Our moods color how we see the world. Sadly, many women will struggle with clinical depression (almost 13 percent) or anxiety (about 33 percent) at some point in their lives. In this handbook to your mind-set, you’ll learn about key factors that influence how you feel—from estrogen levels to sugar intake—as well as cutting-edge treatments. In search of quick pick-me-ups? We’ve got those, too. Read on to lift your spirits.
Fact No. 1: Depression doesn’t always mean sadness
For more than half of people with the diagnosis, irritability and anger are the most prominent symptoms. In fact, those emotions are associated with more severe depression, according to a 2013 study. “Patients report that it doesn’t take much to set them off,” says Philip R. Muskin, MD, professor of psychiatry at Columbia University Medical Center. “They bicker with their spouses as soon as they walk in the door or get upset over little annoyances, such as spilled milk.”
Also keep an eye out for these symptoms: difficulty concentrating, remembering things and making decisions; losing interest in activities you once enjoyed, like having sex; and appetite changes (one common complaint is that food has grown tasteless). Finally, you may feel as slow as molasses—your thinking, reactions and even physical movements could become sluggish. It’s also not uncommon to have trouble sleeping, adds Dr. Muskin: People who are depressed often wake up in the wee hours with no idea why.
Fact No. 2: Therapy really works
Research overwhelmingly shows that talk therapy can help with depression, either alone or in combination with medication. While a 2013 review of nearly 200 studies found that no single method was significantly better than any other, you may want to consider a form called mindfulness-based cognitive therapy (MBCT), which teaches a blend of Eastern meditation techniques and practical skills to counter damaging thoughts. In a 2015 U.K. study, one group of subjects phased out their use of antidepressants while attending eight group MBCT sessions and practicing at home; another group stayed on antidepressants and did not receive therapy. Both treatments showed similar success rates after two years. (A little more than half the people in each group avoided a relapse.)
“When you’re depressed, your view of life becomes distorted, and you may not notice how your mood can spiral downward,” explains Simon Rego, PsyD, director of the Cognitive Behavior Therapy Training Program at Montefiore Medical Center in New York City. “But mindfulness training helps you become more present in the moment, which in turn lets you detach from destructive thought patterns.”
Like any new practice, MBCT takes an investment of time (and often money) to start. The advantage is that it offers tools you can use your whole life, says Rego.
There are many varieties of therapy; your provider may use a combination of techniques, depending on her training and your specific needs. Here, a few common types.
Cognitive behavioral therapy: Aims to help you identify and change negative thought processes and habits.
Psychodynamic therapy and psychoanalysis: Work to raise awareness of how your past experiences and relationship patterns affect the way you feel and act.
Behavioral activation: Encourages you to do pleasurable activities (like exercising or hanging out with friends) to boost your mood.
Interpersonal therapy: Focuses on improving your relationships with others.
Problem-solving therapy: Helps you strengthen your ability to deal with stressful experiences.
Social skills therapy: Teaches communication techniques that can be applied to everyday situations.
Supportive counseling: Assists you through a stressful event (such as a death in the family or a divorce) and helps you develop coping strategies.
Fact No. 3: Foods can boost your mood
“In my opinion, food is one of the most powerful weapons we have in our arsenal when it comes to fighting depression,” says Dr. Ramsey, co-author of The Happiness Diet. A study published in June backs him up: Researchers found that higher consumption of fiber, whole grains and produce had protective effects—while a diet packed with added sugars and refined grains was associated with increased risk. Dr. Ramsey’s five suggestions for your grocery list:
Leafy greens: Try to eat at least one serving a day, urges Dr. Ramsey. Veggies like kale, spinach and Swiss chard are rich in folate, which is critical for making serotonin and dopamine.
Seafood: Women who ate fish at least twice a week had a 25 percent lower risk of depression than those who consumed fish less often, according to a 2014 Australian study. Shellfish count, too, says Dr. Ramsey.
Beans: Beans can help improve mood, says Dr. Ramsey, because their prebiotic fiber feeds the beneficial bacteria in our intestines, which play a role in regulating inflammation and brain health.
Nuts: A 2013 Spanish study showed that a Mediterranean diet supplemented with an ounce of nuts per day reduced a person’s risk of depression by about 20 percent. Nuts appear to help prevent low levels of the healthy-brain compound BDNF.
Dark chocolate: Snack on one small square of a bar that’s at least 70 percent cacao. The dark stuff possesses compounds that help increase blood flow to the brain.
Fact No. 4: Perimenopausal mood swings don’t last
Doctors once thought that the natural drop in estrogen that occurs after menopause makes women more vulnerable to depression, says Pauline Maki, PhD, professor of psychiatry and psychology at the University of Illinois at Chicago. But research has turned that theory sideways, finding that women were experiencing an uptick in bad moods duringperimenopause. “We realized that it was hormone fluctuations—not the final drop in estrogen—that made the difference,” says Maki. The good news is that those ups and downs will come to an end; like hot flashes, they should disappear once your hormones become stable again. But if the irritable dips are interfering with your everyday life, talk to your ob-gyn. Maki says that oral contraceptives are one effective approach. Your doc may suggest taking an SSRI as well.