deplogo

harmful to your health

 

 

 

Focus on women

Approximately 10-15% of older people are thought to suffer from depression, and the incidence in nursing homes is much higher (Blazer, 1995). Rates for depression among women are at least two-fold those of men. There are many theories about why this is so, but no definitive answers. Suicide, strongly linked to depression in older people and often associated with illness or loss of a spouse, is far more common than people realise. Although the problem is more pronounced among men, older women are also vulnerable. A UK study shows that among women, those aged 75 and over account for one in five of all suicides (WHO, World Heath Statistics, 1990).

In one study, general practitioners missed the diagnosis of depression at least half the time because of the co-existence of physical illness (Spitzer, 1995). Doctors and their patients may not recognise the disorder, or they may both be uncomfortable discussing psychological problems. In practical terms, this means that the prevalence of depression is likely to be much larger than even these statistics show.

Socio-economic costs

Overlooking or treating depression inappropriately among older people is an expensive error from every perspective. Not only does it doom older adults and their families to unnecessary misery; it also significantly increases the risk of disease and dependency and the resulting need for medical and social services for acute and long-term care. Women, who suffer disproportionately from this illness, pay the heaviest price. Unlike other disorders, effective treatments for depression are well-established. Properly used, these treatments, which may involve psychotherapy, ant depressants or a combination of the two, are far less expensive than caring for those with a debilitating depression.

Unfortunately, too many doctors rely on old prescribing habits. For example, despite strong efforts to limit the use of drugs classed as hypnotic, sedatives and tranquilizers, UK doctors wrote 21 million prescriptions for them in 1990 (Department of Heath, England, 1992). A recent study found that the highest prescribing rates were to women over 65 (Pharoah, 1990).

Impact on women

Why are mid life and older women at greater risk of depression than other groups? Several reasons have been advanced!

  • Social isolation and loneliness.
  • More likely to be widowed.
  • Physical and psychological difficulties in functioning independently.
  • Financial hardship, and little or no earning power.
  • Care-giving Burnout.
  • Lack of understanding of the problem by both patients and general practitioners
  • Older generation’s reluctance to seek treatment for psychological disorders
  • Longer lifespan, but often accompanied by poor health and disability
  • Higher rates of institutionalisation
  • Hormonal / life-cycle changes.

Biology. Although biological causes have been favoured since Victorian times, the few studies undertaken on homogeneous populations have not demonstrated any differences between the sexes that would explain the disparity (Clare, 1985). Researchers disagree on the association between the menopause and an increased risk of depression.

Research in genetics, neuro and sociobiology may help uncover new answers. In addition, more research on the differing effects of medications and drug interactions on older people in general and women in particular may reveal some important contributing factors.

Psychosocial development. Because of the way femininity has traditionally been defined, women may feel inhibited from speaking with authority, showing assertiveness or anger openly, or directing, organising or carrying out a function energetically. As a result, women often suppress these feelings and behaviours, which can contribute to depression. This is particularly true for mid life and older women, most of whom have been socialised to be dependent. They lack the assertiveness to obtain the services they need in times of illness, bereavement, unemployment or social isolation.

[ EIWH | CHD | Cancer | Osteoporosis | Depression | Advisory | Foreword | Overview | Future | Main | Policy ]

Go Back Home Next Page

Copyright © 2000, 2006 European Institute of Women’s Health

Leave a Comment

I accept the Privacy Policy

This site uses Akismet to reduce spam. Learn how your comment data is processed.