- The exact medical nature of Kate Spade’s depression has not been revealed, but her tragic suicide does highlight links between gender and mental illness.
- Women suffer from depression and bipolar disorder in ways that are distinct from men.
- Hormonal changes around pregnancy and menopause have been studied but lack an abundance of evidence.
- In the case of bipolar disorder, women are prone to a dangerous form of rapidcycling from highs to lows, which can be lethal.
by Ashleigh Garrison
…But there’s another angle that’s underexplored: the role of gender in depression and bipolar disorder.
Psychiatrists and mental health experts stressed that it would not be appropriate or professional to speculate on Spade’s diagnosis, but they did say more research needs to be conducted on the role gender plays in mental illness, whether it is major depressive disorder or bipolar disorder.
A study conducted in the early 2000s by well-known mental illness researcher Ronald Kessler of Harvard Medical School found that major depressive disorder is the leading cause of disease-related disability among women in the world, and depression is much more common among women than men. Kessler said women are also more likely to have anxiety disorders, not every anxiety disorder, but the ones that are associated with suicide, such as panic disorder and phobias, and post-traumatic stress from sexual assault.
….Bipolar disorder in women is a major area of focus
Although women and men are equally prone to having bipolar disorder, women are more likely to suffer from the depressed state versus the manic state, according to the Depression and Bipolar Support Alliance.
…Women tend to suffer from bipolar II, a version of bipolar in which depression and hypomania are the two states, and rapid cycling between the states occur more often than in men, said clinical psychologist Dr. Justin LaPilusa.
Sit said the rapid cycling — patients transitioning from manic highs to depressive lows — can be so distressing that it contributes to increased suicidal thoughts. Depression can be so debilitating, it can often trigger increased suicide risk, Sit said.
“People who are bipolar kill themselves when they are flipping between depression and mania. That’s why rapid cycling is so lethal,” Kessler said.
Dr. Kathleen Cairns, a clinical psychologist, said that men and women experience many of the same symptoms, including insomnia, racing thoughts, hyperactivity and anxiety, but that women may feel more depressed.
It is important to seek help and multiple treatment options
…Extreme cases of bipolar disorder that result in suicide are most often a result of misdiagnosis, not failed treatment, Cairns said. Often, people with bipolar disorder are incorrectly prescribed antidepressants, which Cairns said are completely different than bipolar medication.
…Women may be affected differently due to factors such as pregnancy and menopause and hormonal changes, LaPilusa said.
Sit said monitoring women in the periods directly after giving birth is critical to prevent major depressive episodes postpartum. The period directly after birth is high risk for a depressive episode that could result in hospitalization. And the same vigilance is required for menopausal transition periods. There may be genetic vulnerabilities linked to hormonal transitions as well that increase the risk of depression across a lifespan, Sit said.
But the research evidence on a correlation between hormonal changes and depression has never been strong, Kessler said. “There’s lots of controversy about hormonal changes and gender differences in depression,” he said, but his view is that there is no strong evidence that proves hormones play a role. “True postpartum depression is very rare. … Real biological depression after pregnancy is like 1 in 500 or 1,000. The vast majority of people with postpartum don’t help explain why women have more depression.”
He points to another reason, which he says data does back up.
“Why is it that women have more depression than men? Studies show that when the position of women and men change, when women get the right to vote, for example, measures of income and sex equality, the gender difference in depression goes down.”
Ultimately, mental illness is a people, not gender, issue
“We can’t talk about bipolar pertaining to Kate Spade, because we don’t have data to suggest that,” Sit said. “But we need to encourage people to seek treatment and consider a different diagnosis. … Bipolar is not recognized quickly enough in women,” she said.
…”Do we need some special treatment for women?” Kessler asked. Research shows very little gender difference when it comes to treatment options and the key is getting people into treatment and getting patients to stick with treatment after initial failures.
Read more of that article here
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