1. Recognizing depression : specific issues among the female gender
Hala Kerbage, M.D.
LebMash
Kafa, January 9

2. Outline What is depression? Risk factors for depression
Specific issues in the female gender
When to consult for help
Treatment modalities in depression

3. What is depression? Major depressive episode is a clinical disorder
Different from transient depressed mood
At least one of the following with significant impact for at least 2 weeks, most of the day, nearly every day:
Abnormal depressed mood
Abnormal loss of all interest and pleasure

4. What is depression?
At least 5 of the following symptoms during the 2 weeks:
Appetite or weight disturbance
Sleep disturbance
Agitation or slowing
Fatigue or loss of energy
Abnormal inappropriate guilt
Poor concentration
Thoughts of death or suicide

5. What is depression?
Symptoms not due to another psychiatric disorder (psychosis, bipolar disorder)
Symptoms not due to physical illness, alcohol, medication or drugs
Symptoms not due to normal bereavement

6. Natural course of depression
Slow onset, long duration of prodrome
Episodes last several months
50 % will recur or have an unremitting course
Heavy burden and impact on social, familial and work

7. Risk factors for depression
Frequent disorder (6.6% in Lebanon)
Twice more frequent in females
Peaks at the age of 30, decreases after 40 and peaks again after 55
Two major sources for depressive disorder:
Inheritance
Stress and environmental factors/Loss

8. Specific issues in the female gender
Risk of depression in GBV
Impact on maternal depression on the children
Post-partum: Highly at-risk period
Role of life hygiene in preventing depression
Good response to medications (SSRIs)

9. When to consult for help
If during more than 2 weeks:
You feel sad all the time
You are losing interest in things you used to like
You feel “emotional numbness”
You have suicidal thoughts
You feel fatigue, loss of energy and concentration
You have changes in appetite and sleep pattern
You feel agitated or very slowed
You have excessive guilt or self-devaluation
You feel all this is impacting on your functioning

10. Treatment modalities Pharmacological treatment Psychotherapy
Physical exercise
Intensifying social support and resources