Fight that Sinking Feeling
Decades after novelist Virginia Woolf and poetess Sylvia Plath made their private pain public, female depression as a literary subject matter is more in fashion than ever.
In Britain, one of many countries in the world, where research has established women are around twice as likely as men to become depressed, a minor flurry of female depression memoirs is hitting the book shelves. And there could be more to come as taboos about discussing the illness begin to brake down.
Author of one of the latest books, Stephanie Merritt, who has battled with a form of bipolar disorder, or manic depression, notes the focus on success in Britain and elsewhere makes it very difficult for many people to confront depression.
"We are not comfortable talking about depression in our culture, which places so much emphasis on success and on the belief that achievement equals happiness. Collectively we have not made it easy to admit to depression, and as a result there are people who die each year by their own hand when they might have been helped, had they only known how to ask," she wrote in Britain's 'Observer' newspaper earlier this year.
But there are signs of progress.
British actor and writer Stephen Fry's 2006 television documentary 'The Secret Life of the Manic Depressive' gave many people more confidence to talk about their illness, Merritt said.
She argued, Fry had done for manic depression what Australian singer Kylie Minogue did for breast cancer when she went public about her illness. "Over the past couple of years, a new openness has begun to replace the stigma that previously surrounded mental illness," she wrote.
Her memoir 'The Devil Within', published by Vermilion, is an account of recurring depression, intermittent highs and learning how to manage the condition without medication. Her book is out in stores in May.
Two other depression memoirs published in Britain this year are 'Shoot the Damn Dog' by Sally Brompton, published in January by Bloomsbury, and 'Woman on the Verge of a Nervous Breakdown' by Lorna Martin, released by John Murray earlier this month.
Apart from their inner struggles, what the three authors have in common is that they are all high-flying journalists with fulfilling lives. Why they and so many other women have become clinically unhappy has so far been explained only in part. "There are a number of biological and social reasons for women's vulnerability, among them are higher rates of abuse and domestic violence and subordinated positions within society," said Dr Kathryn Abel, director of the Centre for Women's Mental Health Research at the University of Manchester in Northern England.
"I'm not at all surprised," said one 80-year-old woman sufferer of depression, who asked not to be named, "of the higher incidence among women. Women take everything on board - men's problems and their own."
The United States' National Institute of Mental Health (NIMH) in a document released in 2000, 'Depression - What Every Woman Should Know', said research had shown about 19 million people in the U.S. - or one in 10 adults - experienced depression each year. And around twice as many of these were women as men.
It cited factors including, biochemistry, the reproductive cycle and certain personality traits, such as negative thinking, which some experts have suggested, can result from the way girls are traditionally brought up. Women are also more likely to have experienced the sexual abuse and poverty that is often linked with the onset of depression.
The NIMH said women and children represented 75 per cent of the U.S. population considered to be poor. "And yet," it said, "the specific causes of depression in women remain unclear".
Post-natal depression is clearly a form of the illness that affects women, but the NIMH cited research suggesting those who suffered from it had already had depressive episodes, so their mental state was not necessarily only triggered by having given birth.
The two-to-one ratio has been found in many countries besides Britain and the United States, the NIMH noted, and Dr Abel said she thought it was probably valid throughout the world.
Some have suggested that women are just more in tune with their emotions and more likely than men to seek help and talk about depression. But Merritt argued convincingly that the pressures on modern women to prove they can juggle careers with all the other demands on them made it less likely they would admit to feelings of failure and being unable to cope with life. The positive news is that women tend to be receptive to treatment and even though the incidence of depressive illness is higher in women, the suicide rate is much lower than for men.
According to the latest available government data from Britain's Office for National Statistics, the suicide rate per 100,000 of the population was 5.3 in 2006 for women aged 15 and above, down from 6.7 in 1991. For men, the rate was 17.4, down from 21.
Merritt revealed that when she plucked up courage to visit her doctor, she told her: "If she didn't help me, I would probably be dead by the end of the week ... I had lost any sense that my life was worth living." Previously, she was treated with anti-depressant drugs, but now she uses only the naturally-occurring amino acid 5-Hydroxytrytophan, widely known as 5-HTP.
From this amino acid the brain makes serotonin, the neurotransmitter that regulates our moods and emotional processing and which research has found operates differently in men and women.
Merritt hopes her book will help others to find natural cures, rather than the drugs or even electroconvulsive therapy, which is still used for the most severe forms of depression. Also, writing about depressive illness and raising awareness is another form of therapy without unpleasant side-effects.
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