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One would think with all the advances in modern technology and the sciences that life would be easier and we would be healthier and happier.

Still on the Rise
However, epidemics of stress, anxiety and depression are still on the rise around the world, especially among young women. With every generation onset is becoming younger and risk factors higher.

These are complex disorders impacting every aspect of a woman’s being and usually loved ones and friends around her as well. They are often linked to other comorbid health problems also of major concern, such as substance abuse, eating disorders, obesity and heart disease.

Women are three times as likely as men to be impacted by major depression and dysthymia, starting in adolescence and peaking between the ages of 25 and 45, during the childbearing years.
Possible explanations include a combination of gender-related differences such as brain structure and function, genetic factors, sex hormones (estrogen and progesterone), adverse life stress and trauma, ongoing internal and external stressors, cognitive, emotional and interpersonal relationship styles and conflict, psychosocial and economic stresses.

Symptoms
Besides the typical symptoms of concentration difficulties, making decisions, increased irritability and loss of temper, aches and pains, social withdrawal and loss of interest in pleasurable activities, women also tend to experience more false guilt, anxiety, increased appetite and sleep, decreased energy and fatigue, weight gain and eating disorders than do men. So be alert to possible depression when you observe these indications.

Treatment

Most disconcerting is that many women are suffering needlessly due to misdiagnosis about 30-50% of the time, as most women will first see a general practitioner, not a competent counselor. These misdiagnoses increase the chances of severity and recurring depressions. The sooner depression is diagnosed and treated, especially in young women, the less severe it becomes, and the less chance of recurring episodes later on in life. As a Christian counselor, you are crucial in providing an accurate diagnosis, and an effective treatment plan.

Getting Better and Staying Well
Good therapy is important and antidepressant medication may be essential. However, women want and need more than a pill a day and 45–50 minutes of counseling a week to shape their lives, prevent recurrence and relapse. Women need to know how they can effectively live victorious, meaningful lives each day —how they can build resilience to stress, overcome depression, increase positive emotion, grow in their strengths, discover fulfillment and prevent symptoms from spiraling down with recurring relapse. They are looking for practical, effective strategies to apply to their lives and relationships outside the therapy room or doctor’s office.

As depression in women is complex and impacts every aspect of life, I am discovering that therapeutic effectiveness increases when counselors consider other factors in life—physical and nutritional health, stress levels, rest and recovery, positive emotion and building strengths, as well as finding spiritual happiness and meaning.

The fields of medicine and mental health have recently begun taking an integrative, comprehensive, whole-person approach to preventing and treating maladies such as depression. I find it exciting that as Christian counselors, we can integrate many of these strategies, as they are inherent to Judeo-Christian faith, values and lifestyle.

Strategies for Living Well
Incorporate into your counseling goals a process to help women develop their own ‘wellness-building action plan.’ Here are a few brief essentials with which to begin.

Deal with Underlying Causes
Although the first goal of treating depression is to ‘elevate the mood,’ that is not where it should end. Resolve the complex factors causing depression. A stressful event may have been the trigger, but there may also be underlying connections to previous loss, cognitive and emotional defense styles that create more stress and perpetuate symptoms or hinder resolve.

Aim to partner in equipping women to resolve emotional attachment injuries, pain from abuse, sexual violation, marital conflict, lack of social support or other relationship loss, deep roots of anger, bitterness and unforgiveness. Women also need practical strategies to deal with comorbid maladaptive patterns of dealing with emotional pain, such as substance abuse and eating disorders.

Teach the practice of skills for managing stress
There is a strong link between stress, anxiety and consequential depression, so very often treatment will include addressing all of the above. In a recent video series produced by AACC titled, Conquering Stress and Anxiety, many experts share what they have discovered personally and professionally to be effective in lowering the stress response system, building resilience to stress, and recovering from stress damage. A panel of women share the importance of stress-busting factors such as: sleep, rest and recuperation, practicing relaxation techniques like deep breathing, having quiet and restorative retreat times, laughter, prioritizing what matters most, a healthy lifestyle, and drawing from the encouragement and support of meaningful connections and friendships.

Practically apply God’s wisdom
Balance fixing pathology, correcting weaknesses and healing hurts with building Biblical virtues, amplifying character strengths and experiencing God’s hope, peace and joy. For example, the Word of God tells us that stress and anxiety in the heart (mind, emotions) of a woman can lead to depression, but a hopeful, optimistic word can make it glad (paraphrased from Proverbs 12:25). Encourage women not to be anxious, but take everything to God in prayer, and be thankful. This is the key to having God’s peace in our hearts and minds (paraphrased from Philippians 4:6-9).

Dr. Martin Seligman has developed an Internet website and Reflective Happiness Program that have proven to dramatically decrease depression and increase happiness through a series of simple, formulated exercises and activities that take only a few minutes each day. Many of these exercises can be integrated as ways to practically apply these biblical principles. Here are a few examples: consider three blessings before going to bed at night; show gratitude to someone; discover and function in your strengths; do positive service; build hope and optimism; dispute distorted negative thinking; and give gifts that provide more meaning in the life of others.

Intentional self-care lifestyle
Move to improve mood. Recent studies conducted at Duke University found that exercising one-hour, three times a week can be as effective as 75- 100 mg of Zoloft. Walking out in the sunlight also adds the benefit of Vitamin D and natural serotonin boosters.

Food does affect mood. Eating well-balanced mini-meals of lean proteins, complex carbohydrates and low glycemic fruits and vegetables help balance mood and blood sugar. Vitamin supplements such as B vitamins and Omega 3’s can provide essential nutrients where there may be deficiencies. Harmful substances such as caffeine, ‘white trash’ (sugar, bleached flour) and highly processed food should be avoided.

And finally…Some other effective lifestyle strategies to encourage women include:

* Adequate sleep and rest

* Emotional awareness and expression

* Externalizing feelings through writing and journaling

* Learning effective ways of dealing with difficult emotions and conflict

* Counteracting negative self-talk with accurate-reality-talk

* Building meaningful connections

* Being aware of early signs of recurring depression and having a strategy for intervention and prevention

Catherine Hart Weber, Ph.D., is a licensed marriage and family counselor, teacher, lecturer and author. She has written numerous book chapters, journal and magazine articles, and is the co-author of two books.

Resources:
Hart, Hart Weber. Unveiling Depression In Women. Revell, 2002.
Hart Weber, Hart. Stressed or Depressed. Nashville. Integrity, 2005.
Living on Purpose, Psychotherapy Networker, September/October 2003.
www.reflectivehappiness.com (Dr. Martin Seligman’s website for building happiness)