Jun 26

Jun 26 Anxiety and Depression in Females: Potential Causes and How We Can Protect Ourselves

Today on the blog, we have Lucy Barrett, from the Nourishing Minds Tribe, sharing her knowledge on causes and coping with anxiety and depression.

Anxiety and depression; two different mental health issues which are often mistakenly, assumed to co-exist. Anxiety is the term commonly used to describe ‘a feeling of apprehension and fear characterized by physical symptoms such as palpitations, sweating and feelings of stress’.1 Meanwhile, depression is defined as an illness involving ‘the body, mood and thoughts…that affects the way a person eats, sleeps, feels about himself or herself, and thinks about things’. 1 Each illness can occur for long periods of time or in episodic phases and both are absolutely debilitating. The aim of this article is to explore the possible reasons as to why both conditions are seem to disproportionately affect women and what steps we could take to promote our own emotional wellbeing.

In my youth, I had never heard of anxiety or depression, mental health was not spoken about; if it had of been, I think it would have helped me better understand what I was feeling. Thankfully, in today’s society, individuals are encouraged to speak more openly about their own mental health struggles; this helps people know they are not alone. While I feel this is a significant step in the right direction, it saddens me to read a statement published by the World Health Organisation (WHO) advising our ‘lifetime prevalence rates for any kind of psychological disorder are higher than previously thought’;2 and it appears there is a striking correlation between statistics of anxiety and depression and the incidence of women experiencing these. The Australian based mental health support organisation Beyond Blue report that a shocking ‘1 in 6 women…will experience depression and 1 in 3 women will experience anxiety during their lifetime’.3 In the UK women…are almost twice as likely to be diagnosed with anxiety disorders’4 and in the US, figures published by Mental Health America demonstrate that ‘women experience depression at roughly twice the rate of men’.5

After absorbing those statistics, I began to wonder; why at the same time we are being told women ‘have it all’, are we simultaneously experiencing some of the highest rates of poor mental health we have ever seen?

Is it our biology?

Many argue one of the explanations as to why anxiety and depression affect women in much higher rates than men is due to our biology. Micah Abraham, writer and editor for CalmClinic highlights how research indicates most women have naturally lower serotonin levels than men. Abraham explains that all bodies produce natural chemicals or ‘neurotransmitters’; these neurotransmitters can either be ‘inhibitory’, promoting calm and happiness or ‘excitatory’, promoting excitement, fear and stress. Serotonin is an inhibitory chemical playing a role in stress coping. Adrenaline and epinephrine, on the other hand, are two examples of the excitatory neurotransmitters. Abraham explains that if the latter two neurotransmitters are triggered more than the inhibitory neurotransmitters, this can change the physical structure of the brain by causing it to create more receptors for the excess excitatory neurotransmitters and decrease its serotonin and dopamine (or “happy chemical”) receptors because it doesn’t have as many of them to process. This type of chemical imbalance causes the oversensitivity to environmental and emotional stimuli that is the main characteristic of anxiety.6 As it has been shown that most women have naturally lower serotonin levels than men, this may go some way to explain how a woman may have a natural predisposition towards anxiety and depression.

A further physiological reason as to why women may experience higher rates of anxiety and depression is due to the innate ‘fight or flight’ response. Abraham explains the fight or flight response in both men and women begin in the amygdala area of the brain which regulates the storage of long term memories of events based on the strength of the emotional reactions that accompanied them. In men, the right amygdala is more responsive to stress and is associated with taking action. In women, as well as in people who suffer from anxiety and depression, the left side is more responsive and is associated more with thought and recollection of details;7 if women are more likely to store and vividly recall details of stressful events, this may go some way to trying to explain how the way in which women process and respond to stress differently to men presents a natural predisposition to developing anxiety and/or depression. This argument is further backed up by a study from the University of Pennsylvania School of Medicine which used Functional Magnetic Resource Imaging scans to highlight how during stress, instead of the ‘fight or flight’ response which occurs in men, for women the evolutionary stress response is ‘tend and befriend’ as the more natural nurturer. This study highlighted how as a response to stressors, the female limbic system, a part of the brain primarily involved in emotion, became activated;8 if women respond to stress by increasing activity in brain regions involved with recall of stressful events and emotions, this may help explain the gender difference in the incidence and rate of mood disorders.

Some argue our hormones are a significant risk factor in women developing mental health problems, particularly depression. Christina Gregory from Psycom explains how a woman’s reproductive hormones could be a contributing factor; Christina explains ‘issues with pregnancy, fertility, menopause and menstrual cycles increase women’s risk of developing depression’9. Disorders such as Postpartum Depression or Premenstrual Dysphoric Disorder, can cause severe mood swings, anxiety and negative thoughts. As women are more prone to fluctuating hormone levels not only month to month but throughout our lifetime, it is easy to see how our biology alone could predispose some of us to experiencing a higher prevalence of mental health difficulties compared with our male counterparts.

What about our lifestyle?

There is pressure in today’s society for women to conform to the societal ideals of beauty; these often involve a pressure to weigh less through eating a low calorie diet and working out regularly. While for many women, eating healthful foods and exercising will be good for their health, there is a growing number of females who are discovering there may be a downside to their ‘healthy’ ways. It seems more than ever, women are choosing to cut out food groups or follow strict diets; the risk here is that the less varied the diet, the lesser the opportunity for women to be eating a diverse range of nutrient dense foods. Some health organisations point out that not only could women be depriving their bodies of essential energy, they may also be depriving themselves of ‘essential nutrients’. 10 A diet lacking in nutrients can lead to a greater risk of developing vitamin and mineral deficiencies, which are vital for our bodies to maintain optimal functioning and health. Lacking in minerals such as magnesium and selenium can lead to thyroid function issues, sleep disturbances, irritability, sadness and even contributes to a heightened nervous system.11 Zinc, for example, is an essential trace mineral, a mineral that our bodies cannot produce on our own. Zinc deficiencies are common in strict vegetarian diets as while Zinc can be found in types of foods such as grains and beans, these foods often contain a higher level of phytates which can interfere with the body’s ability to absorb Zinc.12 The highest amount of Zinc in the body is found in our brains, particularly the hippocampus which is the part of the brain central to memory and mood. Being deficient in this mineral can lead to symptoms of depression, difficulties with learning, memory and even aggression.12 Using Zinc as an example here, highlights how sensitive our bodies can be to diet changes and at a time where women are embarking on more and more restrictive food intake, it is imperative that we seek the appropriate advice of a qualified professional to ensure our bodies will continue to receive the nutrients it requires, otherwise we could ironically run the risk of negatively impacting our physical and emotional health in our desire to achieve the opposite.

Aside from what we put in our bodies, what about the physical stressors we often create as a result of undertaking vigorous exercise regimes? We are all well aware of how exercising releases ‘feel good’ endorphins and in fact, many credit exercise as a way they help maintain their mental health. However, for the purpose of this article I took a closer look at how our bodies perceive high intensity exercise regimes and how this can at times negatively impact our mental health as well as our physical health. The message we receive from the fitness industry is often that we need to workout to a maximum effort several times a week in order for us to ‘see the results’. The issue with this message is that there is a risk of individuals embarking on rigorous exercise regimes without the appropriate refueling and resting of the body. Women in particular have very sensitive bodies; we menstruate each month which requires a lot of physical energy. However, if we place our bodies under prolonged periods of stress, this leads to our brain sending messages to the body to shut down non essential functions in order to conserve energy. Undertaking demanding exercise routines and under nourishing our bodies place our bodies under physical and emotional stress; many women can become obsessed with fitting in time to exercise and can worry about gaining weight. Our bodies cannot differentiate the difference between life threatening stressors and the stressors we create from intense exercise. This, in some cases results in Hypothalamic Amennorhea (HA). Mel Aytan, a previous sufferer of HA and founder of the Functional Nutritionist explains when the body is under prolonged stress the hypothalamus, which is the control centre in the brain for various functions including reproduction, stops signalling to produce hormones which are meant to stimulate the production of more hormones resulting in ovulation and menstruation stopping. 13 Under prolonged periods of stress, we begin to release more and more cortisol which is the stress hormone; the more this is released the more our body receives the signal we are currently at risk and shuts down non essential functions such as reproduction as it does not perceive it is currently safe enough for us to have a baby. It is therefore imperative, as women, that we listen to our internal cues. If we are too tired to exercise, we need to rest. If we do workout, we need to ensure we are eating enough to replenish our bodies. Failure to do so creates the ideal environment for stress in our bodies which as the above illustrates, could be detrimental to our emotional and physical health.

Do we need to consider external factors?

We have looked at the ways in which our bodies biology, we have also explored how what we eat and how we exercise can also increase the risk of experiencing difficulties with our mental health. But, are we forgetting the most important? Do we need to acknowledge the pressure that today’s society puts on women to be everything to everyone? The expectation on women to ‘do it all’ is immense says Christina Gregory; she argues women have many life roles including mother, wife, employee, friend, caregiver’. 9 The pressure on women to try and balance multiple responsibilities in our lives can be exhausting and can lead to women feeling they are never enough. It is impossible to be perfect in each and every aspect of our lives, and yet despite society progressing over the past 50 years, there is still a disproportionate sexist expectation on women to be the carer, the cook, the cleaner and the successful career women. Abraham of CalmClinic states it is these ‘sexist attitudes from family or significant others, domestic responsibility overload [and] work related stress’14 that expose women to many more daily stressors in comparison to men, which, if sustained over a long period of time could lead be a potential risk factor in them developing feelings of low self esteem, low self worth, anxiety and depression. Many argue that women have reached equality, many feel women now have the same opportunities as men, however most of us know there is still much progress to be done before we can honestly say we have reached equal status. Women continue to be disproportionately affected by factors which have the ability to contribute to poor mental health. Factors such as, ‘gender based violence, socioeconomic disadvantage, low income and income inequality’2 all of which can contribute to poor health outcomes.

This sustained pressure on women has only increased with the introduction of social media. More women from a young age have access to sites which create an online environment where women feel they need to act, dress and behave a certain way. Deakin University reports that ’91% of young people are using the internet for social networking and rates of depression and anxiety in young people have risen more than 70% in the past 25 years’.15 Dr Richelle Mayshak highlights how social media promotes an idealised image of day to day life and therefore platforms such as Facebook and Instagram may be associated with feelings of inadequacy or reduced self esteem.15 Gender researcher Rachel Simmons discusses how this impact from social media has a tendency to affect women more than men is because ‘girls…grow up being told that they will be valued for their appearance and that appearance is competition’.16 Having access to online content which further promotes this message is adding another layer of pressure on women and how they think they should look. Research has found that the diet industry in particular, prefers to use online platforms such as social media to promote their business. Simmons states how the diet companies often use ‘strong language inducing guilt about weight or the body, and [promotes] dieting, restraint and fat and weight stigmatisation’.16 It is no wonder the pressure from online platforms to have the perfect life and appear flawless, slim and happy has the ability to create a disparity between what they think they should look and feel like, and how they actually are. There is a concern that as sites grow in popularity, so too will reports of low self esteem, feelings of anxiety which may contribute to various mental health disorders in the future.

What can we do?

It is evident from the information presented that there are several risk factors both from our physiology, environment, socioeconomic background and external attitudes which increase the chances of women experiencing anxiety and depression during their lifetime. This article is not an exhaustive list of reasons as to why levels of anxiety and depression are on the rise in women, but it does begin to explore the potential risk factors. Although women may be more predisposed to certain mental health disorders, it does not mean they are inevitable. In our daily lives, we take the time to look after ourselves physically and aesthetically; we may exercise, eat well, take care of our skin - but how often do we take time to look after our emotional health? It is crucial for our overall wellbeing to be aware of what messages we take on from our environment; are we surrounding ourselves by positive people? Are we following social media accounts which make us feel bad about ourselves? What are the expectations of others around us, and do we need to challenge these? Are we able to carve out some time each day to check in with ourselves, do we need more rest? Do we need more sleep? We only have one body and one brain; if you take away one thing from this article, I hope it encourages you to be curious about your own mental health and explore ways in which we can keep our minds in tip top condition. Just because we are told we can have it all, does not mean we have to do it all.

References

1 www.medicinenet.com

https://www.medicinenet.com/script/main/art.asp?articlekey=9947

https://www.medicinenet.com/script/main/art.asp?articlekey=2947

2 www.who.int

https://www.who.int/mental_health/prevention/genderwomen/en/

3 www.beyondblue.org.au

https://www.beyondblue.org.au/who-does-it-affect/women

4 www.mentalhealth.org.uk

https://www.mentalhealth.org.uk/statistics/mental-health-statistics-men-and-women

5 www.mentalhealthamerica.net

https://www.mentalhealthamerica.net/conditions/depression-women