Depression. All about the disease, treatment, symptoms.

Causes and Features of Depression During Pregnancy

Pregnancy is the most beautiful time, but sometimes it is marred by problems of a mental nature. The most common of these is depressive disorder. They suffer about 10% of pregnant women.

Turning to this topic, we consider it necessary to pay attention to the fact that depression during pregnancy is not just mood swings caused by hormonal changes, it is a serious disease. Despondency literally absorbs the whole personality of the future mummy. Nothing pleases her, even the soon appearance of a child causes only fear and anxiety. A pregnant woman becomes a hostage to her inner experiences.

The most unpleasant thing in this situation is that depression of pregnant women can subsequently influence the mental well-being of the future baby. That’s why you should not ignore this problem in any case.

Depression in pregnant women can lead to irreparable health problems. Do not forget that in front of birth. An exhausted nervous system can not withstand such stress. To avoid undesirable consequences and enjoy the joy of motherhood, it is necessary, at the first signs of depression, to contact either a gynecologist or a psychotherapist.

What symptoms should I pay attention to?

Depression of pregnant women can be manifested in different ways. Some women constantly cry, some – can not fall asleep, some – fear the future, leading their fears themselves to suicide attempts. However, there are a number of signs, the presence of which can be judged on the presence of depression. Among them:

• Increased irritability;
• Anxiety;
• Inability to focus attention;
• Feeling hungry or lack of appetite;
• Constant feeling of fatigue;
• Disheartened;
• Fear of going out;
• Suspicion;
• Not passing drowsiness;
• Low self-esteem;
• Feeling of despair and bleakness;
• Feeling of guilt;
• Lack of desire to communicate with anyone;
• Diffidence;
• Tearfulness;
• Sleep disturbances (inability to sleep, nightmares).

What are the causes of depressive disorder in pregnant women?

For a long time it was believed that during the development of hormones that inhibit the development of depression. This conclusion was made by doctors as a result of observations of future mothers. Most of them experienced an emotional upsurge. However, over time, many specialists began to note that stress and physical stress accompanying pregnancy make women more susceptible to depression.

Aggravate the situation additional worldly difficulties. So, one of the most common causes of depression are problematic relationships with the future father of the child. In single women and women living in a state of conflict with their partner, the likelihood of developing depression increases significantly. They do not know what to do in the current, very difficult situation.

In addition, depression during pregnancy can be triggered by a number of the following factors:

Daily accompanying stresses

• • (troubles at work, moving, quarreling, divorce) can cause a nervous breakdown and, as a result, depression.

Low salary.

• • In the period of expectation of the baby this factor becomes more significant. What if there was hardly enough money? If earlier low income was little pleased, now it causes the strongest alarm, because now you have to take care of the child.

Psychophysical problems.

• • They include toxicosis. Morning sickness and poor physical well-being do not add optimism. And if the pregnancy is also unexpected, then these problems do not bring particular joy, becoming the causes of the development of depression.

Negative experience of a previous pregnancy.

• According to the results of research by medical psychologists, the previous pregnancy and depression accompanying the following “interesting situation” have a close relationship.

Depression in pregnant women can be triggered by unsuccessful nurturing in the past or infertility. In the event that the birth of a child was preceded by a test (it took a long time to get pregnant, had to go through a lot of painful medical procedures, listen to a lot of sympathetic comments, there were miscarriages, etc.), then the expectation of the baby will be accompanied by anxious thoughts.

In some families, pregnancy provokes a disrespectful attitude to the future mother from the so-called close people. Ticcups, aggression, rudeness from a husband, mother-in-law or other relatives who see a pregnancy as a threat to personal status or well-being cause a frustration in the emotional state. Such situations happen rarely, however, they cause the most serious damage to the psyche of a future mother and baby.

In addition, depression during pregnancy can be caused by unpleasant memories in women who have experienced emotional, sexual or physical abuse in the past. Changes that occur in the body of a future mother, can recall a long-forgotten misfortune. That is why if a woman has been subjected to or is subjected to any kind of violence in the past, she must inform her doctor about it.

• Personal experience of depression in the past and the presence of relatives suffering from depressions are grounds for classifying as a risk group. Such anamnesis can provoke not only prenatal depression, but also postpartum depression.
• Unplanned conception can become the strongest stressor, capable of causing depression.
• The development of the disease can affect the lack of serotonin, dopamine, norepinephrine and long-term use of sedative drugs.

This list can be continued almost indefinitely. Any stressor, which disbalances the future mother, can cause a mental disorder.

First Trimester

In psychology, the first trimester is known as the “period of negation”. A new life already exists, but the future mother still does not think about her situation and does not take it into account when planning the activity. This, of course, is possible only in the absence of toxicosis. A striking example of this situation can be the planning of a business trip in the rather distant future, at the 36th week of gestation. This is a fairly common and normal situation, the mother does not feel the baby yet, he does not push, the belly does not.

However, this is the most difficult time. The body of a woman begins to rebuild and get used to “work in a new way.” Changes are undergone by all systems of the body, including the nervous system. All sorts of fears and stresses (material well-being, childbirth, social status, child’s health, possible loss of work) surround the future mother. She does not yet know what she will do in the near future, what awaits her.

Depression in pregnant women at this time can be caused by the loss of the opportunity to do your favorite thing (jump with a parachute) or the abandonment of habits that have become a part of life (smoking).

In the first trimester, mood swings and irritability can be quite normal. So with the first changes in the emotional background, you should not label yourself with a depressed patient. In addition, such manifestations, strangely enough, in medicine, act as the first indirect signs of the onset of pregnancy. Pay attention to changes in the emotional background is when they assume the role of a protracted nature, there are talk of death, often there are utterances about the meaninglessness of existence.

Depression in pregnant women at this time can have different consequences for the health of the mother, and for the health of the baby. Scientists from Canada found that the children of women who suffered depression in the first trimester, may experience sleep disorders, have insufficient weight, lag behind in intellectual development.

Second Trimester

At this stage of gestation, the woman begins to realize her position. She thinks about what she will do with the appearance of the child, because her personal life will definitely fly somersault. For this reason, psychologists called this stage “the search for the lost object.” This object is understood as a habitual way of life, favorite work, entertainment, friends, etc. It’s strange at this time that women discover for themselves new opportunities and interests that have not been noticed before. Someone starts to draw, someone goes to learn the languages ​​of other peoples. According to all the same psychologists – this is the most fertile time in the life of a pregnant woman.

However, especially sensitive nature melancholic type, having a history of propensity for depression, during this period experience real emotional storms.

The development of depression in the second trimester contributes to a combination of several factors: hormonal changes, insomnia, misunderstanding of relatives, financial problems.

At this time, depression and pregnancy are most related. An increase in body weight, low back pain, frequent urge to urinate, engorgement of the mammary glands are the causes of the appearance of negative thoughts. A clear connection between the physical and her psychoemotional state of the future mother is seen.

Third Trimester

The third trimester in psychology was called depression. During this period, even the most balanced nature begins to lose control of themselves. In the thoughts of pregnant women, in addition to their will, there are “rainbow” pictures with pots, pots and diapers. In their soul from time to time there are notes of despondency, loneliness, hopelessness. Increasingly, there is discontent with her husband, who are not forced to change their way of life, mother-in-law, who constantly climbs with her teachings.

Depression and late pregnancy are quite common. Increase the feeling of own helplessness changes that have occurred with the body: the unimaginable size of the stomach, which prevents you from moving normally. Many ladies think that they have lost their former sexual attraction and are not interested in their husband, which causes increased sensitivity and tearfulness. Physical and psychological fatigue exacerbate the negative emotional state.

The behavior of pregnant women before giving birth sometimes seems strange. Women tend to seclude themselves, walk alone for long periods in the open air, immerse themselves in cooking dowry for a baby, etc. However, these behavioral features have nothing to do with depression.

How to Cope with the Disease on Your Own

1. Do not try to remake all the cases before the appearance of the baby: equip the nursery, make repairs in the apartment, prepare reports at work for six months ahead, etc. The first item on the list of the most important cases should be personal well-being and well-being. Pregnancy – a great time to pamper yourself, later no longer have to (diapers, ryazhonki, teeth and other joys of infancy).
2. Daily need to do exercises. Moderate exercise will allow you to feel “muscle joy” and emotional satisfaction.
3. Learn to fight your bad mood, find a job. Take care of your favorite thing, which previously was not enough time: embroider, draw, read. Try to do something new, for example, sign up for the pool.
4. Communicate more often with relatives and relatives. If you do not know what to do with your bad mood and anxious thoughts, openly talk to them about your problems.
5. If fatigue overcomes and you, literally, fall down, try to rest more, do not take the whole work on yourself. Ask your husband to give you a gentle massage of the waist and feet.
6. Pay attention to your food. It should not be too high in calories. Try to eat right, including in the diet of dairy products, fresh fruits and vegetables. Avoid flour and sweet products.
7. In order not to “seize” yourself and your husband with far-fetched problems, try to look at the situation from the side and do not rush to make hasty conclusions.
8. More time walk in the fresh air.
9. Do not try to fight depression yourself. Do not take antidepressants. This applies to the funds that you drank before pregnancy.
10. Protect yourself from unwanted information. Refuse to watch the programs with negative character, films with scenes of cruelty.
11. Create a cozy home for yourself, in which there is no room for emotions and despondency.
12. Learn to respect yourself “like that.” Try to realize the beauty of your position.

There is nothing new in the above-listed councils, but we all tend to forget about common truths. If the state of anxiety does not let go, there is only one negative in the mind, and you do not know what to do with it, then you need to seek help from a doctor who is watching the course of pregnancy. To delay with the treatment is not necessary, because the mother’s well-being directly affects the child’s health.

Features of Treatment of Depressive Disorder in Pregnant Women

Treatment of pregnant women from a depressive disorder has its own characteristics. If possible, the doctor tries to exclude the use of antidepressants, using non-medicamentous medications (meditation, respiratory techniques, art therapy, fairy tale therapy, NLP). However, their use is possible only in the early stages of the disease. In neglected cases with depressive disorder, one can cope only with the help of medicines. When prescribing medication for depression, do not worry about the child’s health. At the moment, there are a number of drugs allowed for admission during pregnancy.

One in every 8 women will develop breast cancer during their lifetime. This program should improve your chances.

Women know this statistics very well – one out of every eight. These figures we meet every time we read about breast cancer or hear about a new drug that should reduce our risk. But the risk of breast cancer, despite the new drugs and the millions invested in research, is not reducing.

Proper nutrition helps reduce the risk of breast cancer

Theories offer many ways to reduce the risk of taking tamoxifen, taking regular exercise, taking antioxidants, not living near toxic waste dumps, and even preventive mastectomy. Some of them can help, others seem far-fetched or even barbaric.

We invited five experts on breast cancer for consultation, both with a traditional and alternative approach, and asked them to help us develop a program that would significantly reduce the risk of the disease. The central element of this program is a diet – this is the only thing that you can take under your direct control. And, according to Dr. Mitchell Gaynor, director of the Center for Cancer Prevention in Manhattan, she was the most effective way to reduce risk.

Here we publish 13 simple ways with which you can improve your diet and protect yourself from cancer today.

1. Try the seaweed

What to do?

Eat more often seaweed, such as kelp and nori. Or take daily supplements of blue-green algae, such as spirulina (1 teaspoon) and chlorella (3 g) in a glass of juice.

What for?

Jane Teas, PhD at the Harvard School of Public Health, found that rats given laminaria had fewer breast cancers than rats that were not given algae. Frequent eating of kelp can explain the low incidence of breast cancer among Japanese women (whose incidence is three times lower than that of American women).

Algae, including chlorella and spirulina, contain chlorophyll, which has been shown to have anti-cancer effects, as well as vitamin C and carotenoids, which fight free radicals.

2. Cut half the fat

What to do?

Limit the amount of fat in your daily diet to 20 percent of the total caloric intake.

What for?

A diet high in fat (especially animal fat) is known to increase the risk of breast cancer. One study found that the risk of breast cancer increases in Japanese women who move from Japan (where the fat content is about 20 percent of the total caloric intake) to the United States of America (where the fat content is about 40 percent of total caloric intake).

According to the doctor of medicine Charles Simony, author of the book “Breast Health” (Avery Publishing Group, 1995), the high-fat diet leads to the formation in the intestine of chemical compounds that are processed by bacteria into carcinogenic estrogens. These estrogens can accumulate in the fatty tissues of the breast, making the cells in this area more susceptible to developing cancer.

3. Use dietary fiber

What to do?

Eat fruits and vegetables, legumes and whole grains that contain a lot of plant fiber.

What for?

Robert Arnot, MD, author of the book Breast Cancer Diet (Little, Brown and Company, 1998) says that fiber stops the metabolism of estrogen in the body and reduces the level of its content in the blood. A high level of estrogen in the blood corresponds to a higher risk of breast cancer. A diet high in fiber can reduce the risk of breast cancer to 54 percent.

4. Eat cruciferous vegetables

What to do?

Eat more cruciferous vegetables – broccoli, Brussels sprouts, cabbage, turnips, bok choy, cabbage kale and cauliflower. To better preserve nutrients with anti-cancer properties, eat vegetables raw or steamed.

What for?

Cruciferous vegetables contain sulfur compounds, so-called indoles, which help to remove estrogen from the body and thereby protect against breast cancer. According to Dr. Gaynor, the author of the Gaynor Cancer Prevention Program (Kensington Books, 1999), only cruciferous vegetables have the ability to convert estrogen in the body from a carcinogenic form to a form that can really protect against breast cancer. One of the indole varieties, indole-3-carbinol, inhibits the development of potentially malignant cells in the mammary gland.

5. Get fatty acids from fish

What to do?

Eat at least three servings of cold-water fish per week, such as tuna, salmon, halibut, mackerel, haddock, cod and sardines. If you do not like fish, you can take capsules from fish oil (2 to 10 grams per day) or vegetarian docosahexaenoic acid supplements derived from algae (300 mg per day).

What for?

Omega-3 fatty acids inhibit the action of compounds known as prostaglandins that cause inflammation, which inhibits the ability of the immune system to detect tumors.

In one major study, British researchers examined data on mortality from breast cancer and colorectal cancer in 24 European countries. A high intake of animal fats was associated with a high prevalence of cancer, and with a higher level of consumption of fish and fish oil, the incidence of cancer was lower.

The Finnish researchers found lower levels of EPA and DHA (two omega-3 fatty acids) in women with breast cancer in the mammary gland than in women with benign forms of fibrocystic breast disease.

North American Eskimos, whose diet is extremely rich in Omega-3 fats, women generally do not have breast cancer.

6. Learn the secrets of soybeans

What to do?

Regularly eat soy products, such as tofu, miso and temp. (Not all soy products are equally useful Soy products of high purity, such as soy milk, soy burgers and soy meat, contain significantly less genistein than traditional Asian soy products, and some of them may contain artificial preservatives.) Soybean oil and soy sauce too, are not good sources of genistein, since soybean oil contains harmful fats, and in soy sauce contains too much sodium).

What for?

Soybeans and other soy products contain genistein, a natural plant estrogen that binds to the cellular receptors in the mammary gland and, therefore, makes it impossible to attach to the receptors carcinogenic forms of estrogen.

Scientists are also studying other useful properties of soybeans. In one study, Seventh-day Adventist women, vegetarians who usually ate a lot of soy, had a lower level of breast cancer than usual. They had a higher level of the hormone DHEA, which is typical for women who do not have breast cancer.

Dr. Gaynor says: “Soy does many things – it’s a weak estrogen that blocks estrogen receptors, reduces angiogenesis (the growth of blood vessels that feed the tumor), accelerates apoptosis (the death of cancer cells) and contains enzymes that destroy carcinogens in the body.”

7. Buy Organic

What to do?

If possible, buy natural products: fruits, vegetables, grains, dairy products, meat and poultry.

What for?

Organic products do not contain pesticides, such as DDT, and other environmental toxins that are associated with an increased risk of breast cancer. Although DDT was banned in the US, US producers export pesticides to third world countries, of which tropical or off-season products are then often exported back to the United States. According to Dr. Devrea Lee Davis of the World Research Institute in Washington, DC, organic fruits and vegetables contain more vitamins and minerals than inorganic foods.

Dairy products and meat that have been certified as organic do not contain hormones such as bovine growth hormone, a chemical additive for the growth of livestock, which has been found to promote the growth of breast cancer cells.

8. Take dietary supplements

What to do?

Every day, drink one cup of astragalus tea; take 200 micrograms of selenium; from 30 to 100 mg of coenzyme Q10; 25 mg grape seed extract; from 30 to 100 mg of alpha-lipoic acid, as well as quality multivitamin and mineral supplements.

What for?

Astragalus. In 1990, a study conducted by Dr. Anderson at the Houston Cancer Center showed that daily astragalus intake increases the body’s ability to kill cancer cells tenfold.

Selenium. Larry Clarke, an associate professor at the University of Arizona, showed that selenium can halve the incidence of cancer, and an earlier study published in Holistic Medicine in 1989 concluded that the higher the selenium level in the blood, the lower risk of breast cancer. Buy organic forms of selenium – selenomethionine, and not selenate.

Coenzyme Q10. This nutrient protects the body from cancer by strengthening the immune system and destroying free radicals. However, there is no evidence that Co Q10 is particularly effective for the prevention of breast cancer.

Grape seed extract. According to Gaynor, studies have shown that its antioxidant properties are 20 times stronger than those of vitamin C, and 50 times stronger than those of vitamin E, with respect to free radical scavenging.

Alpha-lipoic acid. It is a powerful antioxidant that enhances and restores other antioxidants in the body, especially vitamin E. Biochemist Richard Passauter has shown that lipoic acid can even inhibit the activation of a gene that causes the growth of cancer cells.

9. Eat more mushrooms

What to do?

Regularly include in your diet of medicinal mushrooms, especially Japanese varieties of maitake and shiitake. Reishi, another medicinal mushroom, is harsh after cooking, so it is better to use it for tea or tincture, or take in capsules.

What for?

Studies have shown that maitake mushrooms stimulate the immune function, and also inhibit tumor growth. “Maitake D-fraction, the active ingredient in maitake, does not kill cancer cells directly,” explains Dr. Kuna Zhuan, who investigates the anti-cancer effect of maitake – “She activates the immune system.” According to Zhuan, it has been shown that maitake mushrooms are particularly effective in protecting against breast cancer in mice. Some evidence suggests that maitake is also effective against tumors in humans.

Shiitake contains a polysaccharide, called lentinan, and is known to increase the activity of the immune system.
Reishi mushrooms also contain polysaccharides.

10. Have a tea party

What to do?

Drink one cup of green tea three times a day. Green tea contains half the caffeine content than coffee – you can also buy decaffeinated tea in sachets, green tea capsules or tincture.

What for?

Green tea contains anti-cancer antioxidants and polyphenols, which heal the damage caused by free radicals.
In one study, in which women drank a lot of green tea – 10 cups a day – there was a significant reduction in the risk of developing cancer.

Green tea can be another important protective factor responsible for the low level of breast cancer among Japanese women.

11. Choose the right vegetable oil

What to do?

Cook on olive oil of the first pressing (“virgin”, “extra-virgin”). And use linseed oil for dishes that do not undergo heating (linseed oil is unstable and its chemical composition varies when exposed to light and heat). Avoid rapeseed, sunflower, corn, soy, sesame oil and margarine.

What for?

Monounsaturated oils, such as olive oil, reduce the risk of cancer. A study of women in Spain demonstrated a lower risk of breast cancer in those women who consumed more olive oil. Lillian Thompson, a professor of dietetics at the University of Toronto, found that daily intake of flaxseed (1 tablespoon of oil or 3 tablespoons of seed) could lead to a reduction in the size of the breast tumor.

Trans fats (solid fats, also called hydrogenated oils and contained, in particular, in margarine) increase the risk of cancer. A study conducted at the University of North Carolina in 1997 confirmed the correlation between the consumption of trans fats from processed margarine and vegetable oils and the incidence of breast cancer.

According to Arnot, saturated fats (for example, dairy products and red meat) raise the level of insulin in the body above the norm. Like some kinds of estrogen, a high level of insulin can stimulate the growth of cancer cells in the mammary gland. In a recent study, MD Pamela Goodwin, an associate professor at the University of Toronto, found an increased risk of breast cancer in women with a high insulin level of 283 percent.

12. Make friends with phytonutrients

What to do?

Eat different vegetables, fruits, grains, seeds, nuts, beans.

What for?

These products contain phytonutrients (plant nutrients, such as polyphenols) – compounds that protect against cell damage and inhibit the growth of a malignant tumor. In one study by the Harvard School of Public Health in women who ate a lot of vegetables, the incidence of breast cancer was 48 percent lower than those who ate a little; and those who ate a lot of fruit, the incidence was 32 percent lower.

Robin Kjunike, author of the book “Breast Health” (Kensington Books, 1998), suggests cooking using herbs such as dill, which contains lemon, an important phytochemical for breast health, and rosemary, which has antioxidant and antitumor properties.

13. Eat lily every day.

What to do?

Eat more vegetables of the lily family – garlic, onions, leeks and shallots. For the greatest benefit (if you are brave), the lilies are eaten raw.

What for?

According to the National Cancer Institute, garlic is one of the best products to protect against cancer. It contains an anti-cancer microelement of selenium, which stimulates the production of white blood cells and causes apoptosis (death of cancer cells).

Onions and other vegetables of the lily family produce a similar therapeutic effect – the lily contains compounds that stimulate the production of enzymes that neutralize free radicals that contribute to the development of cancer. Liliaceae also contain saponins that prevent cancer cells from multiplying.

Dr. John Milner, director of the Department of Nutrition at the University of Pennsylvania, successfully applied a garlic extract to prevent the development of breast tumors in rats with injected carcinogens. Ninety percent of the rats that did not receive garlic extract developed cancerous tumors, and only 35 percent had rats in the group that received garlic. And in 1995, cancer studies showed that sulfur compounds in the garlic extract inhibit the growth of precancerous breast cells in humans and increase the level of enzymes important for detoxification.

What to do and what not to do to prevent cancer

Do:

Do 4 hours a week with energetic aerobic exercise. Out of 1000 women surveyed, those who were engaged in 3.8 or more hours a week had half the incidence of breast cancer.

Do not let your weight deviate from the ideal by more than 12 pounds. Many studies have confirmed the association of obesity with an increased risk of breast cancer. Excess fat produces estrogen, which can then accumulate in the breast tissue and cause the growth of cancer cells.

Feed the babies. Breastfeeding interrupts ovulation and thus reduces the time of circulation of estrogen in the body.

For several hours every day, go without a bra. The authors of the book “The connection between a bra and breast cancer” Sydney Ross Singer and Soma Grismaier (Avery Publishing Group, 1995) found that women who wore a bra for more than 12 hours a day had a 19 times higher risk of developing breast cancer than those who wore a bra less than 12 hours. The scientific validity of this conclusion is still being discussed.

Sleep in total darkness. Light suppresses the production of the hormone melatonin in your body, and lower levels of melatonin are associated with an increased risk of breast cancer.

Spend 15 minutes a day in the sun, 3 times a week. Sunlight helps the body produce vitamin D, which is associated with lower levels of the incidence of breast cancer.

Carefully use hormone replacement therapy. Some researchers associate the supplements of DHEA and other hormones with an increased risk of breast cancer, although no convincing information so far. Consult your physician before starting any hormone replacement program.

Do not do it:

Do not get carried away with alcohol. According to Simonyi, women who drink between 2 and 4 servings of alcoholic beverages per week have a 2-3 times higher risk of developing breast cancer than those who do not drink.

Do not use dark hair dyes continuously for several years. A study conducted in 1980 showed that women who dyed hair to change their color had a three times higher risk of developing breast cancer.

Do not smoke. In one study, almost 85,000 women received a higher risk of breast cancer among smokers compared to non-smokers.

Some age moments

Girls in the adulatory period: frequent use of organic yogurt at this age can reduce the risk of breast cancer by half, according to studies published in the International Journal of Immunotherapy.

Teenagers: Intensive exercise in adolescence reduces the risk of breast cancer in later life. If possible, avoid the use of birth control pills – they increase the risk of breast cancer at a later time. In the period of onset of menstruation, one should not hide their problems – tell parents about their feelings as they arise.

From 20 to 30 years: ideally, tablets should be used only after a long time after the birth of a woman’s first child. Birth of the first child under the age of 35 reduces the risk of breast cancer.

40 years: the experts do not have a common opinion about whether to do a basic mammogram in 40 years. Talk to your doctor. At this stage, it is very important to do monthly self-monitoring of the condition of the mammary glands.

50 and older: annual mammography is needed. At the age of 51 to 70, increase your daily dose of vitamin D to 400 ME. If you are 71 years and older, you should take 600 ME. per day.

Psychology

Certainly, our thoughts and emotions play a key role in the prevention, prevention of relapse and remission of breast cancer. In a recent study published in the National Cancer Institute newsletter, it was reported that after breast cancer surgery, more marked signs of stress and depression in women were also accompanied by a greater depression of the immune system.