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Women are now almost twice as likely to be on antidepressants as men. Why?
"Why can't a woman be more like a man?" laments Henry Higgins in the 1964 Lerner and Loewe classic musical "My Fair Lady." In the show Higgins is stymied by Eliza Doolittle's emotional reactions to his science-based efforts to re-engineer her in his image of a proper woman.
Click here for Rex Harrison's rendition of "Hymn to Him" from the movie.
It's the age-old problem of men and women having different sensibilities. But fast forward 50 years or so, and Henry Higgins may well have the answer to his problem – antidepressants.
A study published in the Journal of Clinical Psychiatry finds that more than 69% of people on antidepressants aren't actually depressed. They don't meet the criteria for major depressive disorder (MDD). And 38% never met the criteria for other conditions for which antidepressants are prescribed, at any time in their life. These include obsessive-compulsive disorder, panic disorder, social phobia, or generalized anxiety disorder.[i]
But what many of these "patients" have in common is that they are women. The researchers found that being female was statistically associated with antidepressant prescriptions.
In other words, according to actual medical practice, it looks like being a woman may be a treatable mental health condition.
Other major reasons linked to taking antidepressants included being Caucasian, having recent or current physical problems (e.g., loss of bladder control, hypertension, and back pain) or a recent visit to a mental health facility.
Women are now almost twice as likely to be on antidepressants as men. One in four women is now on psychiatric medication according to Julie Holland, a psychiatrist in New York and the author of "Moody Bitches: The Truth About the Drugs You're Taking, the Sleep You're Missing, the Sex You're Not Having, and What's Really Making You Crazy."
In a recent op-ed piece in the New York Times Dr. Holland noted that women are under constant pressure to tamp down their emotions. "We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical," she writes.
But, as Dr. Holland points out, most antidepressants don't create a positive mood. Instead, they numb you physically and mentally. They make you more rational and less emotional. Some women also report,
"less of many other human traits: empathy, irritation, sadness, erotic dreaming, creativity, anger, expression of their feelings, mourning and worry."
And they make it difficult to cry.
Henry Higgins would be delighted.
But these traits are essential to being human. Recent research has found, for example, that even anxiety is a healthy, necessary feeling. According to French researchers anxiety acts like a "sixth sense" which could save your life.
Without anxiety you may not react so quickly to real threats. The study showed that without anxiety brain signals went to the part of the brain linked to normal sensory perception rather than threats.
It's time to lose our fear of feeling a little gloomy. After all, being sad or unhappy won't kill you. In fact, a study of one million women published in the Lancet, found that happiness and related measures of wellbeing do not appear to have any direct effect on mortality in middle aged women.[iii]
In other words, the effects of negative emotions may be more helpful and less harmful than you might think.
Before trying to rejigger your emotions with chemical drugs, try using foods to allow your body to gently cope with the natural flux of emotions. Here are seven tips that can help you do it.
1. Clean up your diet.
Eating a Mediterranean diet or similar healthy eating plan, comprised of fruit, vegetables, legumes, and nuts, and low in processed meats, can help prevent the onset of depression. A 10-year study of 15,093 people published in BMC Medicine suggests depression could be linked with nutrient deficits from a poor diet.[iv]
The researchers cited the benefits of minimizing foods like processed meats and sweets, while increasing nuts, legumes, fruits, vegetables, and omega-3 fats.
But your diet doesn't need to be perfect. They found a threshold effect rather than a "dose-dependent" effect. In other words, moderate adherence to a healthy eating plan is good enough. They found no additional benefits among people who showed a high or very high adherence to their food rules.
2. Avoid processed carbs.
A diet high in refined carbohydrates may lead to an increased risk for new-onset depression in postmenopausal women. That's the finding of a study from the department of psychiatry at Columbia University Medical Center (CUMC) and published in The American Journal of Clinical Nutrition. [v]
Researchers looked at the dietary glycemic index, glycemic load, types of carbohydrates consumed, and depression in data from more than 70,000 postmenopausal women. The data came from the National Institutes of Health's Women's Health Initiative Observational Study between 1994 and 1998.
They found that eating foods with higher dietary glycemic index (GI) scores, as well as added sugars and refined grains, were linked with increased risk of new-onset depression in post-menopausal women.
Conversely, eating more foods with a lower GI score like fiber-rich foods, whole grains, vegetables, and whole fruits, was linked with a lower depression risk.
The GI scale goes from 0-100 and measures the amount of sugar found in the blood after eating a certain food. Refined foods such as white bread, white rice, and soda trigger blood sugar spikes that may cause mood changes, fatigue and other symptoms of depression.
3. Eat more fish.
A review of 26 studies involving 150, 278 people found eating a lot of fish may help curb the risk of depression. The review, published online in the Journal of Epidemiology & Community Health, found women eating the most fish had a 16% reduction in depression risk compared with those eating the least.[vi]
The researchers suggested that "omega 3 fatty acids found in fish may alter the microstructure of brain membranes and modify the activity of the neurotransmitters, dopamine and serotonin, both of which are thought to be involved in depression."
They also noted that the high quality protein, vitamins, and minerals found in fish may help stave off depression.
Dietary sources of DHA come primarily from animal products such as oily fish. Mackerel, herring, salmon, trout and sardines, are the richest dietary sources. They contain 10 to 100 times more DHA than vegetarian sources such as nuts, seeds, flax seeds, whole grains and dark green, leafy vegetables. Pastured eggs and meat are other good sources of DHA.
4. Avoid Grains and Dairy.
Gluten and lectins in grains, and casein and other proteins in dairy are suspicious compounds in foods that may sabotage your brain and lead to mental problems like depression, bipolar disorder, and even schizophrenia.
5. Add more black currants.
They strongly reduce the activity of enzymes known as "monoamine oxidases" (MAO). In fact, black currant compounds act in the same way as MAO inhibitor drugs used in the treatment of Parkinson's disease, depression, stress, and anxiety. But without the serious side effects.
6. Boost your protein.
Julia Ross, a clinical psychologist and author of The Mood Cure, recommends stabilizing moods with a whole foods diet that sustains blood sugar levels for the longest time possible. That means getting at least 25 to 30 grams of protein per meal. Getting enough proteins can help decrease cravings for sugar and high starch foods that contribute to moodiness.
7. No more aspartame.
Researchers from the University of North Dakota found that just one half of the FDA's "safe" acceptable daily intake of aspartame might cause serious neurobehavioral changes including cognitive impairment, irritable moods, and depression.[vii]
[i] Yoichiro Takayanagi, MD, PhD; Adam P. Spira, PhD; O. Joseph Bienvenu, MD, PhD; et al.
"Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study." J Clin Psychiatry 2015;76(1):40–44. 10.4088/JCP.13m08824
[ii] Marwa El Zein, Valentin Wyart, Julie Grèzes. "Anxiety dissociates the adaptive functions of sensory and motor response enhancements to social threats." eLife 2015;4:e10274. DOI: https://dx.doi.org/10.7554/eLife.10274
[iii] Bette Liu, DPhil, Sarah Floud, PhD, Kirstin Pirie, MSc, et al. "Does happiness itself directly affect mortality? The prospective UK Million Women Study." The Lancet 2015. DOI: https://dx.doi.org/10.1016/S0140-6736(15)01087-9
[iv] Almudena Sánchez-Villegas, Patricia Henríquez-Sánchez, Miguel Ruiz-Canela, et al. "A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project." BMC Medicine 2015:13:197. DOI: 10.1186/s12916-015-0428-y
[v] James Gangwisch, PhD et al. "High Glycemic Index Diet as a Risk Factor for Depression: Analyses from the Women's Health Initiative." American Journal of Clinical Nutrition, August 2015
[vi] Fang Li, Xiaoqin Liu, Dongfeng Zhang. "Fish consumption and risk of depression: a meta-analysis." Journal of Epidemiology and Community Health, 2015; jech-2015-206278 DOI: 10.1136/jech-2015-206278