely than men to use health care services, especially for reproductive health. Depression is more common in women than in men (5.1% versus 3.6%).

Unipolar depression is twice as common in women. Self-harm, including suicide, occurs throughout life and is the second most common cause of death among women aged 15-29 worldwide. Mental illnesses, including depression, preferentially affect one gender and not the other. This observation has raised many questions: is there a genetic or physiological explanation for such differences, or are they a reflection of the social construction of the female and male sexes? Are women more likely to suffer from major depression because the female gender is said to have more right to express these emotions than the male gender? Or are men macho men unwilling to admit weakness?

For every two men affected by a depressive episode, there are three to four women. And this is not related to women’s specific living conditions (lower wages, longer life expectancy, etc.). The observation holds true even when risk factors are taken into account: same age, equivalent work situation and identical education level…. A woman is twice as likely to be depressed as a man.

Physiology has a lot to say

Depression is a disease that affects women twice as often as men, especially after the age of 55. Depression is an increasingly common problem among women in their 40s, among others, when they reach what is known as “the age of depression. premenopause. Symptoms of depression develop, and hormonal imbalances are not necessarily to blame. Women are prescribed antidepressants. They often do not affect their quality of life and can have significant side effects. On the other hand, drugs do not solve the basic problem of hormonal imbalance. That is why it is so important to consult an endocrinologist.

Angels of Life and Angels of Death

This is because often the problem is due to hormonal imbalance caused in most cases by estrogen deficiency. They have a powerful effect on the brain and mood, memory and learning ability. Its levels are beneficial when their levels are balanced, but devastating when they are in excess or not balanced by progesterone. For this reason, they are called Angels of Life and Angels of Death. Both excess and deficiency can lead to a whole process of symptoms that impede normal functioning. Estrogen deficiency, for example, alters the action of almost every neurotransmitter in the brain, including epinephrine, serotonin, dopamine and GABA. Then there is depression.

When hormones peak in the body, from the age of twenty to thirty-five, they allow a woman to live life to the fullest in terms of energy and intellectual capacity. But between the ages of thirty-five and forty-five, she goes through a period when external factors and lifestyle can more easily affect her hormonal cycle, since she has already begun to suffer a more or less significant decline in hormone production. They also affect emotional stress. For example, if a woman is under constant stress of any kind, her adrenal glands secrete large amounts of cortisol.

To meet the demand, the body uses progesterone to produce even more cortisol. In addition, it blocks the production of other steroid hormones, including estrogen. This extra need for cortisol leads to long-term adrenal overload and can jeopardize the menopause transition. The most illustrative example is that women often find it difficult to balance family and work life and tend to neglect themselves during these years.

A woman may suffer from both excess cortisol associated with chronic stress and adrenal exhaustion, which is unable to maintain adequate production of other adrenal hormones. After a while, the drop in cortisol is inevitable, and this plunges the woman into a vicious circle. After years of trying to cope with the demands of chronic stress, the adrenal glands are badly affected. They increase the volume and cause an inflammatory process that leads to the death of gland cells. In medicine, this is called moderate adrenal insufficiency. But simply put, the adrenal glands are exhausted. Symptoms range from simple fatigue, muscle weakness, hypotension, excessive skin pigmentation, allergies, inability to cope with stress, low immunity to disease and can even reach depression.

According to Prof. Aleksander Araszkiewicz, head of the Department of Psychiatry at the UMK Medical College in Torun, women’s vulnerability to depression is due to a number of psychosocial, biological and genetic factors. One of the causes of the condition may be the female endocrine system, affecting the brain neurotransmitter.

As the specialist points out, many women do not want to admit to their illness because they are afraid of stigmatization, i.e. being considered mentally ill or disabled. Unfortunately, hiding the disease or treating yourself with home remedies can end in severe complications. Some time ago, a survey was conducted among postmenopausal women. It turned out that of all the patients in whom gynecologists found suspected depression and to whom they suggested seeing a psychiatrist, only 49% took the advice, explains Prof. Araszkiewicz.

Depression and the age of women

Periods of greater vulnerability to depression in women correspond to moments of significant hormonal changes, such as puberty, postpartum and peri-menopausal periods. This has to do with the period-specific levels of neurotransmitters associated with mood control (e.g. serotonin, norepinephrine, dopamine). On the other hand, it should not be forgotten that the hereditary component plays a role, making some people more vulnerable to developing depression after stressful life events. Despite the fact that there is a strong correlation between female hormonal regulation and the incidence of depression, the psychosocial aspects associated with female gender concepts should also not be overlooked.

Identification with the female or male gender influences perceptions of one’s own depressive symptoms. Indeed, because the male gender is associated with attributes such as emotional control and independence, men are much less likely to seek medical help when they have symptoms of depression. This also applies to women, whose construction of gender identity gives them a certain fragility compared to men, making them more likely to consult when they don’t feel well. In addition, social roles associated with periods when vulnerability is particularly heightened in women (e.g., puberty, pregnancy) may also provide some explanation for the prevalence of depression among women.

All these periods correspond to moments when the image of the woman herself is modified. The girl sees herself entering the world of women as her body changes, taking on more feminine forms (e.g., breast development, pelvic enlargement). During pregnancy and the postpartum period, she goes from being a woman to a mother and must now assume the new social roles that come with these responsibilities. In North America, menopause is seen by women not only as the end of menstruation, but as a sign that old age awaits them. Consequently, periods of change are accompanied by doubts and fears, and are therefore stressful, making those who experience them more susceptible to developing various stress-related illnesses, including depression.

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Left to their own devices

About 1 in 8 women may experience a depressive episode in their lives, twice as many as men (in Hungary, Poland, Portugal, Czech Republic, more than 25% of women report depressive symptoms). The multiplication of roles and responsibilities on a daily basis (mother, wife, work) and the stress associated with them can lead to depression, especially among women who receive little help on a daily basis: single mothers suffer 3 times more depressive episodes than married women, single women suffer less depression than divorced women, poverty among single mothers is a risk factor for depression. Physiology, material situation, family situation.

All of this affects a woman’s psyche to a much greater degree than in men. Women, the unemployed and the divorced are most affected by depression. society’s highly gendered perception of women has a major impact on women’s self-esteem. One theory postulates that women combine more roles than men, making them more susceptible to depressive disorders. Conversely, other theories suggest that depression is more common among women with minimal roles (Statistics Canada, 1996). Belle and Doucet (2003) point out that poverty, inequality and discrimination often lead to severe depressive symptoms in women. Finally, pharmaceutical and dietary factors are also involved.

There is a link between being overweight and depression

People who are obese or overweight have a higher risk of developing depression, according to a new Danish study. The body mass index (BMI) allows you to find out if you are overweight or obese. To calculate this, you must divide your weight (in kilograms) by your height (in meters) previously multiplied by yourself. If the score is greater than 25, you are overweight. If the score is greater than 30, it is obesity. Researchers at Aarhus University Hospital in Aarhus, Denmark, have just discovered a link between depression and being overweight: for example, being about 10 kilograms overweight would increase the risk of developing depression by 70%. Women are subjected to much more “image” pressure from social media, for example. Often the idea of a perfect, Instagram-perfect look is the main focus, forgetting about one’s health. It is therefore easy to link overweight with depression.

Diet has an impact

According to naturotherapist J.E. Pizzorno, recommendations offered to the population in dietary guides to maintain optimal health remain the same for depression 8 . However, he recommends a multivitamin and mineral supplement. It is advisable to eat more oily fish (such as mackerel, herring and salmon) because their flesh is rich in omega-3 fatty acids, an essential nutrient. Also remember to eat foods rich in folic acid, such as meat, legumes and dark green leafy vegetables. One study found that a Mediterranean diet reduces the risk of depression. 93 .

A diet high in processed foods increases the risk of depression by 58% in this study. On the contrary, the Mediterranean diet reduces the risk of depression by 30%. How can diet work so much for depression? Probably providing omega-3s, antioxidants, folic acid and perhaps other elements. A French study conducted by NutriNet-Santé and published in BMC Medicines focused on the impact of consuming ultra-processed foods. The results showed that, overall, there is an association between the consumption of ultra-processed foods and the incidence of depressive symptoms. Thus, a 10% increase in consumption of such foods would increase the risk of depressive symptoms by 21%.

Poland does not deviate from the norm

Polish studies also confirm this trend. In Babicki and Mastalerz-Migas’ 2020 study. 77% of respondents expressed fear of contracting Covid-19, 23% had high levels of anxiety. In contrast, as many as 45% suffered from generalized anxiety. A study by psychologists from the University of Lodz showed that 53% of those surveyed had stress levels above 7 sten, a high level.

In turn, in May 2020. the team of Dr. Margaret Gambin conducted a study, the result of which indicated that 36.6% of the respondents aged 18-34 were in the risk group for clinical severity of depressive symptoms. This result is alarming in that it is more than twice as high as it was before the pandemic broke out. According to statistics, women in Poland are a more susceptible group to depression than men. In Poland, twice as many women as men develop depression (4% vs. 1.9%). Women also account for nearly 74% of diagnosed depression patients – risk factors cited include social factors, exorbitant expectations, pressure, burdensome responsibilities.

Unlike using doctors for bodily illnesses, when it comes to mental health deterioration, Poles are still reluctant to go to specialists for help. What could this be due to? It can be assumed that a low level of knowledge still exists among the public about what depression is, how it manifests itself and how it is treated. The same is sometimes true of the use of antidepressants, where the belief still persists that this type of medication is addictive, stupefying, and only “mentally ill” people take them.

Relationship protects against depression

Having an arm to lean on makes it possible to face the storms. It has been observed that the risk of depression evolves according to family situation: a married person is less likely to suffer from depression than a person who is simply in a relationship, who in turn is more resilient than a single person. And among single people, those most likely to suffer from depression are those who have a serious episode are divorced or widowed. Because separation multiplies by two to three the possibility of depression incidence. Again, the difference among the sexes. Men are more likely to be affected by the death of a spouse, while women are more likely to be affected by the death of a spouse. A relationship, the presence and support of a partner strengthen self-confidence. Equally important is a healthy lifestyle.

Doing activities that are enjoyable, staying in touch with other people, thinking positively, breaking down your goals into smaller objectives, looking at reality more realistically, eating healthy, playing sports regularly, having moments of relaxation, getting enough sleep, caring for others as you care for yourself.

Fear of stigmatization

It is estimated that 15 percent. People with affective illnesses, including depression, commit suicide. – Women are more likely to attempt suicide, and men are more likely to commit suicide. Men choose more effective methods of suicide, in Poland they mostly hang themselves, and in the US they shoot themselves with firearms. Women are more likely to poison themselves with drugs, which makes it easier to revive them, explains Prof. Dudek.

According to Professor Araszkiewicz, “In general, women are more likely to take care of their health than men. Seeing a psychiatrist and getting treatment for depression involves revealing one’s vulnerability and fear of stigmatization – being counted as mentally ill. In 2006. we conducted research on the prevalence of depressive disorders in postmenopausal women. Interestingly, gynecologists to whom the women reported menopausal disorders reported that they suspected depression in these patients. They suggested they report to a psychiatrist. Only 49 percent took the advice. these patients. This may be a symptom of the fear of stigmatization from being considered disabled.”

UDOSTĘPNIJ

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