Depression is rife in the lesbian community, particularly among younger women, but a range of solutions are available, Katrina Fox reports.

Consumed by "black clouds" and "getting sucked suddenly into muddy whirlpools of darkness" is how 47-year-old Mignon Lee-Warden, an events and festival producer, describes her lifelong experience with depression. "As I grew into my mid-twenties my ability to get 'down in the dumps' became more frequent and I believed if I was sad there was something 'wrong' with me. I was ashamed to admit that I had any feelings other than happy positive ones," she says.

Depression in lesbian women is commonplace. The Private Lives study into the wellbeing of GLBTI people in Australia, published by Gay and Lesbian Health Victoria (GLHV) in association with La Trobe University, in March this year, found that 44 per cent of women scored on at least one of the two criteria outlined in the survey for a major depressive episode. An earlier study, The Longitudinal Study of the Health of Australian Women, in 2003 found that same-sex attracted women aged 22-27 were significantly more likely than other women in the study to report being depressed (38 per cent vs 19 per cent) and having tried to harm or kill themselves (12.6 per cent vs 2.7 per cent).

Symptoms of depression are broad and can range from lethargy, poor appetite, low self-esteem, taking little or no pleasure in day-to-day activities, to feeling miserable, hopeless or suicidal. Behaviours associated with the condition include becoming reclusive and withdrawn, unable to complete tasks at work and a reliance or dependence on alcohol or drugs.

So what are the main causes of depression among lesbians? According to Anne Mitchell, director of GLHV and one of the authors of the Private Lives report, it is often a result of "living in a homophobic and heterosexist world, being at risk of discrimination and violence and thinking constantly about your way of being in the world - modifying daily activities and so on".

Mitchell's opinions are shared by Sydney-based lesbian GP, Dr Liz Rickman, who argues that there are internal and external causes. "A culture which doesn't affirm your sexuality affects how you see yourself, so there are inner-worldly and outer-worldly challenges," she says. "So a lesbian woman's depression could come from the fact she is getting harassed at work or her relationship has broken up and there's no support to help her grieve, or she may have the support in the [lesbian] community but there's still that nagging feeling that she's not good enough for the world at large."

As well as homophobia, discrimination and life-changing events or experiences such as the death of a loved one, depression can also be due to a myriad of physical conditions such as changing hormones, under-active thyroid or post-viral syndrome. In addition, counsellor Georgina Abrahams, argues that the causes of depression can be political. "Who isn't depressed sometimes, with all the things going on in the world?" she asks. "Many, if not all, of the women I work with are sometimes overwhelmed souls. We can't separate our own psychology from what is going on in our war-engulfed world. I know women who are burned out and depressed because they are at a loss at what to do with their anger."

While depression affects lesbians of all ages, the experiences of older and younger women vary. "We see a very marked difference between younger and older lesbians in terms of their self-reported health which can give us a clue as to their different experiences of depression," Mitchell says. "The self-reported health of lesbians catches up to and passes that of heterosexual women across middle age but is very much below it for women under 30. We think this is about finding somewhere where you can be yourself and so feeling stronger in your identity. Young women are less secure and may feel they are not accepted at school, work, in their social group or by their family so that can be a real recipe for depression. They are also, at a younger age, more likely to take on board negative things said to them about being gay and as they get older are better able to dismiss these ideas as homophobic."

The diagnosis of depression and apparent willingness on the part of many doctors or psychiatrists to dish out anti-depressant drugs to the exclusion of other treatments is an area of controversy. "I feel depression in women is too quickly diagnosed without due care to analysing what might be the best way to proceed with assistance," Anique Duc, convenor of the annual Women in Depression Conference, which began last year in Sydney, says. "Sometimes a woman may present to a doctor with what seems to be depression, when really, she is just so exhausted by caring for children all on her own, or she has been struggling with domestic violence and simply needs help. A referral to a suitable agency or service may be all she needs."

Rickman, who is a holistic practitioner, agrees. "Anti-depressants are very useful when people are really on the edge," she says. "But it wouldn't be my only solution. Without addressing the cause, we can do nothing for the person. To stop at anti-depressants is to totally negate the issues that are the causative factors of depression. Depression is a symptom, not a diagnosis - until it becomes a diagnosis. When someone says 'I'm depressed', for me that's the beginning of the medical and psychological assessment of the person."
With homophobia inherent in society, it's logical that it would filter down into the medical system. In order to help same-sex attracted women overcome depression, both Rickman and Mitchell believe that primary healthcare service providers need to be better informed and more welcoming of people with non-heterosexual identities. Rickman also calls for doctors and medical students in particular to refer women to other healthcare practitioners for alternative solutions to depression, whether they be naturopathic treatments such as acupuncture and herbs, or counselling, psychotherapy and hypnotherapy.

In addition, women suffering from depression can take simple steps such as practising meditation, taking regular exercise and making diet changes, to gain relief. "To replace depression we have to approach the idea of being willing to change our way of thinking, the way we are in the world, our diet and old beliefs," Abrahams says.

For Lee-Warden, the use of creative arts as a tool for healing has been an inspiration. Despite bouts of depression, she has run festivals, retreats and workshops for over 20 years and continues to work with women who struggle with depression, using creative arts. Her current project is called 'Journeys to Joy' which focuses on writing, music, theatre, visual arts, meditation, yoga and dance as alternative choices to drugs and counselling for women suffering from depression. "Sometimes the tools I have learned work, sometimes when I am under a black cloud I forget I have them and I sink deeper," she says. "Sometimes nothing I have learned works and I have to be in the moment, accept the present without trying to make it better, and within that acceptance I learn new ways."

The Women in Depression Conference takes place 23-25 May, 2007. Submissions for papers regarding lesbians and depression are especially welcome. Deadline for abstracts: 31 October. http://www.womenanddepression.herwill.net

For more information and help with depression, visit Beyond Blue www.beyondblue.org.au

For more information on Journeys to Joy, email Mignon Lee-Warden at migwaves@hotkey.net.au

Lesbians on the Loose (LOTL) is Australia's national lesbian magazine. For more information visit the magazine's website at www.lotl.com