When women hurt in mind and body: Managing depression and physical symptoms

It is estimated that depression will become the second most disabling condition worldwide by the year 2020. Overcoming some of the challenges of global epidemiology, studies worldwide have shown that women are affected by depression at twice the rate of men, with earlier age of onset and higher rates of hospitalization. Depression in young women can cause failure during critical life transitions, such as occupational advancement and child rearing, which has a cascading effect on the severity and chronic course of depression. This is compounded by the fact that speed of initial treatment contact is inversely related to age. Depression in both men and women is a treatable condition that may be ameliorated if detected and addressed at early onset. Physicians must be aware that while emotional symptoms are usually the focus of the diagnosis and treatment of depression, many depressed patients present only with physical symptoms. New evidence suggests a common neurochemical pathway for the physical symptoms in depression, which implicates both serotonin and norepinephrine dysregulation. Dual reuptake inhibitors may have advantages over selective serotonin reuptake inhibitors and tricyclic antidepressants in achieving a more robust response and complete remission of depression