Written by two psychiatrists, “Feminine Depression”, which will be released in September, describes a disorder which affects women more than men in today's world. Why is this and how can pointing out this difference change the approach and care of patients? We asked our questions to Dr Lucie Joly, co-author of the work.
In your book, you describe depression in the feminine sense. So there is a difference depending on gender?
Dr Lucie Joly. Indeed, and this is the whole subject of our book with Hugo Bottemanne (psychiatrist at Bicêtre hospital and co-author of the book). Today, the figures speak for themselves: women are twice as likely to suffer from depression as men. In percentage terms, we know that 8 to 16% of women aged 18 to 50 will experience depression in their life and that this figure rises to 20% for pregnant women and in the postpartum period, and 30% among women in socially precarious situations. But this does not always manifest itself in the same way as we expect.
What are the symptoms specific to women?
In women, the symptoms will be what we call “atypical”: increased sleep (rather than insomnia), increased appetite (rather than anorexia), agitation rather than slowing down. psychomotor seen in so-called classic depressions.
There is also a rhythmicity of these symptoms in women, monthly for example, or even winter, sensitivity to temperature changes also being more common in women. There are therefore specificities that need to be highlighted, because for a very long time, research and tests were only based… on humans! It is now becoming essential that women become priority in research on depression and the prospect of treatments. We can no longer rely on non-“personalized” subjects.
Is depression in women biological, cultural, or both?
In research, the role of reproductive cycles including menstruation, pregnancy, menopause is suspected of having a role in mental health. Premenstrual syndrome, for example, characterized by negative emotions and unpleasant sensations, affects 30 to 50% of women, and can lead to suicidal thoughts, which persist, then disappear within two days following the arrival of the symptoms. rules. It is a fact.
But we can't explain everything by biology and hormones. There is a cultural and social aspect that must be taken into account in women's lives: working conditions, marital organization, professional harassment, without forgetting domestic violence. All of these elements play a role in the prevalence of depression.
Can addressing depression from a feminine perspective provide better care?
Medicine with a personalized approach is quite new. But she has made great progress, for example in cardiology, by taking into account risk factors and female symptoms in myocardial infarction. It's the same for depression: since it does not translate in the same way, we need medicine that is no longer unisex, but personalized. And it works. For postpartum depression, for example, this personalized medicine has made it possible to design the treatment which has just been released in the United States which acts on specific receptors. We also think in terms of molecules or more suitable doses. But to do this, we must encourage clinical trials on women. It was previously wrongly thought that hormonal variations would bias the results. It's quite the opposite, by taking into account these feminine variations, we can ensure that women are better taken care of today.
