Dutch men like their women bossy while Dutch women are not keen on macho men. Long used to a measure of economic freedom, Dutch women worked before marriage from as early as the 14th century, when the decimations of the plague made female labor a necessity and conferred a habit of independence that some historians have called the first feminist revolution.
Ellen de Bruin, a Dutch psychologist and journalist argues in her book just released in the Netherlands, that women in the Netherlands are a whole lot happier than their counterparts in most parts of the world.
de Bruin’s observations suggest that glamour, hospitality and charm may not be essential ingredients for female happiness. She asserts a long history of financial independence, consensual marriage and lighter family burdens has led to a lower incidence of depression in Dutch women.
What’s it all about?
“It has to do with personal freedom,” said de Bruin, whose work, sure enough, is titled Dutch Women Don’t Get Depressed. “Personal choice is key: in the Netherlands people are free to choose their life partners, their religion, their sexuality, we are free to use soft drugs here, we can pretty much say anything we like. The Netherlands is a very free country.”
Major depression is a mood disorder characterized by one or more major depressive episodes (i.e., at least two weeks of depressed mood or loss of interest or pleasure in nearly all activities) accompanied by at least four additional symptoms (see below: What are the symptoms of depression?). Dysthymia or dysthymic disorder “is characterized by at least two years of depressed mood for more days than not, accompanied by additional depressive symptoms that do not meet criteria for a major depressive episode (American Psychiatric Association, 1994, p. 317).
Depression and Women
Over the course of a lifetime, depression occurs in approximately 20 percent of women compared with 10 percent of men. Although the exact reason for this difference is not known, major depression and dysthymia affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. The same ratio has been reported in ten other countries all over the world. Men and women have about the same rate of bipolar disorder (manic-depression), though its course in women typically has more depressive and fewer manic episodes. Also, a greater number of women have the rapid cycling form of bipolar disorder, which may be more resistant to standard treatments.
A variety of factors unique to women’s lives are suspected to play a role in developing depression. Research is focused on understanding these, including: reproductive, hormonal, genetic or other biological factors; abuse and oppression; interpersonal factors; and certain psychological and personality characteristics. And yet, the specific causes of depression in women remain unclear; many women exposed to these factors do not develop depression. What is clear is that regardless of the contributing factors, depression is a highly treatable illness.
What are the symptoms of depression?
- Depressed mood.
- Reduction of interest or pleasure in activities.
- Loss of interest in sex.
- Feelings of guilt, hopelessness, and worthlessness.
- Recurrent suicidal thoughts.
- Not being able to sleep or sleeping too much (insomnia or hypersomia).
- Changes in appetite including weight loss or weight gain.
- Difficulty concentrating or maintaining attention.
- Lack of energy or constant fatigue.
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
What are the risk factors for depression in women?
- Oral contraceptives–particularly those with high progesterone content.
- History of physical/sexual abuse in childhood.
- Infertility treatments involving the use of gonadotropin stimulants.
- Loss or threat of loss of social support system.
- Death of a parent before the age of 10.
- Family history of mood disorders.
- Personal history of mood disorders, particularly during the early reproductive years.
What are the treatments for depression in women?
The most commonly used treatments for depression are antidepressant medication, psychotherapy, or a combination of the two. Which of these is the right treatment for any one individual depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, one or both of these treatments may be useful, while in severe or incapacitating depression, medication is generally recommended as a first step in the treatment. In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows the opportunity to learn more effective ways of handling problems.