All too often women’s mood disorders get brushed off as moodiness or irritability due to “that time of the month.” The role of women in many cultures still relegates the lioness’s share of work around the home – cooking, cleaning, laundry, childcare, etc. – to women despite also needing to work outside the home. Add in discrimination in the workplace, lower pay, and concerns for personal safety and it’s a small miracle that more women do not show signs of depression or anxiety, or worse.
Everyone experiences bad moods and has bad days. Having quirky fears or getting a case of nerves before stressful events is pretty normal too. How can you tell when you or someone you love has crossed the line, from just a case of “the blues” to clinical depression? Is your best friend just nervous, or does she have an actual anxiety disorder? Here are some basic questions that may help to tease apart normal habits or quirks from actual mental illness.
Stress, hormones, or other life challenges can reach a tipping point where you feel overwhelmed for a period of time. How can you tell if you are dealing with depression, and not just a normal response to difficult situations? Let’s take a look at your whole week, and try to be objective.
- Overall functioning is one important diagnostic clue. Did you go to work, or did you call in sick? Did you participate in any social activities? Low moods can make you feel like you can’t get out of bed, but you do manage to drag yourself through your day. People with clinical depression may not actually get out of bed, and often go through periods of time where functioning is impaired in at least one setting.
- Sleep problems are extremely common when suffering from depression. Both insomnia and “hypersomnia” (oversleeping, sleeping excessive numbers of hours) may develop in women struggling with depression. How many hours did you sleep each day over the last week?
- Depression also affects appetite, and again, this may lead to either extreme: not eating much at all, and overeating. Did you eat every day? Did you skip meals because you just had no appetite? Did you overeat?
- Your thoughts can also be an important diagnostic clue. The content of your thoughts and also the “style” of your thinking may indicate clinical depression. What have you been thinking about lately? Do you find that no matter what thought you start with, it seems to lead back to thoughts of worthlessness or shame and guilt? How was your concentration? Were you stuck in a rut in terms of your thinking, going over and over the same thoughts? Or were you struggling to think at all?
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Normal nervousness about things that trigger anxiety is an annoying but expectable part of life. Anxiety disorders can be truly debilitating. Diagnosing an anxiety disorder can begin with a careful examination of your last week or two.
- How was your overall functioning? Did you go to work, or see friends, or do anything fun with your partner or children? Is feeling nervous stopping you from doing things you need to do (like go to work or drive a car)?
- Have you had any episodes of physical problems – racing heart rate, sweating, feeling nauseated or faint? Headaches? Diarrhea or other gastro-intestinal distress? How fast have these episodes come on? Have you noticed that they are connected to anything specific?
- Are you more nervous at bedtime? Are you having trouble falling asleep?
- What do you find yourself thinking about most of the time? Are you struggling with fears or are you constantly worrying about something? How about concentration and decision-making – can you set your worries aside and function intellectually, making decisions at home or work? Or are you worrying pretty much all the time, even when you need to focus on other things?
- Would you describe yourself as restless or tense? Are you clenching your jaw or tensing your muscles without realizing it?
Mental illnesses such as depression and anxiety are not merely inconvenient or uncomfortable. These disorders have a profound impact on functioning, making it incredibly hard to go to work, school or social events. Parenting can be affected, and friendships and romantic relationships can also become strained. Women struggling with untreated depression, for example, may have so little energy they will sleep for upwards of 18 hours a day. Untreated anxiety disorders can lead to agoraphobia – again, impacting nearly every aspect of a person’s life. And both anxiety and depression can be fatal, as the impact upon your thoughts can lead to believing that suicide is the only option.
For some women, being diagnosed with depression and/or anxiety can also lead to guilt and shame. When you are responsible for others, but struggle to feel normal or good about yourself, that feels like failure. Many women admit to feelings of guilt and shame for not taking better care of themselves and/or family members.
Feeling better may seem like an insurmountable challenge, but treatment can be truly life-changing. Therapeutic approaches such as Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) have been well researched and studies show very positive results. It is possible not only to survive, but to thrive despite being diagnosed with a mental illness like depression or anxiety.