I have read with interest and empathy your description of "weariness" and other comments that resonate with an all too-familiar ring. I have experienced depression/weariness/SAD in the past, and I also treat lots of women in my family practice panel who struggle with it as well. I don't treat as many men with depression, either because they don't recognize it, or don't want to come to a woman, or don't want to treat it (or are better at treating it themselves, either with healthy things, or unhealthy solutions). Here are my thoughts about the physiological aspects and spiritual aspects of this complex constellation of symptoms called depression for women.
I think estrogen and progesterone (especially progesterone, which is the silent bad girl that lets estrogen take all the bad publicity) are responsible for a lot of what women experience during the peri-menopausal years (which can be around 10 years). I think when our ovaries stop sending the message that we are "fertile Myrtles" by slowing production, or skipping ovulation cycles, or degrading the FSH and LH levels, etc, we start feeling it. We were biologically meant to be baby factories: I mean, really: ovulating every single month---to have the chance of conception EVERY SINGLE MONTH?!?!?!? No other species does that. Other species "come into heat" at much more reasonable time periods....but we humans, oh no....we can do this anytime!
So. When we start slowing down the production factory, our bodies feel it. You can't tell me that our emotions don't pick up on that, as well. We KNOW when we ovulate. We feel rotten during the week before our periods. And some women go psychotic during that week and the week of the period because of those incredibly drastic changes in estrogen and progesterone levels. Men's testosterone levels are pretty steady all the time. AND, they continue to produce it as long as they have testicles. They don't have the mood swings and weight gain and collagen breakdown and bone loss that women do during peri-menopause and post menopause, because they still have that production factory going strong. They are also deemed more handsome and virile as they grey and age, whereas women are deemed dry and old and used up after they are no longer "useful" (strictly biologically speaking).
If a male patient of mine has to have an orchiectomy (testicle removal for cancer or other problem) I have to spend A LOT of time with them during their difficult transition of becoming suddenly emasculated. They become emotional, gain weight and lose bone mass. They feel disillusioned about their role as men, and become depressed. Sound familiar?? It is truly amazing to watch the transition and the awareness of the loss of testosterone, and see how their understanding of women during peri- and post menopause suddenly becomes manifest. I am not suggesting that men can't understand how women feel during this transition unless they have orchiectomies, but it is something that is so unfamiliar to them, they CAN'T understand it....like fish in water....they always have it, so they can't understand what it is like not to have it around. Now, you may think I am biased because I am a woman, and as such, I also can't speak about how men feel. Here is where I speak from: I grew up with a father who absolutely embodied the worst in masochism. He was a urologist. I have seven brothers, no sisters. Tell me I don't know testosterone.
I think women (more than men) have the potential to become sadder as we have been forced away (or have chosen to move more away) from what our biology dictates we do: have babies and stay at home and nurture them and tend the hearth. Men are responsible to provide for their family. They are supposed to go away to work and get paid and receive "pay" in various ways for their success in accomplishing that (promotions, congratulations, prestige, etc.). "Mothers are primarily responsible for the nurture of the children." (The Family: A Proclamation to the World). I think we want to do more and be more, and have had to do more and be more than what our primary roles dictate. I have three children and a career in health care. I understand the challenges of being a mother and taking care of children. I also have the extra challenge of a severely multiply handicapped child in the mix. I don't condemn women for having careers at all: I just think we need to realize what we do when we decide to, or are forced to leave our basic role and take on the responsibilities of providing as well as nurturing. And I think when we try to do too much, (perhaps because we feel we have to because we have held ourselves up in comparison to others) we get overwhelmed and easily depressed as a result.
My husband (who is also a family doctor) and I talk a lot about these challenges that face women and men and menopause and mid-life crises and etc. He offered this observation and insight: Biologically, the male species are meant to continue producing seed with the most fertile, healthy and promising females (and as many of them as possible). So, perhaps this challenge of biology (meaning men remain fertile and virile and women wane in both areas) was given to men to test their resolve to commit to remain with and stay loyal to their spouses. Meaning in spite of these biological and emotional changes that come with time in women, men are given the opportunity and tremendous challenge to continue to remain faithful (and the world doesn't make it easy for them). That is huge! I applaud men and women who are able to overcome biology and remain faithful to each other. I love it when couples come in and they obviously really care for each other.
I love every one's suggestions about what to DO when we feel down, and I will offer what I offer others who come in to the office and need help.
First I would suggest you get some lab work done to make sure you aren't deficient in some way (especially thyroid). So go to your PCP and talk and ask for labs first. If they are normal, then come back and talk about treatment (whether counseling alone or with medication as well).
Second: It's not a character flaw. You shouldn't beat yourself up for feeling this way. Your body is responding to stress by decreasing the availability of serotonin and dopamine and norepinephrine. So, if you need medication to help keep the "sex, drugs and rock and roll" endorphins around, it is okay.
Third: Remember, if you start on medication to help with depressive symptoms, the medication is only responsible for keeping it around. It doesn't MAKE serotonin or dopamine or norepinephrine, so you have to work hard to continue producing it....this is where the exercise (getting out in nature, doing things that normally please you and relax you and replenish you) comes in. Also, make sure you get enough protein in every day (proteins make proteins).
I also spend a lot of time talking to folks about the Five Love Languages (physical, time, service, gifts, language). I read it about 20 years ago, and it really made a huge difference in the way I expect and express love to my family. Read it. www.fivelovelanguages.com
If you aren't getting the message that your spouse loves you, pay attention to the ways he/she is trying to express his/her love to you. It may be in a totally different language that you don't recognize. That may be contributing to the lower levels of serotonin and dopamine and norepinephrine that are available.
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