What is depression?

Depression is a serious mental health condition that affects how you think, feel and behave.

While it is common to feel sad or down at times, people who experience depression may feel this way more intensely and for longer periods. Depression can affect many parts of your life.

Depression and related mental health conditions, such as anxiety and post-traumatic stress disorder (PTSD), are more common in women. Although women are more likely to experience depression, they are also more likely to reach out for help and support, which is an important first step in recovery.

This information is about depression in women. Many aspects and risk factors of depression are not gender or sex specific. Read more on depression in the general community.

What are the symptoms of depression in women?

Everyone goes through times of feeling sad, down or low. However, if this continues for 2 weeks or more, you may be experiencing depression. Signs and symptoms vary greatly between people. Some have only a few symptoms, while others may have many.

Women and men also tend to experience depression slightly differently. Women are more likely than men to show internalising behaviours. They are also more likely to engage in self-harm. Women are more likely to feel:

• stressed
• indecisive
• uneasy
• worthless
• a sense of loss
• pessimistic about the future

Other symptoms may include:

• loss of pleasure in activities you usually enjoy
• feelings of hopelessness, failure or low self-esteem
• social withdrawal and isolation
• changes in appetite, with or without weight loss, or overeating and weight gain
• physical symptoms, such as headaches, stomach aches or panic attacks
• changes in behaviour, such as acting 'flat' (not expressive), speaking more slowly or avoiding eye contact
• acts of self-harm, indirect self-harm or thoughts of suicide

If someone is having suicidal thoughts or making plans for suicide, it can be hard for other people to notice. Warning signs include:

• social withdrawal and isolation
• reckless behaviour
• giving away possessions

Some may also express:

• a sense of hopelessness
• feeling worthless
• being a burden to others

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

What causes depression in women?

The exact cause of depression is unknown. Every person has different circumstances.

Depression can be triggered by big life changes such as:

• pregnancy
• parenthood
• divorce
• employment challenges
• menopause
• loss of parents

These events can cause both physical and emotional stresses in women. Negative life experiences can also affect your mental health and wellbeing.

There are many other factors that can contribute to depression including:

• family history (genetic factors)
• changes in the brain
• feeling isolated
• physical health problems
• personality
• long-term stresses (such as relationship stress or work stress)
• stressful or traumatic events

Some experiences add to women's higher risk of depression:

• Caring roles — Many women are primary carers for children, parents and partners. Balancing caring roles with other responsibilities can impact a woman's physical and mental health.
• Violence or abuse — Many Australian women have experienced violence or abuse by an intimate partner. This often negatively affects a woman's health and wellbeing.
• Infertility and miscarriage — Many Australian couples face trouble getting pregnant and experience perinatal loss. This can be very painful, especially since these losses are often mourned privately. Women with a strong desire to have children can find these events especially stressful.
• Pregnancy and birth — Some women experience depression during pregnancy, or in the year after giving birth due to hormonal changes and lifestyle changes.
• Menopause — Hormonal changes and the life transitions that occur around menopause can increase the risk of depression.

What types of depression are specific to women?

Premenstrual dysphoric disorder (PMDD)

Hormone changes that lead to moodiness and irritability before menstruation are common.

This is sometimes called premenstrual syndrome (PMS).

A severe and less common type of premenstrual disorder is called premenstrual dysphoric disorder (PMDD). If you have PMDD, it can be disabling. Along with other symptoms of depression, you may have:

• bloating
• breast tenderness
• joint or muscle pain

Perinatal depression

Perinatal depression is common during both pregnancy (prenatal depression) and after childbirth (postnatal depression). Many women with these conditions may not realise they have depression.

Pregnancy and the weeks following childbirth involve many changes and adjustments. After childbirth, you may experience the 'baby blues', which can make you feel exhausted, anxious or unhappy.

Postnatal depression is different and much more serious than 'baby blues'. Along with the usual symptoms of depression, if you have postnatal depression you may question your ability to care for your baby and find it difficult to feel attached to your baby. You may sometimes have thoughts of harming yourself or your baby.

If you think you have perinatal depression, talk to your healthcare provider. If you think your partner or someone you care about is experiencing perinatal depression, encourage them to seek help from their healthcare provider.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Perimenopausal depression

Because of changing hormone levels, menopause can be a challenging time. This includes symptoms such as:

• abnormal periods
• problems sleeping
• mood swings
• hot flushes
• weight change
• anxiety and panic for no apparent reason
• issues with concentration ('brain fog')

The risk of depression for women increases during perimenopause.

Some of the symptoms of perimenopausal depression are the same as the symptoms of typical depression. However, they also include problems with:

• memory and concentration
• paranoid thoughts
• irritability

When should I see my doctor?

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

If you are experiencing symptoms of depression, it's best to seek help early. The sooner your symptoms are addressed, the better the outcome is likely to be. You should seek help and speak with your doctor if you:

• have been feeling sad or depressed most of the time
• have symptoms of depression for 2 or more weeks
• are worried that you may be depressed

Talking about depression and thoughts of suicide can be hard. Your doctor is a trained professional and will not judge you.

If you are experiencing occasional signs of depression, or just feeling low, you can reach out to a friend or family member. This could be to chat or go out together to do something you enjoy. However, depression is best managed with support from health professionals.

How is depression in women diagnosed?

A health professional, such as a GP, psychiatrist or psychologist, can diagnose depression. If you are concerned about your mental health, or the mental health of someone you care about, contact your GP.

To diagnose depression, your doctor will do a mental health assessment. This usually involves a discussion or answering a questionnaire, as well as a physical examination. This will help your doctor identify the cause of your symptoms.

Your doctor will ask how you have been feeling and if you've had any physical symptoms. They will ask if you have symptoms of depression, such as:

• changes in your energy levels
• appetite changes
• sleep changes
• whether you are feeling restless, hopeless or sad

This can help them find any underlying causes for how you are feeling. You should also tell them if you have felt this way before.

They may also ask about your medical and family history of depression or any other condition. They will rule out possible medical conditions that can mimic symptoms of depression.

Your answers will also help your GP decide if a specialist such as a counsellor, psychologist or psychiatrist might be helpful.

For advice and to connect to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating hours.

How can I help a woman with depression?

If you think that a woman you know may be experiencing depression, you can offer them help and support.

Here are tips to help a woman you care about with depression:

• Support them by learning about the life stages they may be struggling with such as pregnancy, birth or menopause.
• Spend time listening — you don't always need to offer advice or solutions.
• Help by taking on some of their day-to-day responsibilities, such as household chores and childcare.
• Encourage them to speak to a doctor or mental health professional — they might need your help to take the first step.

Read the healthdirect page on how to help someone with depression.

How is depression treated?

If you are experiencing depression, your doctor can help you build a mental health treatment plan.

This plan will help you get up to 10 Medicare-subsidised sessions per year with a mental health professional such as a social worker, occupational therapist or psychologist. Ask about any fees or out-of-pocket costs when you book your appointment.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Your treatment plan may include different types of treatments depending on your type of depression, your symptoms and how severe they are. Your doctor will also ask you about your preferences — what services or therapies you'd like to try and what you would prefer to avoid.

Psychological treatments

There is a wide range of psychological treatments for depression, such as:

• cognitive behavioural therapy (CBT)
• interpersonal therapy (IPT)
• mindfulness-based cognitive therapy (MBCT)

This can be through face-to-face meetings, telephone consultation, online treatment or a combination of these.

Medicine

Antidepressant medicines affect chemical processes in the brain that affect your mood. They normally take 4 to 6 weeks to be effective.

Many different medicines are used to treat depression. Your doctor will work with you to find the one that is right for you. It can take several weeks for an antidepressant medicine to work, and often your doctor may need to adjust your dose. You may experience side effects or suicidal thoughts when starting a new antidepressant.

Remember to check with your doctor or pharmacist before taking any medicine (prescribed or over the counter) while you are pregnant or breastfeeding.

Other treatments

Physical treatments are sometimes appropriate to treat depression.

Transcranial magnetic stimulation (TMS) uses an electromagnetic coil placed on the scalp to stimulate the nerve cells in your brain that control mood.

Electroconvulsive therapy (ECT) involves a brief electrical stimulation of the brain while you are under anaesthetic. It is used to treat specific types of depression, including severe depression that has not responded to medicines. While it is generally considered safe, it is only used in severe cases of depression including during pregnancy when carefully supervised.

Self-help and alternative therapies

A wide range of self-help techniques and alternative or complementary therapies can be used to treat depression either alone or together with other types of therapies.

Not all types of depression can be treated using these methods alone. It is important that you build a personal mental health treatment plan with your doctor. Self-help and alternative therapies include:

• meditation and mindfulness
• eating healthy and exercising regularly
• avoiding alcohol and drugs
• yoga
• massage therapy

If you are experiencing depression, your doctor may recommend one of these types of therapy by itself or together with other types of treatments.

What are the complications of depression in women?

Depression can lead to mental health and physical complications. When depression becomes very severe, you can experience dark or distressing thoughts. These can even lead to self-harm or suicide. If you are having thoughts of suicide, talking to someone you trust can help.

Depression can also make it harder to manage daily responsibilities and worsen other medical conditions. Untreated depression during pregnancy can lead to poor health outcomes and pregnancy complications.

If someone you care about has severe depression, learn the warning signs. They may be feeling so bad that they cannot see another option on their own.

Read more about suicide warning signs.

Can depression in women be prevented?

Even if you are more likely to get depression, there's a lot you can do to keep symptoms away. Some proven strategies for good mental health are:

• exercising
• avoiding harmful levels of alcohol and other substance use
• getting enough sleep
• reducing anxiety, such as through relaxation techniques
• meeting up with friends, so you avoid becoming isolated

If you are struggling with infertility or experiencing complications during your pregnancy, speak to your doctor about it. They can support you throughout your pregnancy.

You can also see a psychologist if you're not depressed. This is a good way to maintain your mental health.

Resources and support

If you, or someone you know, is having suicidal thoughts and is in immediate danger, call triple zero (000). For help and support, call Lifeline on 13 11 14.

It is important to reach out to your doctor if you are feeling down or think you may be experiencing depression. You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Pregnancy, Birth and Baby's video call service allows you to speak face-to-face with a maternal child health nurse. Video call is a free service and is available from 7am to midnight (AET), 7 days a week (including public holidays). Call if you are experiencing depression related to pregnancy or birth.

Here are some resources for further help and information.

• These organisations offer telephone counselling support to people at risk and those affected by suicide:
• Lifeline crisis support on 13 11 14
• Suicide Call Back Service phone and online counselling on 1300 659 467
• Beyond Blue provides resources and support to people struggling with depression as well as their family, friends and work colleagues.
• Complete Beyond Blue's K10 test to understand your level of distress and receive support options.
• Read more on what the evidence says about what treatments work for depression.
• SANE Australia is for people living with a mental illness.
• If you are experiencing mental health issues related to your sexuality or gender identity, QLife has a counselling and referral service.
• The Mum2MoodBooster program is an online program to help if you're experiencing depression during pregnancy.

If you have symptoms of depression during your pregnancy:

• COPE (Centre of Perinatal Excellence) provides support for the emotional challenges of becoming a parent. They also have information in different languages.
• PANDA (Perinatal Anxiety & Depression Australia) has information on mental health problems during and after pregnancy. Phone their National Helpline on 1300 726 306.

Languages other than English

• Embrace Multicultural Mental Health has services and information available.
• This Way Up has translated resources on mental health topics.
• The Transcultural Mental Health Centre has translated mental health resources in more than 40 languages.
• The Multicultural Centre for Women's Health has a fact sheet on perinatal depression and anxiety, available in 19 community languages.
• Perinatal Anxiety & Depression Australia (PANDA) has support in different languages and a checklist to help you understand how you're feeling and whether you might need support.

Information for Aboriginal and/or Torres Strait Islander peoples

The Black Dog Institute has mental health and wellbeing information for Aboriginal and/or Torres Strait Islander peoples.

Beyond Blue has information on how depression affects Aboriginal and/or Torres Strait Islander peoples.

PANDA provides support for Aboriginal and/or Torres Strait Islander peoples.