women and depression and culture
DESCRIPTION
December 2012 Women's Connection luncheon presentation on Women and Depression by Connie Marsh, MD, associate medical director of Via Christi Senior Behavioral Health.TRANSCRIPT
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Women and Depression:What’s Culture Got To Do
With It?Connie Marsh MD
University of Kansas School of Medicine-Wichita
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Importance of topic
By 2020, depression will be the second greatest cause of disability world wide
Women and Depression
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In any given year, what percentage of individuals will have depression?a. 2%b. 5%c. 10%
Women and Depression
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True or FalseWomen and men have the same rates of depression.
Women and Depression
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What percentage of women, over a life time, will have depression?a. 7%b. 13%c. 21%
Women and Depression
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Importance◦ impact
Women and Depression
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Impact◦ Isolation◦ Work problems◦ Family problems◦ Worsening medical problems◦ Suicide attempt and completion
15%
Women and Depression
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Importance◦ Impact on illness
Greater disability and impairment Diabetes Lung disease High blood pressure Back problems Heart disease
Women and Depression
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For most women, depression usually first occurs
a. Age 15-24b. Age 25-44c. Age 45-55
Women and Depression
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Neglected◦ 60% detection by primary care doctor◦ Less than 2/3 of people with depression seek
treatment Inadequate treatment is common
Women and Depression
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What does depression look like?
Women and Depression
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Mood Sleep Appetite Energy Interests Guilt Concentration Slowed down Thoughts of suicide
Depression
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Women more likely ◦ Seasonal component◦ Excess eating◦ Excess sleeping
Depression and Women
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What does depression look like?
What’s Culture Got To Do With It?
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Perception of mental illness Stigma Willingness to accept treatment Compliance to treatment Role expectations Immigration
What’s Culture Got To Do With It?
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Rates of depression across races/ethnic groups◦ Globally◦ Within US culture
900 young women 21% of whites 28% of African Americans 29% of Hispanics
What’s Culture Got To Do With It?
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Male/female disparity
What’s Culture Got To Do With It?
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Social◦ Introspection encouraged in girls
Socioeconomic◦ Single parent◦ Social isolation
Psychological◦ Increased rates of sexual/physical abuse in
females
What’s Culture Got To Do With It?
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Male/female disparity◦ ENDOCRINE/neurotransmittors
ESTROGEN
What’s Culture Got To Do With It?
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Puberty Premenstrual Pregnancy/lactation Postpartum Perimenopause
When?
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Estrogen
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What are risk factors for depression?
Risk Factors
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For males and females◦ Family history◦ Personal history◦ Serious medical illness◦ Decreased social support◦ Serious life stress◦ Substance abuse, including alcohol, MJ, cigarettes
Risk Factors
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For females◦ Loss of parent before age 10◦ Childhood sexual/physical abuse◦ History of depression after pregnancy◦ Single parent◦ Unhappy/abusive marriage◦ Presence of young children in home
Risk Factors
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Psychotherapy Antidepressant medication Life style changes
◦ Exercise◦ Nutrition◦ Socialization
Treatment
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If risk factors◦ Recognize susceptibility◦ Don’t ignore symptoms, including irritability◦ Get therapy
Stay healthy◦ Exercise◦ Avoid substances—drugs, alcohol, MJ, smoking
Prevention?Modification?
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Get help early◦ More treatable◦ Less impact on job/family/relationships
Vicious cycle◦ Recognize stressful times as susceptible times
Increase social support network◦ ASK for help◦ If young children in home, especially important
Prevention?Modification?
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