Hmmm: Getting Away from Men Reduces Depression in Women.

In a world where just about everything is co-ed, maybe there’s room for occasional gender separation. A new study shows that depressive symptoms improved among women with coronary heart disease who participated in a cardiac rehabilitation program exclusively for women.

Depression is common in people with heart disease and is more evident in women. There are reported physiological effects that could make heart disease worse, but there are psychological and practical issues, too. Being depressed interferes with adherence to lifestyle modifications and the willingness to attend rehab, which makes it harder for people to recover.

“Women often don’t have the motivation to attend cardiac rehab particularly if they’re depressed,” said Theresa Beckie, Ph.D., lead investigator and author of the study and professor at the University of South Florida’s College of Nursing in Tampa, Florida. “Historically women have not been socialized to exercise and their attendance in cardiac rehabilitation programs has been consistently poor over the last several decades. This poor attendance may be partly due to mismatches in stages of readiness for behavior change with the health professional approaching from an action-oriented perspective and the women merely contemplating change – this is destined to evoke resistance.”

Cardiac rehabilitation programs tailored to the needs of women and to their current level of readiness to change may improve adherence to such programs and potentially improve outcomes for women, she said.

The primary goals of the 5-year randomized clinical trial were to compare multiple physiological and psychosocial outcomes of women who participated in a 12-week stage-of-change matched, motivationally enhanced, gender-tailored cardiac rehabilitation program exclusively for women compared to women attending a 12-week traditional cardiac rehabilitation program comprised of education and exercise.

“We didn’t push them if they weren’t ready to make the changes,” Beckie said. “We have found that if some patients receive long lists of behaviors they are expected to change immediately — such as quitting smoking, eating healthier, exercising regularly — they are overwhelmed. Pushing such patients who are not ready can lead them to tune out or drop out. Instead, for these women, we acknowledged their ambivalence about change and gave them strategies to move toward being ready by reinforcing their own motivations for changing. It’s unrealistic to expect all patients to change their lifestyle all at once, right now in front of you.”

The woman-centered program was a more individualized approach to rehabilitation, she said, adding, “You can’t treat everyone the same when it comes to changing health behaviors.”