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Monthly Archives: August 2013

Is depression more prevalent in women or more diagnosed in women than men?

29 Thursday Aug 2013

Posted by crossroads420 in Depression

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addictive behaviors, and other situational stressors, Cognitive behavioral therapy, depression, Diagnostic and Statistical Manual of Mental Disorders, eating disorders, grief and loss, Hope, ICD-10, Major depressive disorder, Menopause, Prevalence, relationship issues, University of California Los Angeles

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It is often thought that women are more prone to depression than men.  Figures for the lifetime prevalence of depression vary according to the criteria used to define depression. Using DSM-IV’s criteria for ‘major depressive disorder’ which are similar to the ICD-10 criteria for ‘moderate depression’, the lifetime prevalence of depression is about 15 percent and the point prevalence about 5 percent. This means that an average person has about a one in seven (15 percent) chance of developing depression in the course of his or her lifetime, and about a 1 in 20 (5 percent) chance of suffering from it at this very point in time.[1]

But this may be misleading because it is not gender specific.  Women are twice as likely as men to suffer from depression.  The reasons are not entirely clear but it appears that the answer is biological, psychological, and sociocultural.  Women have higher incidence of fluctuating hormone levels.  Most obvious is postpartum depression and during menopause.  Biologically, we have a greater genetic predisposition to depression.

Women are more likely to think (or overthink?) about problems—which is a strength and a weakness.  We are also by our God-given nature more invested in relationships.  The affect on women of relationship problems often leads to depression.  Men are more apt to react to relationship problems with anger, substance misuse, or with a stoic tolerance that we, as women, see as indifference.

Sustained or chronic stress leads to elevated hormones such as cortisol, the “stress hormone,” and reduced serotonin and other neurotransmitters  in the brain, including dopamine,  which has been linked to depression.

From a cultural standpoint, women often have stress due to multiple responsibilities of working, bringing up children, maintaining a home, caring for older relatives, and the list goes on.  Added to that is that women live longer than men.  The loss of their support system of partners and friends through death and the resulting loneliness combined with declining physical conditions can lead to depression.  A woman is more apt to talk to her physician about her feelings and be diagnosed more frequently with depression.  Which leads us to wondering wether it is more prevalent in women or more diagnosed in women than men?

Regardless of the answer depression results in many women feeling hopeless and helpless.  A research study (Ages and Stages) by the University of California Los Angeles says that younger women depend on friends when depressed but women going through menopause and older rely on medication.  Young women think they can just ‘get over’ depression with the aid of friends and family. This is when the first episode of major depression is most likely – maybe after childbirth or a failed relationship. When women are in their 40’s and 50’s, depression may be assumed to be part of menopause and consequently the condition may go unrecognized. However life changes (children leaving home, divorce and aging parents) may be the actual triggers for depression than menopause.

In their sixties women tend to keep depression to themselves. In this survey, fewer than one in five confided in others. If they are dealing with the loss of a spouse, this can intensify their feeling of isolation. The take-home message of the survey is that younger women should realize that depression is a real illness that may need medical treatment. The older woman should recognize the importance of social support, as well as medication, in treating depression.

Cognitive behavioral therapy (CBT)—which focuses on changing behavior, rather than talking about your childhood, for instance—can be effective with medication or even a substitute for drugs. It is much more focused on what you seem to be doing and thinking that is keeping you depressed.

Hopelessness and helplessness are feelings that overcome us when we are depressed.  Hope is a crucial ingredient in all healing—physical and emotional.  So depression can become very debilitating for this reason.  Ask most women who have experienced depression and they will relate that they just want to stay in bed and pull the covers over their heads!

Hopelessness robs us of the joy of each day and from fully embracing all that life has to offer.  There is help and tomorrow does not have to be like today but things won’t change until the depressed person reaches out for help.

 


[1] Psychology Today

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Binge Eating Disorder: What Is It?

17 Saturday Aug 2013

Posted by crossroads420 in Eating Disorders

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American Psychiatric Association, binge eating, Binge eating disorder, DSM-5, Eating, Eating disorder, eating disorders, Food, help for food issues, Overeating, Polycystic Ovary Syndrome, women and food

ImageEven the most disciplined of us occasionally overeats, helping ourselves to seconds or even third portions, especially on holidays or at parties.  This is not a binge eating disorder.  It becomes a disorder when the bingeing occurs regularly and is accompanied by shame and secrecy.  The binger is deeply embarrassed about overeating and vows never to do it again.  However the compulsion is so strong that subsequent urges to gorge themselves cannot be resisted.

The DSM-V, released by the American Psychiatric Association in May 2013,  legitimizes the suffering of millions of Americans by designating  Binge Eating Disorder as a psychiatric illness which may make it possible to get the cost of treatment reimbursed by insurance.

According to the DSM-V, binge eating disorder is characterized by several behavioral and emotional signs:

  1.  Recurrent episodes of binge eating occurring at least once a week for three months
  2. Eating a larger amount of food than normal during a short time frame (any two-hour period)
  3. Lack of control over eating during the binge episode (feeling you can’t stop eating or control what or how much you are eating)
  4. Binge eating episodes are associated with three or more of the following:
    1. Eating until feeling uncomfortably full
    2. Eating large amounts of food when not physically hungry
    3. Eating much more rapidly than normal
    4. Eating alone out of embarrassment over quantity eaten
    5. Feeling disgusted, depressed, ashamed, or guilty after overeating

In addition there is marked distress regarding binge eating present, it is not associated with frequent inappropriate behavior such as purging, excessive exercise, etc.  Also it does not occur exclusively during the course of bulimia or anorexia.

There are many reasons people binge.  Everyone uses food to meet needs other than hunger sometimes.  It is not about an “event” of overeating.  It is about a “pattern of behavior”.  It’s also important to remember the relationship with food and eating behaviors are the symptoms of more profound underlying factors for most people with Binge Eating Disorder.  Individuals with Binge Eating Disorder use food to:

  •  Escape
  • Reward themselves
  • Avoid a stressful issue or problem
  • Sooth anxiety, fear, shame, grief, and loneliness
  • Express anger or frustration
  • Rebel from dieting, from others needs, from the “rules”
  • Distract from feelings, people, and feared situations or stressors
  • Distract from disturbing memories of traumatic experiences

While the exact causes are unknown, several factors are thought to play a part in binge eating disorder. The combination of causes and risk factors varies from person to person. Possible factors include genetics, a history of significant weight changes due to dieting or restrictive /irregular eating patterns, depression, mood disorders, weight related discrimination or bullying, problems with significant relationships, trauma and loss, emotional abuse or neglect, addictions, and sexual trauma.

People who are obese and also have binge eating disorder may be at greater risk for several potentially life-threatening complications, including Type 2 diabetes, high blood pressure and cholesterol, gallbladder disease, certain cancers, osteoarthritis, joint and muscle pain, gastrointestinal problems, depression, anxiety, sleep apnea, and Polycystic Ovary Syndrome.

The experience of living with binge eating disorder is as distressing as any other eating disorder and often accompanied by a belief that it is a willpower issue and they are simply not “strong enough” to stop.  Within a diet and thin-focused culture, the focus has been on weight loss as the goal. This “treatment” is often promoted by well-intentioned friends, family, and professionals. But with binge eating, dieting is a causal factor in the development of binge eating disorder. So it’s essential for treatment to provide alternatives to dieting for improving health and body image. In fact, weight loss as a goal of treatment—as opposed to goals of improved self care–can be damaging to the process of recovery.

For recovery to be lasting, people typically work with trained therapists, physicians, and others to address any underlying mood disorders, family dynamics, and complications from trauma. Ultimately, individuals must learn to treat themselves with the compassion and self-awareness needed for lasting recovery.

Recovery is typically an ongoing life-long process of growth and insight. But change is possible.  Treatment is about helping people and their supporters begin this process successfully and knowing it will not be a perfect journey. There will be ups and downs. But over time and with proper treatment, those with binge eating disorder can find a much more peaceful relationship with food, their bodies, and themselves.

But nothing changes until something changes!  Help is available.  http://www.crossroadsprogramsforwomen.com    800-348-0937

Bonnie Harken has been in the eating disorders treatment field since 1987. She was a founding officer of Remuda Ranch Centers serving as a Vice President until February 2002. Since February 2002 she has served as the Managing Director of The International Association of Eating Disorders Professionals Foundation (iaedp). She has also served many major eating disorders treatment facilities as a consultant.  In 2013 she opened Crossroads Programs for Women in Pekin, IL.

Reference Sources for this article:  Binge Eating Disorder Association, DSM-V, and Medical News Today.com

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