Understanding and Supporting Depression in Women: Signs, Symptoms, and Treatments

Depression in women is often overlooked, minimized, or trivialized by society — despite its significant impacts on women’s daily life. If you’re a woman, understanding the unique face of depression in the female population requires examination through a biological, psychological, cultural, and environmental lens to recognize specific factors that shape your experiences with depression. This can range from acknowledging how women are perceived in society to their increased genetic predisposition. 

According to a National Survey on Drug Use and Health (NSDUH), 10.3% of adult females in the U.S. had a major depressive episode in 2021 ¹. This alarming statistic highlights the prevalence of women struggling with mental health, and underscores the need for female-focused treatment.

Here’s what depression in women looks like, factors that contribute to higher rates of depression in women than in men, and how you can find treatment.

Depression in Women vs. Men: Societal Pressures and Biological Influences

Research from the National Center for Health Statistics (NCHS) shows that women are nearly twice as likely to be diagnosed with depression compared to the male population ². One reason for this trend could be that during puberty, young women experience hormonal changes that may influence stress responses, potentially making them more vulnerable to social factors that can contribute to depression than their male counterparts ³. Additionally, societal norms often accept expressions of sadness in girls during puberty, whereas boys’ emotional expressions tend to be channeled toward anger and frustration. Despite the higher prevalence, women are typically more likely than men to seek diagnosis and treatment for depression.

Additionally, women generally tend to experience depressive symptoms through internalized expressions — rumination, self-criticism, inward sadness — but men with depression typically show symptoms through externalized behaviors. Societal expectations, demand to conform to feminine ideals, biological changes from childbirth, hormonal fluctuations, and disproportionate caretaking responsibilities and parenthood pressures can further complicate diagnosis and treatment. 

Causes of Depression in Women

There are a myriad of factors that can increase a person’s risk for depression. However, the unique biology of women’s bodies and the distinct pressures women may face in the household and society at large add another layer to these influences.

Hormonal fluctuations and pre-existing medical conditions

Hormonal fluctuations emerging from pregnancy, menstruation, and menopause can all contribute to women developing depression. These hormonal changes are not only abrupt, but they send your entire body’s system into a frenzy. Trying to adjust to these hormonal changes that can emerge throughout different periods of your life can be difficult, especially on top of managing debilitating symptoms like fatigue, abdominal pain, and mood swings.

Additionally, women are more genetically predisposed to developing clinical hormonal disorders. Chronic hormone-related medical conditions like thyroid disease and polycystic ovary syndrome (PCOS) affect women at significant rates and can fuel depressive symptoms. PCOS specifically is a disorder that causes irregular periods, excess facial hair growth, hair loss on the head, and weight gain — symptoms that can negatively affect women’s self-image and create fertile ground for depression. 

Some women may struggle to differentiate between symptoms of depression and biological changes that affect mental health. These include entering perimenopause, struggling with undiagnosed PCOS, being vitamin D deficient, or having thyroid or pituitary gland dysfunction.

Societal expectation of beauty standards and feminine ideals

When women are constantly being bombarded by digitally altered images and idealized portrayals of female beauty standards, it can increase feelings of poor self-image, inadequacy,  and depression. This concerning trend is further amplified in women that have a difficult time recognizing these standards as arbitrary external constructs rather than a measurement of worth. This is evident by studies that show women who internalize societal beauty standards are 2 to 3 times more likely to develop depression than those who maintain a more critical perspective ⁴.  

Intersectional challenges

Depression can also be amplified by racial, sexual orientation, and socioeconomic barriers. If you’re a woman who’s part of a marginalized community, navigating depression can be particularly overwhelming as you face the reality of inequitable access to mental health treatment and support. Additionally, cultural stigma around mental health in different communities can make seeking mental health care a taboo topic, and medical providers may dismiss emotional symptoms as moodiness. 

The multiple role burden

Women tend to bear the heavy mental load of constantly fulfilling various responsibilities, from emotional labor to the pressure to “do it all” — a reality for single and married women alike. Despite evolving social norms, internalized societal pressures to cook, clean, and tend to the family, while somehow finding time for self-care create often unrealistic expectations.

The disproportionate burden of emotional labor 

Women also are expected to carry a disproportionate amount of emotional labor. You may have felt the overwhelming pressure to hold space for others’ emotions, actively talk through emotionally turbulent moments, and guide loved ones during times of psychological distress. This would be a heavy burden for anyone to carry, and since caregiving roles are almost always placed on women, it can significantly contribute to depression. 

The pressure to “do it all”

In general, perfectionist ideals tend to be significantly ingrained in women. Women who choose to pursue a career while maintaining caregiving responsibilities may feel the pressure to do it all, which is an unsustainable expectation. Failure to meet these demands or achieve perfectionism can lead to feelings of disappointment, inadequacy, and low self-worth, further fueling depressive symptoms. 

Common factors for depression across genders

While these factors are specific to women and the various influences they experience that may trigger depression, there are also gender-neutral risk factors, including: 

• Genetic predisposition to mood disorders, or a family history of mental health conditions. 
• Difference in brain chemicals, such as dopamine, serotonin, and norepinephrine. 
• Environmental factors, life stressors, or trauma — including childhood trauma.
• Pre-existing medical conditions, chronic illnesses, or chronic inflammation. 
• Perfectionist tendencies, deep-seated beliefs, or regularly engaging in negative thought patterns. 

It’s important to remember that there is rarely one cause of mental illness. Rather, a combination of causes can compound their negative effects and trigger depression. 

Common Types of Depression in Women

There are many types of depression that people can be diagnosed with. However, there are a few that stand out as it relates to mental health conditions experienced by women, including: 

• Premenstrual Dysphoric Disorder (PMDD) is more severe than premenstrual syndrome (PMS) and can cause depressive symptoms, affecting 5% to 8% of menstruating women ⁵.
• Perinatal depression, a term that encompasses prenatal and postpartum depression.
• Perimenopausal, menopausal, and postmenopausal depression, conditions that are both related to menopause but encompass different timelines. 

There are also types of depression that affect both genders but at disproportionately higher rates in women, such as major depressive disorder (MDD), persistent depressive disorder or high functioning depression, atypical depression, and seasonal affective disorder (SAD).

Related: Perinatal Mood and Anxiety Disorders (PMADs)

Signs and Symptoms of Depression in Women

Symptoms of depression in women can manifest with various levels of severity, including: 

• Persistent feelings of sadness, loneliness, guilt, anxiety, worthlessness, self-blame, and tendencies to ruminate or engage in suicidal ideation.
• Physical symptoms such as appetite changes, unintended and dramatic weight fluctuations, eating disorder development, or gastrointestinal issues.
• Decision fatigue, difficulty concentrating, and disinterest or withdrawal from activities that once brought joy.
• Hypersomnia or sleep disturbances.
• Self-image issues or appearance-related concerns.
• Frequent complaints about physical aches or chronic pain, sadness, or relationship issues, or frequent bouts of crying that seems disproportionate to the trigger.  
• Mood fluctuations corresponding to seasons, or changes in menstrual cycle or libido — women are more likely to experience SAD ⁶.

Actionable Steps, Self-Care Tips, and Support: Depression Treatment for Women

Untreated symptoms of depression in women can worsen overtime, potentially leading to increased risks of self-harm, self-destructive behaviors, substance abuse, relationship turmoil, and decreased quality of life, so early intervention is critical to ensure your safety. 

Here are some options for treatment for women with depression and how to find support. 

How therapy can help women with depression

Depression therapy is very effective for people struggling with depression, regardless of their gender. However, therapeutic modalities can approach treatment from a female-focused angle for enhanced efficacy. For example: 

• Cognitive behavioral therapy (CBT) can restructure ruminating thought patterns, reframe negative self-talk relating to body image and beauty standards, and process traumatic experiences — such as physical or sexual abuse.  
• Dialectical behavior therapy (DBT) can teach emotional regulation skills for managing hormonal fluctuations and mindfulness practices that combat rumination. 
• Acceptance and commitment therapy (ACT) can help you view media’s portrayal of feminine ideals and beauty standards through a more critical lens rather than absolute truths, and support you in recognizing emotions without avoiding them. 
• Interpersonal therapy is a type of talk therapy that can be particularly effective if you’re in a caregiving role, and can help you delegate responsibilities and identify relationship dynamics that don’t serve you.
• Eye movement desensitization reprocessing (EMDR) can help process traumatic experiences that disproportionately affect women — such as sexual assault, intimate partner violence, or birth trauma — by allowing you to safely reprocess these memories and reduce their emotional impact without requiring detailed verbal descriptions.

Remember, therapy is not a “cure all” solution to depression, and comprehensive treatment plans will incorporate several care approaches for the best results.

Medication and considerations for women with depression

Antidepressants for women come with a few considerations. For one, women typically respond better to Selective Serotonin Reuptake Inhibitors (SSRIs) than men. However, women historically report higher rates of antidepressant side effects, and you’ll generally need a lower medication dosage compared to men due to female body’s having a higher fat percentage and faster liver metabolism. 

Related: Brain Zaps as a Side Effect of SSRIs

TMS for women with depression 

If you decide that antidepressants aren’t for you — whether that’s due to pregnancy concerns or your increased risk of antidepressant side effects — transcranial magnetic stimulation (TMS) therapy presents itself as a non-invasive and safe alternative. If you’re wondering how TMS therapy works, this treatment delivers gentle magnetic pulses to your brain, stimulating areas that are underactive in women with depression, and doesn’t come with potential hormone-related side effects. Additionally, research shows that approximately 80% of women with major depression saw notable improvements in symptoms after completing the TMS therapy program ⁸.

Self-care, mind-body approaches, and resilience building 

Mental health is also related to the body and how well you’re taking care of it. Make sure you get ample sleep, especially since on average, women require more sleep than men due to hormonal factors that contribute to sleep disruptions ⁷. 

Exploring holistic and healthy stress management techniques like mindfulness, breathing exercises, and gentle movement can also benefit depression treatment, particularly if you frequently ruminate. Diet and exercise also plays a role, as having proper nutrition and physical activity can aid with mood stability and emotional regulation.

How to reclaim balance and boundaries

Learning how to set boundaries that prioritize your needs is critical when managing depression symptoms. The more you say no to requests that will overextend yourself, the less stress you’ll experience. Over time, your daily obligations may feel more manageable as you delegate responsibilities and manage perfectionist tendencies, which can reduce the weight of your mental load and benefit you long term. 

Finding support for women with depression

There are several national organizations with female-only support groups or that solely focus on treatment for women with mental disorders, including: 

• National Alliance on Mental Illness (NAMI).
• Depression and Bipolar Support Alliance (DBSA).
• Women for Sobriety. 
• Postpartum Support International (PSI). 
• The Lullaby Project. 
• JoinMidi.com.

Each organization has its own strengths and weaknesses, and additional support can be found through your local hospital or mental health clinic.

Recognizing when to seek professional care

It’s completely normal to feel sad sometimes, but persistent sadness may indicate a more serious mental health condition. When your psychological distress doesn’t seem to improve, or it leads to feelings of emptiness, guilt, or anger, it may be time to seek treatment from a mental health professional. Depression can manifest differently in everyone, but noticing when you’re withdrawing, less talkative or communicative, overly negative, stressed, or lonely may give you clarity on when it’s time to seek help. Additionally, physical symptoms like changes in weight, appetite, and sleep patterns may indicate a need for professional treatment.

How Neuro Wellness Spa Can Treat Depression in Women

At Neuro Wellness Spa, our compassionate care team will thoroughly assess you and your mental health needs before starting therapeutic services. They will take into consideration hormonal, biological, and social factors to identify the best approach for your treatment plan. We proudly create a stigma-free environment that supports women’s health.

Our therapists and psychiatrists provide care through CBT, DBT, in-person and online psychotherapy, and TMS therapy. If you require more intensive treatment, our psychiatric medication management service can find the optimal dose and the best antidepressant for you. And for teenage girls navigating depression early in life, our adolescent psychiatry sessions can help by tailoring treatment to young women’s needs and interests.

Contact Neuro Wellness Spa today to start your journey of setting boundaries, reframing negative media narratives regarding female roles and ideals, and finding lasting mental wellness.

References

1. 2021 National Survey on Drug Use and Health (NSDUH) releases. (n.d.). CBHSQ Data. https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2021

2. Products – Data Briefs – Number 303 – February 2018. (n.d.). https://www.cdc.gov/nchs/products/databriefs/db303.htm

3. Gong, F., Jia, Y., Sun, X., Min, H., Jia, X., Wang, F., Huang, X., Lin, X., Li, Z., & Wu, Y. (2023). The influence of media use degree on public depressive symptoms: mediating role of big five personality. BMC Psychiatry, 23(1). https://doi.org/10.1186/s12888-023-05097-w

4. Merino, M., Tornero-Aguilera, J. F., Rubio-Zarapuz, A., Villanueva-Tobaldo, C. V., Martín-Rodríguez, A., & Clemente-Suárez, V. J. (2024). Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors. Healthcare, 12(14), 1396. https://doi.org/10.3390/healthcare12141396

5. Mishra, S., Elliott, H., & Marwaha, R. (2023, February 19). Premenstrual dysphoric disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK532307/

6. Seasonal affective disorder. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/publications/seasonal-affective-disorder

7. Clinic, C. (2025, February 7). Why women need to sleep more than men. Cleveland Clinic. https://health.clevelandclinic.org/why-women-need-more-sleep