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Aging, Systemic Disease and Oral Health: Implications for Women Worldwide (Part II)

Course Number: 330

The Condition

Depression affects men and women of all ages; it can be disabling, interfere in daily activities, limit normal functioning, and potentially lead to suicide. Worldwide, it has been estimated 340 to 360 million people suffer from major depressive disorders with 18 million represented in the United States.84 According to the National Institute of Mental Health (NIMH), 12 million US women yearly are affected by depressive disorders.84 It has been estimated one in 33 children and one in eight adolescents have been diagnosed with depressive disorders and most likely numerous cases go undetected.84 Studies have demonstrated depression occurring twice as frequently in women than in men, and 25% of all women sometime during their life will suffer from a major depressive disorder.85

No single cause of depression has been identified; however, studies indicate combinations of factors are likely to exist. Since women are being diagnosed more than men, research is currently exploring factors associated with their increased risk for depression. Social, genetic, hormonal, biological and chemical factors unique to women are being examined as potential links to depression.84

Depressive illnesses have been characterized as brain disorders; magnetic resonance imaging (MRI) has demonstrated brain matter in those with depression appear differently than in those where no depression has occurred.84 Neurotransmitters, chemicals used for brain cell communication appear unbalanced as well as mood and appetite regulators seem to improperly function in the brains with depressive illnesses.84

Depressive episodes can last several months or up to one year depending on the individual’s family support system and access to treatment. Depression has been shown to influence subsequent episodes. Recurrent episodes can vary among women and years may lapse between occurrences; however, as women age the frequency of episodes tends to increase.86 Studies have indicated at least 60% of those suffering their first depressive episode will typically encounter a second and those experiencing two episodes will have a 70% chance to suffer a third.86 Five to ten percent of those with a single depressive episode will develop manic disorders, changing their initial diagnosis to a bipolar disorder.86

In some individuals, depressive disorders can start as young as 15 years of age. This early onset has been associated with family histories of mood disorders. An early onset in women has been associated with low self-esteem and poor school grades.84 Such patterns of depression are being classified as progressive and lifelong challenges.86

Data extrapolated from remission studies one-year post diagnosis reported only 40% of individuals achieve partial remission, 30% achieve full remission, and 30% were resistant to treatment. Unfortunately, evidence is showing more women than men not seeking treatment for their depression, even though in severe depressive conditions, women have shown some improvement from treatment measures.84