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Depression in Women: Could that unexplained headache be Depression?

30 Dec 2015

Dipti, a homemaker and mother of two kids was a good cook and managed her house to perfection, much to an outsider’s envy until one day she started experiencing sudden severe headache and backache.

These rendered her incapable of carrying out household chores to the extent she did earlier. Alarmed, her husband took her to a physician who prescribed one test after another only to find no conclusive results. He declared there was nothing wrong with Dipti. However, she continued to complain of body aches and headaches, the kids started to get neglected and their studies suffered. Further, there was financial pressure on her husband to hire a maid as Dipti could no longer carry out all the household chores by herself. She started remaining aloof and also had trouble sleeping at night. Frustrated with the added pressure and her constant complains, her husband accused her of faking it in order to avoid doing work. Her in-laws added fuel to the fire citing it was all a drama. This further led to Dipti’s downfall and her apetite significantly reduced. Two months down the line, she weighed 6kgs lighter and her self-care decreased. She used to lie on the bed for hours and hardly interacted with anyone. Now concerned, her husband took her to the physician who referred Dipti to a psychiatrist. At the psychiatrist’s office, after detailed history taking, Dipti was diagnosed to be suffering from depression and the psychiatrist pointed out that the unexplained body aches were a symptom of depression itself. She was started on medications and therapy and soon recovered.

Depression is the most prevalent mental disorder and seen in 3 of every 100 people in urban areas like Delhi and Mumbai. Depression affects 10% of the population with one in 4 women and one in 10 men suffering from this disorder at some time in their lifetime. It is more common in women with their being twice as likely to develop depression as compared to men.

Depression in women differs from that in men. It may occur earlier in women, last longer and is more likely to recur and be associated with stressful life events, and be more sensitive to seasonal changes. They are more likely to experience guilty feelings and attempt suicide. They also tend to blame themselves and feel anxious and scared.

The increase of a chance of depression in women is due to several reproductive, genetic, biological factors; interpersonal factors (relationship stress, separation or divorce, loss of a job);societal factors and certain personality characteristics (poor coping skills). Women these days juggle both work and home, raising kids as well and hence suffer more stress which may in turn trigger symptoms of depression.

When one talks about depression, a sad frowning face comes to mind. But depression is more than just that. Vague aches and pain are often the presenting complaints of depression. These include chronic joint pain, limb pain, back pain, gastrointestinal problems, tiredness, sleep disturbances, psychomotor activity changes, and appetite changes. Especially in women, a higher prevalence of depression is seen to be coupled with a higher prevalence of pain complaints.

Depression and physical pain are closely related on multiple levels. Certain genes lead to both depression as well as chronic pain. Research also indicates that the presence of depression increases the experience of pain. The body mechanisms in these disorders overlap significantly in terms of areas involved in the perception of pain. Several other factors predispose people to both chronic pain and depression. These may be stressful events or even other chronic physical diseases.

Depression has been seen to be closely associated with migraines. Over a two year period, a study found that a patient with history of major depression was three times more likely to have a migraine attack and a person with history of migraine was five times more likely to have a first episode of depression. Depression contributes greatly to the disability caused by headache and backaches. More than 50% of patients with depression who visit general practitioners complain only of physical symptoms and in most cases, these symptoms include pain. If physicians test all pain patients for depression, they might discover 60% of currently undetected depression.

If someone already suffers from back pain, it may get worse if they become depressed. Also, depressed women are four times more likely to develop neck and lower back pain than those who are not depressed. Depression can also make muscle and joints pain even worse. Chest pain has also been seen to be associated with depression.

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Pain slows recovery from depression and depression makes pain more difficult to treat. Depression leads to isolation and isolation leads to further depression. When depression is treated, pain goes away.

Women with chronic pain often report that pain interferes with their ability to engage in occupational, social, romantic, or recreational activities. Their inability to engage in these reinforcing activities may contribute to increased isolation, feelings of worthlessness, and depressed mood.  In addition, conditions such as anxiety, substance abuse, and personality disorders occur at a greater rate in individuals who have a chronic pain condition than in individuals who do not. Further, women suffering from depression and pain report more intense pain, less control of their lives and more unhealthy coping strategies.

Treatment for pain includes medication and physiotherapy. Also, psychotherapists employ cognitive and behavioral technique to teach patients how to avoid fearful anticipation, banish discouraging thoughts, and adjust everyday routines to ward off physical and emotional suffering along with working on the thoughts and behaviors that maintain depression. Other techniques that a psychotherapist may employ are progressive muscle relaxation and hypnosis.

Chronic pain is not to be taken lightly and one must consult a psychiatrist at the earliest.Depression is a difficult & debilitatng diesease to live with. Both depression and chronic pain are treatable but the earlier the diagnosis, the earlier is the recovery.


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Tags: #Depression #Women