Eating disorders are devastating mental illnesses that affect more than 7 million American women. Ninety percent of the people who suffer from the eating disorders Anorexia Nervosa and Bulimia Nervosa are women, according to the National Association of Anorexia Nervosa and Associated Disorders. Although they revolve around eating and body weight, eating disorders aren't entirely about food, but also about feelings and self-expression. Women with eating disorders can use food and dieting as ways of coping with life's stresses. For some, food becomes a source of comfort and nurturing, or a way to control or release stress. For others, losing weight is a way to gain the approval of friends and family. Eating disorders are not diets, signs of personal weakness or problems that will go away without treatment.
Eating disorders occur in all socioeconomic and ethnic groups. Eating problems usually develop in girls between age 12 and 25. Age 17 is the average age that an eating disorder develops, and about five percent of young people have eating disorders. Because of the shame associated with this complex illness, many women don't seek treatment or get help until years later. Eating disorders also occur in older women and in men, but much less frequently.
Treatment for anorexia nervosa and/or bulimia can be extremely expensive. Many patients require extensive medical monitoring and treatment, and therapy often extends over two years or longer. Inpatient treatment can cost $30,000 per month, and many patients are hospitalized more than once. Outpatient treatment can cost $100,000 or more. Educational programs (in public schools, college and the community) and services are in short supply in some states, and prevention programs have been shown to have a limited success at best. Typically, women with eating disorders are described as having low self-esteem and feeling helpless and inadequate. There are several categories of eating disorders, including anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS). All are considered psychiatric disorders according to the American Psychiatric Association's DSM-IV diagnostic manual. Anorexia nervosa is a disorder in which preoccupation with dieting and thinness leads to excessive weight loss. If you suffer from this disease, you may not acknowledge that weight loss or restricted eating is a problem, and you may "feel fat" even when emaciated. Women with anorexia nervosa intentionally starve themselves or exercise excessively in a relentless pursuit to be thin, losing from 15 percent to 60 percent of their normal body weight. Roughly half of all women suffering from anorexia nervosa never fully regain their health and 20 percent remain chronically ill. About half of women with anorexia also purge, but they do not have bulimia. The main difference between someone with anorexia who purges and someone with bulimia is weight: severely underweight individuals get a diagnosis of anorexia. Anorexia nervosa has the highest mortality rate of any psychiatric illness other than substance abuse, with 20-year mortality rates of 20 percent. Half are by suicide and half from complications related to starvation.
Women with bulimia nervosa regularly and sometimes secretly binge on large quantities of food-up to 20,000 calories at one time-then feel intense feelings of guilt or shame and try to compensate by getting rid of the excess calories. Some purge by inducing vomiting, abusing laxatives and diuretics, or by taking enemas. Others fast or exercise to extremes. If you suffer from this disease, you feel out of control and recognize that your behavior is not normal but often deny to others that you have a problem. Women with bulimia can be any weight and often experience weight fluctuations.
A third type of eating disorder, "eating disorders not otherwise specified" (EDNOS), refers to symptoms that don't fit into the other two categories of eating disorders. Individuals with EDNOS simply don't fit into either anorexic or bulimic diagnosis. They can have binge eating disorder, or be close to anorexia or bulimia without quite meeting full diagnostic criteria. EDNOS is simply a catch-all term for anyone with significant eating problems who doesn't meet for the other diagnoses.
Although it has become synonymous with eating disorders, anorexia is relatively rare, affecting less than one percent of adolescent women. Another two to three percent develop bulimia. Yet statistics don't tell the whole story. Many more women, who don't necessarily meet all the criteria for an eating disorder, are preoccupied with their bodies and caught up in destructive patterns of dieting and overeating that can seriously affect their health and well-being.
There is no single cause of eating disorders. Biological, social and psychological factors all play a role. Evidence suggesting a genetic predisposition shows that anorexia may be more common between sisters and in identical twins. It is estimated that one has roughly a five-to-six greater chance of developing an eating disorder if an immediate relative has one.
In some women, an event or series of events triggers the eating disorder and allows it to take root and thrive. Triggers can be as subtle as a degrading comment or as devastating as rape or incest. Times of transition, such as puberty, divorce, marriage or starting college can also provoke eating problems. Parents who are preoccupied with eating and overly concerned about or critical of a daughter's weight, and coaches who relentlessly insist on weigh-ins or a certain body image from their athletes, especially in weight-conscious sports including ballet, cheerleading, diving, wrestling, and gymnastics, may also encourage an eating disorder. So can the pressure of living in a culture where self-worth is equated with unattainable standards of slimness and beauty. Our society's "ideal" body size for a woman has decreased, and the difference between the size of the average American woman and the size many women think they should be has grown tremendously.
Thursday, November 22, 2007
Management Key
Management is Key to Living Well with Diabetes
Although diabetes is a chronic and potentially life-threatening condition, it can be effectively controlled and managed once it has been accurately diagnosed. The goal of diabetes management, according to the American Association of Clinical Endocrinologists, is to prevent short-term and long-term complications of diabetes from developing.
Without proper management, individuals with either type 1 or type 2 diabetes can develop serious or deadly complications from high glucose levels including blindness, kidney disease and nerve damage, as well as vascular disease that can lead to amputations, heart disease and strokes. Uncontrolled diabetes can complicate pregnancy; birth defects also are more common in babies born to women with uncontrolled diabetes.
For women with type 1 diabetes, controlling blood sugar levels means three to four (and sometimes more) shots of insulin a day, adjusting insulin doses to food and exercise, testing blood glucose up to eight times a day depending on their health care provider's recommendations and adhering to a planned diet.
Type 2 diabetes may be controlled initially by a planned diet, exercise and daily monitoring of glucose levels. Frequently, oral drugs that lower blood glucose levels or insulin injections need to be added to this regimen.
Treating diabetes comprehensively—that is, managing not only blood glucose, but also blood pressure and cholesterol—is crucial to helping prevent heart attacks and stroke. The good news is that women with diabetes who maintain lower blood glucose, blood pressure and cholesterol levels can lower their risk of cardiovascular disease. To reduce your risk, follow the "ABC" approach recommended by the National Diabetes Education Program, National Institute of Health and the American Diabetes Association. The ABCs are easy to remember:
A stands for the A1C, or hemoglobin A1C test, which measures average blood glucose over the previous two to three months
B is for blood pressure
C is for cholesterol
Diabetes treatment guidelines issued by the American College of Physicians (ACP) and published in the April 2003 issue of the Annals of Internal Medicine emphasize the importance of aggressive blood pressure control in lowering the risk for heart disease, stroke and early death in type 2 diabetes patients. Until these guidelines were released, most of the focus in diabetes care has been on tightly controlling blood sugar, but new evidence suggests that both blood sugar and blood pressure are very important in managing the disease.
The ACP recommends that patients with diabetes and high blood pressure strive for blood pressure levels of less than 130/80 mm/Hg, and that both thiazide diuretics and angiotensin-converting enzyme (ACE) inhibitors be used as first-line agents to control blood pressure in most patients with diabetes.
Although diabetes is a chronic and potentially life-threatening condition, it can be effectively controlled and managed once it has been accurately diagnosed. The goal of diabetes management, according to the American Association of Clinical Endocrinologists, is to prevent short-term and long-term complications of diabetes from developing.
Without proper management, individuals with either type 1 or type 2 diabetes can develop serious or deadly complications from high glucose levels including blindness, kidney disease and nerve damage, as well as vascular disease that can lead to amputations, heart disease and strokes. Uncontrolled diabetes can complicate pregnancy; birth defects also are more common in babies born to women with uncontrolled diabetes.
For women with type 1 diabetes, controlling blood sugar levels means three to four (and sometimes more) shots of insulin a day, adjusting insulin doses to food and exercise, testing blood glucose up to eight times a day depending on their health care provider's recommendations and adhering to a planned diet.
Type 2 diabetes may be controlled initially by a planned diet, exercise and daily monitoring of glucose levels. Frequently, oral drugs that lower blood glucose levels or insulin injections need to be added to this regimen.
Treating diabetes comprehensively—that is, managing not only blood glucose, but also blood pressure and cholesterol—is crucial to helping prevent heart attacks and stroke. The good news is that women with diabetes who maintain lower blood glucose, blood pressure and cholesterol levels can lower their risk of cardiovascular disease. To reduce your risk, follow the "ABC" approach recommended by the National Diabetes Education Program, National Institute of Health and the American Diabetes Association. The ABCs are easy to remember:
A stands for the A1C, or hemoglobin A1C test, which measures average blood glucose over the previous two to three months
B is for blood pressure
C is for cholesterol
Diabetes treatment guidelines issued by the American College of Physicians (ACP) and published in the April 2003 issue of the Annals of Internal Medicine emphasize the importance of aggressive blood pressure control in lowering the risk for heart disease, stroke and early death in type 2 diabetes patients. Until these guidelines were released, most of the focus in diabetes care has been on tightly controlling blood sugar, but new evidence suggests that both blood sugar and blood pressure are very important in managing the disease.
The ACP recommends that patients with diabetes and high blood pressure strive for blood pressure levels of less than 130/80 mm/Hg, and that both thiazide diuretics and angiotensin-converting enzyme (ACE) inhibitors be used as first-line agents to control blood pressure in most patients with diabetes.
Women - Diabets
Women and Diabetes: Special Concerns.
According to the cholesterol management guidelines issued in May 2001 by the National Cholesterol Education Program, National Heart, Lung, and Blood Institute (NHLBI), diabetes poses as great a risk for having a heart attack in 10 years as heart disease itself and should be managed as aggressively as heart disease. A recent survey showed that most people with diabetes don't know that heart disease and stroke are the major causes of death of people with diabetes. In fact, approximately two-thirds of people with diabetes die from cardiovascular disease and they die younger than women without diabetes.
Women with diabetes have lower levels of high-density lipoproteins (HDL) cholesterol (the good cholesterol) and higher levels of triglycerides, or fats, in the blood. According to the NHLBI's cholesterol management guidelines, elevated LDL cholesterol is a major cause of coronary heart disease and should be treated aggressively. Although low-density lipoproteins (LDL) cholesterol (the type of cholesterol that contributes to plaque buildup in your arteries) levels are not higher in women with diabetes, studies find that reducing LDL levels to less than 100 mg/dL can help prevent heart attacks and strokes in women with diabetes.
High cholesterol is typically treated with specially designed diets low in saturated fat, weight loss, exercise and, if necessary, medication.
Other health issues of concern to women with diabetes include:
High blood pressure. The ideal blood pressure for those with diabetes is less than 130/80 mm/Hg, according to the American Diabetes Association.
Urinary tract and vaginal infections. Urinary tract infections and vaginal yeast infections are more common in women with diabetes. The fungi and bacteria that cause these infections thrive in a high-sugar environment and the body's immune system can't fight them as effectively when blood glucose levels are too high.
Menstrual problems. Irregular menstrual periods are common in women with diabetes, especially if their blood sugar isn't well controlled. Blood sugar levels may rise and insulin needs may increase before a woman's period, and fall once it begins.
Adverse reactions to hormonal birth control methods. Contraceptives containing hormones (such as birth control pills), IUDs that contain progesterone, and long-lasting progestin implants and injections may alter blood glucose levels. Birth control pills may increase insulin resistance in some women with diabetes. Women with type 2 diabetes may find it harder to manage their blood glucose while taking birth control pills. Although rare in healthy individuals, the risk of complications from birth control pills, such as high blood pressure and stroke, are greater for women with diabetes. However, the American Diabetes Association says most birth control methods are safe for women with diabetes—talk to your health care professional about any potential risks.
According to the cholesterol management guidelines issued in May 2001 by the National Cholesterol Education Program, National Heart, Lung, and Blood Institute (NHLBI), diabetes poses as great a risk for having a heart attack in 10 years as heart disease itself and should be managed as aggressively as heart disease. A recent survey showed that most people with diabetes don't know that heart disease and stroke are the major causes of death of people with diabetes. In fact, approximately two-thirds of people with diabetes die from cardiovascular disease and they die younger than women without diabetes.
Women with diabetes have lower levels of high-density lipoproteins (HDL) cholesterol (the good cholesterol) and higher levels of triglycerides, or fats, in the blood. According to the NHLBI's cholesterol management guidelines, elevated LDL cholesterol is a major cause of coronary heart disease and should be treated aggressively. Although low-density lipoproteins (LDL) cholesterol (the type of cholesterol that contributes to plaque buildup in your arteries) levels are not higher in women with diabetes, studies find that reducing LDL levels to less than 100 mg/dL can help prevent heart attacks and strokes in women with diabetes.
High cholesterol is typically treated with specially designed diets low in saturated fat, weight loss, exercise and, if necessary, medication.
Other health issues of concern to women with diabetes include:
High blood pressure. The ideal blood pressure for those with diabetes is less than 130/80 mm/Hg, according to the American Diabetes Association.
Urinary tract and vaginal infections. Urinary tract infections and vaginal yeast infections are more common in women with diabetes. The fungi and bacteria that cause these infections thrive in a high-sugar environment and the body's immune system can't fight them as effectively when blood glucose levels are too high.
Menstrual problems. Irregular menstrual periods are common in women with diabetes, especially if their blood sugar isn't well controlled. Blood sugar levels may rise and insulin needs may increase before a woman's period, and fall once it begins.
Adverse reactions to hormonal birth control methods. Contraceptives containing hormones (such as birth control pills), IUDs that contain progesterone, and long-lasting progestin implants and injections may alter blood glucose levels. Birth control pills may increase insulin resistance in some women with diabetes. Women with type 2 diabetes may find it harder to manage their blood glucose while taking birth control pills. Although rare in healthy individuals, the risk of complications from birth control pills, such as high blood pressure and stroke, are greater for women with diabetes. However, the American Diabetes Association says most birth control methods are safe for women with diabetes—talk to your health care professional about any potential risks.
Diabets Types
There are several types of diabetes:
In type 1 (insulin-dependent) diabetes, the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. Type 1 diabetes is less common than type 2 diabetes, accounting for about five to 10 percent of diabetes cases. It typically develops during childhood or young adulthood. Although formerly known as "juvenile diabetes," the disorder can appear at any age.
Type 1 diabetes is classified as an autoimmune disease—a condition that results when the immune system turns against a specific part or system of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that both genetic and environmental factors are involved.
In type 2 (noninsulin-dependent) diabetes, the pancreas makes insulin but the body does not respond to it properly (insulin resistance). In time, the pancreas can fail to produce enough of its own insulin and requires insulin replacement. Type 2 diabetes most often occurs in overweight or obese adults after the age of 30, but may also develop in children. Factors that contribute to insulin resistance and type 2 diabetes are genetics, obesity, physical inactivity and advancing age.
Type 2 diabetes is on the rise in the US and rates are expected to continue increasing for several reasons, according to the CDC. The increasing prevalence of obesity among Americans is a major contributor to the rise in type 2 diabetes. Approximately 127 million Americans—or about 64.5 percent of the adult population—are overweight or obese and the number of obese children in the US is growing. Another reason is related to the relatively low levels of physical activity among American adults. (Sixty percent of American adults don't get enough physical activity.)
Other factors contributing to the rise of type 2 diabetes include:
· The increasing age of the population
· The fast growth rate of certain ethnic populations at high risk for developing the condition, including Latino and Hispanic Americans
· A third type of diabetes, gestational diabetes, is one of the most common problems of pregnancy. Left uncontrolled, it can be dangerous for both baby and mother.
Gestational diabetes results when hormones produced by the placenta increase the mothers' resistance to insulin. This resistance usually disappears when the pregnancy ends, but women who have had gestational diabetes have a greater risk of developing type 2 diabetes later in life. All pregnant women are routinely screened for gestational diabetes between their 24th and 28th week.
A new term, "pre-diabetes," describes an increasingly common condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. About 41 million people in the US between the ages of 40 and 74 have pre-diabetes.
Those with pre-diabetes have impaired fasting glucose (between 100 and 126 mg/dL after an overnight fast) or they have impaired glucose tolerance as indicated by one or more simple tests used to measure glucose levels. The ADA reports that in one study, about 11 percent of people with pre-diabetes developed type 2 diabetes each year during the average three years of follow-up. Other research shows that most people with this condition go on to develop type 2 diabetes within 10 years unless they make modest changes in their diet and level of physical activity.
Some long-term damaging effects to the body, particularly the heart and circulatory system, may start during the pre-diabetes phase of the disease.
In type 1 (insulin-dependent) diabetes, the pancreas makes little or no insulin because the insulin-producing beta cells have been destroyed. Type 1 diabetes is less common than type 2 diabetes, accounting for about five to 10 percent of diabetes cases. It typically develops during childhood or young adulthood. Although formerly known as "juvenile diabetes," the disorder can appear at any age.
Type 1 diabetes is classified as an autoimmune disease—a condition that results when the immune system turns against a specific part or system of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. At present, scientists do not know exactly what causes the body's immune system to attack the beta cells, but they believe that both genetic and environmental factors are involved.
In type 2 (noninsulin-dependent) diabetes, the pancreas makes insulin but the body does not respond to it properly (insulin resistance). In time, the pancreas can fail to produce enough of its own insulin and requires insulin replacement. Type 2 diabetes most often occurs in overweight or obese adults after the age of 30, but may also develop in children. Factors that contribute to insulin resistance and type 2 diabetes are genetics, obesity, physical inactivity and advancing age.
Type 2 diabetes is on the rise in the US and rates are expected to continue increasing for several reasons, according to the CDC. The increasing prevalence of obesity among Americans is a major contributor to the rise in type 2 diabetes. Approximately 127 million Americans—or about 64.5 percent of the adult population—are overweight or obese and the number of obese children in the US is growing. Another reason is related to the relatively low levels of physical activity among American adults. (Sixty percent of American adults don't get enough physical activity.)
Other factors contributing to the rise of type 2 diabetes include:
· The increasing age of the population
· The fast growth rate of certain ethnic populations at high risk for developing the condition, including Latino and Hispanic Americans
· A third type of diabetes, gestational diabetes, is one of the most common problems of pregnancy. Left uncontrolled, it can be dangerous for both baby and mother.
Gestational diabetes results when hormones produced by the placenta increase the mothers' resistance to insulin. This resistance usually disappears when the pregnancy ends, but women who have had gestational diabetes have a greater risk of developing type 2 diabetes later in life. All pregnant women are routinely screened for gestational diabetes between their 24th and 28th week.
A new term, "pre-diabetes," describes an increasingly common condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. About 41 million people in the US between the ages of 40 and 74 have pre-diabetes.
Those with pre-diabetes have impaired fasting glucose (between 100 and 126 mg/dL after an overnight fast) or they have impaired glucose tolerance as indicated by one or more simple tests used to measure glucose levels. The ADA reports that in one study, about 11 percent of people with pre-diabetes developed type 2 diabetes each year during the average three years of follow-up. Other research shows that most people with this condition go on to develop type 2 diabetes within 10 years unless they make modest changes in their diet and level of physical activity.
Some long-term damaging effects to the body, particularly the heart and circulatory system, may start during the pre-diabetes phase of the disease.
Diabetes
Diabetes is a chronic condition in which the body produces too little insulin or can't use available insulin efficiently. Insulin is a hormone vital to helping the body use digested food for growth and energy.
An estimated 20.8 million Americans (seven percent of the population) have diabetes, and each year about 1.3 million more aged 20 or older are diagnosed with the disorder, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Untreated, diabetes can cause long-term complications that affect almost every part of the body. Diabetes was the sixth leading cause of death in the US, however diabetes is likely to be underreported as the underlying cause of death on death certificates.
You are at higher risk for developing type 2 diabetes if you are overweight, don't exercise and are over 30, or if you have close relatives with diabetes, especially type 2 diabetes. Higher-risk ethnic groups include African American, Latino/Hispanic, Native American, Alaskan Native, Asian or Pacific Islander American heritage. These groups of people have twice the risk of Caucasians for developing type 2 diabetes.
Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lifestyles.
How Diabetes Develops
Much of the food we eat is broken down by digestive juices into a simple sugar called glucose, which is the body's main source of energy. Glucose passes into the bloodstream and, from there, into cells, which use it for energy.
However, most cells require the hormone insulin to "unlock" them so glucose can enter. Insulin is normally produced by beta cells in the pancreas (a large gland located behind the stomach). In healthy people, the process of eating signals the pancreas to produce the right amount of insulin to enable the glucose from the food to get into cells. If this process fails or doesn't work properly, diabetes develops.
In people with diabetes, the pancreas produces little or no insulin, or the body's cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.
An estimated 20.8 million Americans (seven percent of the population) have diabetes, and each year about 1.3 million more aged 20 or older are diagnosed with the disorder, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Untreated, diabetes can cause long-term complications that affect almost every part of the body. Diabetes was the sixth leading cause of death in the US, however diabetes is likely to be underreported as the underlying cause of death on death certificates.
You are at higher risk for developing type 2 diabetes if you are overweight, don't exercise and are over 30, or if you have close relatives with diabetes, especially type 2 diabetes. Higher-risk ethnic groups include African American, Latino/Hispanic, Native American, Alaskan Native, Asian or Pacific Islander American heritage. These groups of people have twice the risk of Caucasians for developing type 2 diabetes.
Although diabetes is a potentially life-threatening condition, people with well-managed diabetes can expect to live healthy lifestyles.
How Diabetes Develops
Much of the food we eat is broken down by digestive juices into a simple sugar called glucose, which is the body's main source of energy. Glucose passes into the bloodstream and, from there, into cells, which use it for energy.
However, most cells require the hormone insulin to "unlock" them so glucose can enter. Insulin is normally produced by beta cells in the pancreas (a large gland located behind the stomach). In healthy people, the process of eating signals the pancreas to produce the right amount of insulin to enable the glucose from the food to get into cells. If this process fails or doesn't work properly, diabetes develops.
In people with diabetes, the pancreas produces little or no insulin, or the body's cells do not respond to the insulin that is produced. As a result, glucose builds up in the blood, overflows into the urine and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.
Depression - Types
Depression is classified as a mood disorder. The primary types of depression are:
Major depression: Major depression is marked by a combination of symptoms that interfere with life activities, such as work, sleep and eating, as well as a loss of interest in previously pleasurable activities. The depressed mood represents a change from previous behavior or mood and has lasted for at least two weeks.
Dysthymia. This is a form of chronic but low-grade depression marked by low energy, a general negativity and a sense of dissatisfaction and hopelessness. A person suffering from dysthymia may experience many of the same symptoms that occur in major depression, but they are less intense and last much longer—at least two years. If you suffer from dysthymia, you may not feel good, but you aren't as disabled as during an episode of major depression. However, sometimes women with dysthymia also suffer from episodes of major depression, a condition known as double depression.
Postpartum depression (PPD): While the "baby blues" are common in many women within the first few days or weeks following pregnancy and childbirth, they are temporary. However, for some women these symptoms become more severe and long lasting. This is known as postpartum depression. The condition typically occurs from three days to six weeks after the baby is born, but can appear any time within the first year. About eight to 15 percent of women report diagnosable PPD within three months of delivery. If you've had prior depressive episodes, you have a much higher risk of developing PPD. Postpartum depression can seriously interfere with your ability to care for yourself and your child. You should report any symptoms immediately to your health care professional for further evaluation.
Premenstrual dysphoric disorder (PMDD): The syndrome of more severe depression, irritability and tension occurring seven to 14 days prior to the start of the menstrual period is known as premenstrual dysphoric disorder (PMDD) (also called late-luteal phase dysphoric disorder). It affects an estimated two to 10 percent of women of childbearing age. Though PMDD shares many of the characteristics of premenstrual syndrome (PMS), particularly the timing of the symptoms, there are differences between the two. When diagnosing PMDD, the focus is more on the mood-related symptoms than physical symptoms because the mood-related symptoms are significantly more severe in PMDD than in PMS. Experts say the difference between PMDD and PMS is similar to the difference between a mild tension headache and a migraine.
Seasonal affective disorder (SAD). Also called winter depression, SAD is a form of depression that affects an estimated 10 to 20 percent of Americans. Women in their 20s, 30s and 40s seem particularly susceptible to SAD, outnumbering men four to one. The key feature of SAD is your response to less light during the winter months. Experts believe that brain chemistry in some people is affected by diminished daylight, triggering depression at this time of the year. However, it is episodic—it comes and goes—and many people who experience SAD recover in the spring. These people, however, have an increased risk of developing bipolar disorder, another form of depression.
Bipolar disorder. This form of depression is sometimes called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by intense episodes of elation and despair, with any combination of mood experiences in between, including periods of normal moods. When in the depressed phase, an individual can have any or all of the symptoms of a depressive disorder. Symptoms during the manic phase include a decreased need for sleep, increased talkativeness, racing thoughts and increased activity, including sexual activity, excessive spending or having a great deal of energy. Sometimes manic episodes may include extreme irritability. Women who are bipolar may have more episodes of depression than mania.
Major depression: Major depression is marked by a combination of symptoms that interfere with life activities, such as work, sleep and eating, as well as a loss of interest in previously pleasurable activities. The depressed mood represents a change from previous behavior or mood and has lasted for at least two weeks.
Dysthymia. This is a form of chronic but low-grade depression marked by low energy, a general negativity and a sense of dissatisfaction and hopelessness. A person suffering from dysthymia may experience many of the same symptoms that occur in major depression, but they are less intense and last much longer—at least two years. If you suffer from dysthymia, you may not feel good, but you aren't as disabled as during an episode of major depression. However, sometimes women with dysthymia also suffer from episodes of major depression, a condition known as double depression.
Postpartum depression (PPD): While the "baby blues" are common in many women within the first few days or weeks following pregnancy and childbirth, they are temporary. However, for some women these symptoms become more severe and long lasting. This is known as postpartum depression. The condition typically occurs from three days to six weeks after the baby is born, but can appear any time within the first year. About eight to 15 percent of women report diagnosable PPD within three months of delivery. If you've had prior depressive episodes, you have a much higher risk of developing PPD. Postpartum depression can seriously interfere with your ability to care for yourself and your child. You should report any symptoms immediately to your health care professional for further evaluation.
Premenstrual dysphoric disorder (PMDD): The syndrome of more severe depression, irritability and tension occurring seven to 14 days prior to the start of the menstrual period is known as premenstrual dysphoric disorder (PMDD) (also called late-luteal phase dysphoric disorder). It affects an estimated two to 10 percent of women of childbearing age. Though PMDD shares many of the characteristics of premenstrual syndrome (PMS), particularly the timing of the symptoms, there are differences between the two. When diagnosing PMDD, the focus is more on the mood-related symptoms than physical symptoms because the mood-related symptoms are significantly more severe in PMDD than in PMS. Experts say the difference between PMDD and PMS is similar to the difference between a mild tension headache and a migraine.
Seasonal affective disorder (SAD). Also called winter depression, SAD is a form of depression that affects an estimated 10 to 20 percent of Americans. Women in their 20s, 30s and 40s seem particularly susceptible to SAD, outnumbering men four to one. The key feature of SAD is your response to less light during the winter months. Experts believe that brain chemistry in some people is affected by diminished daylight, triggering depression at this time of the year. However, it is episodic—it comes and goes—and many people who experience SAD recover in the spring. These people, however, have an increased risk of developing bipolar disorder, another form of depression.
Bipolar disorder. This form of depression is sometimes called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by intense episodes of elation and despair, with any combination of mood experiences in between, including periods of normal moods. When in the depressed phase, an individual can have any or all of the symptoms of a depressive disorder. Symptoms during the manic phase include a decreased need for sleep, increased talkativeness, racing thoughts and increased activity, including sexual activity, excessive spending or having a great deal of energy. Sometimes manic episodes may include extreme irritability. Women who are bipolar may have more episodes of depression than mania.
Depression
Feelings of sadness can be normal, appropriate and even necessary during life's setbacks or losses. Or you may feel blue or unhappy for short periods of time without reason or warning, which also is normal and ordinary. But if such feelings persist or impair your daily life, you may have a depressive disorder. Severity, duration and the presence of other symptoms are factors that distinguish ordinary sadness from a depressive disorder.
Depression can happen to anyone of any age, race, class or gender. It afflicts almost 19 million Americans each year, and up to one in five American women will suffer from clinical depression at some point in her life. Women are two to three times more likely than men to suffer from depression. Many women first experience symptoms of depression during their 20s and 30s. Once you experience depression, there's a 50 percent chance you'll be depressed again at some point in your life.
A complex combination of physiological, social, environmental, cultural, hormonal, biological and psychological factors may contribute to the reasons why women experience depression at a higher rate than men.
Depression affects both mind and body. If you are depressed, you feel a sense of helplessness, hopelessness or despair. You lose interest in your favorite activities, may experience changes in appetite, weight and sleep patterns, have difficulty concentrating and may be preoccupied with death or suicide.
Additionally, depression often occurs in conjunction with certain chronic illnesses, like diabetes, and after a heart attack or stroke. Research sponsored by the National Institute of Mental Health (NIMH) suggests that depression may even be a major risk factor for osteoporosis. It also can develop as a result of conditions that cause unrelieved pain. Left untreated, depression contributes to increased complications, prolonged recovery time and a greater chance of death.
The good news is that depression is a treatable illness. Yet according to a major study published in 2003 in the Journal of the American Medical Association (JAMA), only about one in five women with depression ever receive adequate treatment.
One reason that treatment for depression is inadequate is that many people do not know or are confused about where to seek mental health treatment. Another reason is that many individuals do not perceive depression as a real medical condition that should or can be treated. Also, there is still a social stigma attached to mental illnesses like depression. These perceptions are wrong. Depression is a potentially life-threatening disorder and anyone suffering from its debilitating symptoms deserves to have it treated.
Depression can happen to anyone of any age, race, class or gender. It afflicts almost 19 million Americans each year, and up to one in five American women will suffer from clinical depression at some point in her life. Women are two to three times more likely than men to suffer from depression. Many women first experience symptoms of depression during their 20s and 30s. Once you experience depression, there's a 50 percent chance you'll be depressed again at some point in your life.
A complex combination of physiological, social, environmental, cultural, hormonal, biological and psychological factors may contribute to the reasons why women experience depression at a higher rate than men.
Depression affects both mind and body. If you are depressed, you feel a sense of helplessness, hopelessness or despair. You lose interest in your favorite activities, may experience changes in appetite, weight and sleep patterns, have difficulty concentrating and may be preoccupied with death or suicide.
Additionally, depression often occurs in conjunction with certain chronic illnesses, like diabetes, and after a heart attack or stroke. Research sponsored by the National Institute of Mental Health (NIMH) suggests that depression may even be a major risk factor for osteoporosis. It also can develop as a result of conditions that cause unrelieved pain. Left untreated, depression contributes to increased complications, prolonged recovery time and a greater chance of death.
The good news is that depression is a treatable illness. Yet according to a major study published in 2003 in the Journal of the American Medical Association (JAMA), only about one in five women with depression ever receive adequate treatment.
One reason that treatment for depression is inadequate is that many people do not know or are confused about where to seek mental health treatment. Another reason is that many individuals do not perceive depression as a real medical condition that should or can be treated. Also, there is still a social stigma attached to mental illnesses like depression. These perceptions are wrong. Depression is a potentially life-threatening disorder and anyone suffering from its debilitating symptoms deserves to have it treated.
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