Depression in Special Situations

It's important to learn more about depression in special situations. These situations may include depression in men, depression in women, depression in the elderly, and treatment-resistant depression. In each of these special situations, depression may have different signs and symptoms, causes, and treatments.

What Is Depression?

Depression is a serious and pervasive mood disorder that causes feelings of sadness, hopelessness, helplessness, and worthlessness. Depression can be mild to moderate with symptoms of apathy, little appetite, difficulty sleeping, low self-esteem, and low-grade fatigue. Or it can be major depression, with symptoms of depressed mood most of the day, diminished interest in daily activities, weight loss or gain, insomnia or hypersomnia (sleeping too much), fatigue, feelings of guilt almost daily, and recurring thoughts of death or suicide.

How Common Is Depression in Men?

Although men don't commonly recognize or acknowledge their own symptoms of depression, more than 6 million men in the U.S. suffer from clinical depression each year. Depression was once thought of as a "woman's disease" and linked to hormones and premenstrual syndrome. This stereotypical view still lingers and may be what keeps men with depression from recognizing it and seeking appropriate treatment.

The symptoms of clinical depression in men are similar to the symptoms of depression in women. But men tend to express the symptoms differently. The most common symptoms of depression in men include:

  • apathy
  • changes in appetite
  • fatigue
  • loss of interest in usually pleasurable activities,
  • low self-esteem
  • sexual problems, including reduced sex drive
  • sleep disturbances
  • suicidal thoughts

Women tend to be sad and emotional when they have depression. Men who are depressed, on the other hand, may be irritable, aggressive, and sometimes hostile.

For in-depth information, see WebMD's Depression in Men.

Is Clinical Depression Common in Women?

Yes. Depression in women is very common. Between 10% and 25% of women will experience an episode of major or clinical depression at some point in their life. In fact, women are twice as likely to develop depression as men.

Depression in women differs from depression in men in several ways:

  • Depression in women may occur earlier, last longer, and be more likely to recur than depression in men.
  • In women, depression is more likely to be associated with stressful life events and be more sensitive to seasonal changes.
  • Women are more likely to experience guilty feelings and attempt suicide, although they actually kill themselves less often than men.
  • Depression in women is more likely to be associated with anxiety disorders -- especially panic and phobic symptoms -- and eating disorders.
  • Depressed women are less likely to abuse alcohol and other drugs.

For in-depth information, see WebMD's Depression in Women.


How Does Depression Affect the Elderly?

Depression in the elderly is very common, but it is not a normal part of aging. Late-life depression affects about 6 million Americans age 65 and older. Unfortunately, only 10% receive treatment for depression. One likely reason is that symptoms of depression in the elderly are often confused with the effects of multiple illnesses and the effects of medicines used to treat them.

Depression in later life frequently coexists with other medical illnesses and disabilities. In addition, advancing age is often accompanied by loss of key social support systems due to the death of a spouse or siblings, retirement, or moving. Because of their change in circumstances and the fact that older people are expected to slow down, doctors and family may miss the diagnosis of depression in the elderly. That, in turn, delays effective treatment. As a result, many seniors find themselves having to cope with symptoms that could be easily treated.

For in-depth information, see WebMD's Depression in the Elderly.

What Is Treatment-Resistant Depression?

Treatment-resistant depression refers to depression symptoms that aren't responding to medications and/or psychotherapy. The latest findings report that 30% of depressed patients in primary care have no response at all to antidepressant medication. While 40% do respond to the first antidepressant medication they take, about 20% of these patients stop the medication because of side effects.

Men and women who have treatment-resistant depression may have tried a variety of drugs --including different types of antidepressants -- along with different types of psychotherapy and even other approaches. Yet no treatment seems to work to ease their depression.

If you have treatment-resistant depression -- also called refractory depression -- you might feel hopeless and frustrated. But don't give up. There are additional options for treatment, and the one you need is likely to be among them. If you and your doctor work together, you should be able to find it.

For in-depth information, see WebMD's Treatment-Resistant Depression.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on September 23, 2016



American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

National Institute of Health: "Teens with Treatment-resistant Depression More Likely to Get Better with Switch to Combination Therapy."

Food and Drug Administration: "The Lowdown on Depression."

Mental Health America: "Factsheet: Dealing with Treatment-resistant Depression: What to Do When Treatment Doesn't Seem to Work."

Families for Depression Awareness: "When Depression Won't Go Away."

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