Hello my beautiful WIMBAs. Welcome back to the show. I hope you’ve been doing well. I have been super busy, but happy. I want to just share that my intention is to talk about things that are uplifting, but I also see value in talking about common struggles women in medicine face.
So today, we’re going to talk about a very important subject, depression. This is especially important for women in medicine given the highly publicized suicides and suicide attempts of female physicians in recent years.
To set the record straight, the rates of depression in US women ranges between 7-25%. When it comes to women in medicine, they fall in that range, but they tend to have higher rates of depression than their male counterparts.
Depression is something that can be biological, environmental, or both. Like most mental illnesses, it runs in families. So if you struggle with depression, see if you have a family history of this. Even if you are biologically predisposed to depression, this does not mean you will experience it, but if you do it might have been triggered by an event such as role conflict or harassment, which can put you at greater risk.
And perhaps part of the reason the rates of depression are bigger in women than in men is because certain types of depression are associated with hormonal and physical changes that only women experience. If you’ve ever been pregnant, you know what a hormonal shit show that can be. And for those of you who did fine during pregnancy, you might have experienced the roller coaster ride after the baby came with postpartum depression. If nothing else, we women are blessed with a monthly menstrual cycle where our emotions are up and down like yo yos and then of course we get to perimenopause where we get a whole other cascade of goodies.
How can you know if you’re depressed? Here’s what you want to look out for. Keep in mind that you won’t have all of these symptoms necessarily and depending on your level of depression, you will likely experience more types of symptoms.
Here they are:
- Feeling sad or empty for long periods of time
- Feeling hopeless about the future
- Feeling irritable
- Feelings of guilt, worthlessness, or helplessness
- Decreased energy or fatigue
- Disturbed sleep or oversleeping
- Loss of interest or pleasure in hobbies and activities that you typically enjoy
- Moving or talking more slowly than is normal for you
- Feeling restless or having trouble sitting still
- Difficulty concentrating, remembering, or making decisions
- Changes in appetite or weight
- Thoughts of death or suicide, or suicide attempts
- And somatization of your depression which can show up in a variety of physical symptoms that have no clear physical cause and that are difficult to treat. These can include aches or pains, headaches, cramps, or digestive problems
Traditional treatments for depression center around therapy and medications. The types of therapies more notably used include Cognitive Behavioral Therapy or CBT for short, Interpersonal Therapy, and Psychodynamic Therapy.
Medications include antidepressants, mostly ones that work on increasing serotonin in your brain. They come in a variety of names, but their effect can take a couple of weeks to kick in. The meds you take may work for others but not you which means you’ll have to titrate down and try something else. Not to mention that they come with a laundry list of side effects.
Medications are essential, especially for people with severe depression, but if you are in the mild or moderate range, you might want to consider some alternatives.
In a moment I will share some alternative treatments, but I also want to highlight the importance of lifestyle changes. When we are depressed, we are more likely to lose our motivation. This translates into sitting in bed or on the couch and watching Netflix for hours. Or in severe cases, staring at the walls and just having the negative thoughts in your head spin around and around incessantly.
When we are depressed we also want to isolate. We typically want to disappear, but isolation only increases depression.
So while I would normally tell you to follow your gut, consider this. When you are depressed, you are out of balance. Whatever your inclination is, try doing the opposite.
If you want to isolate, seek out social support.
If you want to be a couch potato, force yourself to go outside and exercise.
If you want to eat nothing but greasy or sugary foods, focus on eating healthy.
And if you just want to drown your sorrows out with alcohol, do yourself a favor and refrain. Alcohol is a depressant. It might make you forget your problems for a bit, but it then comes back to bite you in the ass.
Cool. So now let’s uncover alternative treatments for depression that you may not have considered. These are often not things your doctor will talk to you about, so do your due diligence and research all your options.
Supplements have been shown to help mild to moderate depressions, but can also be problematic. For example, according to the Mayo Clinic, St. John’s Wort is an herb that can interfere with other meds you might be taking.
You could tweak your diet to include more omega-3 fatty acids which are largely found in cold-water fish, walnuts, and flax. Researchers came across this as something that could potentially help when they found that depression and other mood disorders were less common in cultures that incorporate a lot of fish in the diet.
Sometimes, what can help with mild to moderate depression might be hiding in your spice cabinet. Researchers have found that saffron works better than a placebo on depression and is equal or better compared to placebos and at least equivalent to the therapeutic doses of common antidepressants such as imipramine and fluoxetine.
5-HTP is a supplement that increases your serotonin levels and therefore your mood. You can learn more about this and other amino acids in the book, The Mood Cure by Julia Ross. She includes a great handout that spells out how to know if you are depleted and which supplement would help with that, all in the interest of improving your mood.
Finally, I want to talk about 2 hormones created by the body that are linked to depression. The first is DHEA. The second is vitamin D. You can test for your levels with a blood draw and then take supplements to augment either as needed. But with vitamin D, it might also be worthwhile to consider how you might spend more time outdoors in the sun or purchase a sun lamp to balance your levels out.
And I want to offer that while traditional therapies as mentioned above may be effective in treating depression, I am a huge fan of a modality called Eye Movement Desensitization and Reprocessing, or EMDR for short. This is especially helpful for people who find talk therapy to be too painful or too slow OR for people whose depression is caused by exposure to a traumatic or difficult event. With EMDR, much of your experience is internal and you just notice what comes up for you physically, cognitively, and emotionally and it rapidly transforms and evaporates.
If you want to learn more, check out the show notes for a link to an explanatory video on EMDR.
The good news is that if you are struggling with depression, there are lots of options and hopefully you can find something that fits your needs. The important thing is that you reach out for help. Remember, if you are in a slump, it is just that. You can turn this around and you don’t have to figure this out alone. Reach out to a colleague, friend, or family member you can trust or see your doctor to take the next step.
Keep in mind that everyone feels sad once in a while. That does not mean you are depressed. So make sure to understand this distinction. Refer back to the list of symptoms I mentioned. You can find it all in the show notes.
If you are just stressed out or overwhelmed, then I’ve got just the thing for you. Head on over to www.drsharongrossman.com and download the Mindset Mastery Starter Kit which includes articles and videos to help you have the right mindset so you can feel good. You often have much more control over your outcome than you realize.
On that empowering note, I want to wish you an amazing week ahead. Be in touch and stay strong.