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7 - Depression and anxiety

from Part I - Health promotion

Published online by Cambridge University Press:  21 August 2009

By
Anne Walling
Edited by
Jo Ann Rosenfeld
Anne Walling
Affiliation:
University of Kansas, Wichita
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
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Summary

Case: “I am turning into a big fat lump that just lies around eating, sleeping and feeling sorry for myself all the time!” This sudden outburst during a visit for a “routine pap smear” is completely out of character for Marie, a 44-year-old divorced schoolteacher who is usually smartly groomed, articulate, and vivacious. Tactful questioning reveals about a four-week history of excessive sleeping and feelings of fatigue, low stamina, and worthlessness. She has been snacking excessively and has gained about six pounds. Marie admits to severe “blues” during her freshman college year and after the births of her children, but she “toughed it out.” This time, she does not have the energy or will to continue her daily activities and she has called in sick for the first time ever as she “just could not face doing a mediocre job for the class.”

Introduction and epidemiology

Up to 30% of women seen in primary care clinics suffer from a depressive illness, compared with an estimated 19% of male patients. In the general population, approximately one-quarter of all women but only 10% of men suffer from depression at any time during the lifespan. This gender difference begins in adolescence and continues until the sixth decade. As individuals, women generally carry a greater burden of illness in depression than men. Depression is more likely to begin at an earlier age in women and to follow a pattern with more severe, chronic, and recurrent illness with greater functional impairment and more comorbid conditions than in male patients.

Keywords

antidepressantsbenzodiazepinesbuspironecomorbid depressionselective serotonin-reuptake inhibitorspersonality disordersobsessive-compulsive disordergeneralized anxiety disordersocial anxiety
Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
 , pp. 97 - 122
Publisher: Cambridge University Press
Print publication year: 2004

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