Andrea Petersen
The Wall Street Journal
Originally posted 2 APR 22
For years, middle-aged women have had some of the country’s highest rates of antidepressant use. Now, scientists are starting to better understand why—and to develop more targeted treatments for women’s midlife depression.
About one in five women ages 40 to 59 and nearly one in four women ages 60 and over used antidepressants in the last 30 days during 2015 to 2018, according to the latest data from the National Center for Health Statistics.
Among women ages 18 to 39, the figure was about one in 10.
Among men, 8.4% of those ages 40 to 59 and 12.8% of those 60 and older used antidepressants in the last 30 days, according to the NCHS data.
The figures are drawing increasing attention from scientists and doctors. Many are alarmed at how high depression rates were among midlife women even before the pandemic, now that the past two years have exacerbated mental-health issues for many Americans.
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Researchers at NIMH who have been following 90 women since 1988 have found that the incidence of women’s midlife depression is concentrated in the two years before and after the last menstrual period, says Dr. Schmidt.
The quality of women’s midlife depression is distinct, too, Dr. Schmidt says, in that it often involves intense anxiety, irritability and sleep problems along with the more typical sadness and loss of pleasure in once-enjoyed activities.
Doctors speculate that antidepressant use among middle-aged women is being driven in part by the reluctance of women—and many of their physicians—in recent decades to use hormone-replacement therapy for menopausal symptoms. In 2002, a large study, the Women’s Health Initiative, was stopped after women taking hormone therapy had an increased risk of breast cancer, heart attacks and strokes.
Later analyses found that the risks were largely concentrated among women who were older when they started hormone therapy. For women in their 50s, hormone therapy actually reduced the risk of heart disease and death from any cause.
Hormone therapy, either estrogen alone or combined with a progestogen, is the most effective treatment for hot flashes and night sweats, according to the North American Menopause Society and the American College of Obstetricians and Gynecologists.
Some research has found that it can also improve mood.
