via Trying to Be Supermom Can Raise Risk for Depression.

While the study was small, the findings are promising for doctors who have been hesitant to treat with antidepressants out of fear that the drugs might harm the fetus.

On the other hand, some worry that untreated depression during pregnancy could also lead to birth complications, said Dr. C. Neill Epperson, who heads the Penn Center for Women’s Behavioral Wellness in Philadelphia and was not involved in the current study.

“A lot of people feel like they’re in between a rock and a hard place,” she told Reuters Health.

via Light therapy may help depression in pregnancy | Reuters.

“It made me cry, and I seriously couldn’t stop crying for 24 hours,” Rose said. “I was so upset I had to call in sick.”

Having battled depression on and off for years, Rose went to see her psychiatrist who diagnosed her as having stress and anxiety disorder brought on by pregnancy. He advised her to take Wellbutrin, an antidepressant, to cope with her mood changes. Her obstetrician prescribed Zoloft, another type of depression medication. Both told her the drugs posed only a small risk to the fetus, but Rose remained unconvinced.

After doing her own research, and discussing it with her psychiatrist, Rose decided not to take the drugs — unsure of what they would do to her unborn baby girl.

via Antidepressants During Pregnancy Pose Dilemma for Women | Depression Treatment | Postpartum Depression | My Health News Daily.

via Depression – Facts about Women and Depression.

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Flaming June by Frederic Lord Leighton

Women suffer from unipolar (as opposed to bipolar or manic) depression in greater numbers than men do; twice as much by most estimates.

Causes

The reason or reasons why women have unipolar depression more frequently than men is less definite, due to a great extent to the fact that we don’t fully understand what causes depression, whether in men or women. Depression is a highly individual disease. Each case is different. One person’s depression may be wholly chemical, while someone else’s is brought on by events and stressful factors in her life. Yet another person may suffer depression due to a combination of chemical and environmental factors.

Several theories have been brought forward to explain the greater frequency of depression in women. At this point it is difficult to either completely discount any of them or to point to one and say, “That’s it!”. There is no question that women have to deal with a greater number of risks to their physical and emotional well-being than men. We have yet to learn to what extent each of these plays a role in depression in women. Until then, it is wise to be aware of these potential risks, in the same way we are aware of risk factors for heart disease or high blood pressure.

Biology

Women experience several major biological changes in their lives; onset of menstruation, pregnancy, postpartum and menopause. We also go through a hormonal metamorphosis every month. It’s likely, although not proven scientifically, that hormonal changes play a part in depression in women.

Girls entering puberty are twice as prone to depression as boys, and it is possible that this is due, at least in part, to the hormonal changes brought on by the onset of menstruation. However, there is a strong argument to be made that this is a time at which they are vulnerable to internal and external conflicts and pressures which would be more likely to contribute to depression than changing hormones.

Sunlight by Frank Weston Benson

Despite the image many people have of a pregnant women being emotional and prone to crying jags, pregnancy depression is rare, even among women who have suffered bouts of depression before becoming pregnant. Postpartum depression (different from the “baby blues”), however, affects as many as one in four first-time mothers in one form or another. Interestingly, menopause, which many people assume is a time of potential depression for women, does not seem to put them at a greater risk for depression than men of the same age.

The question of whether premenstrual syndrome leaves women more open to depression, or is in itself a form of depression, is a subject of much debate, and no easy answers. Any woman who has had a man say to her, “You have PMS, don’t you?” in the middle of an argument can understand why some women are reluctant to have PMS and depression mentioned in the same sentence. However, completely discounting the possibility of a link between the two could do women on the whole a disservice. At this point, the understanding of the causes of depression in women is too uncertain to rule anything out. Certainly PMS and depression share some characteristics: irritability, appetite change, listlessness, crying jags. However, one thing to bear in mind is that when some women think they are suffering from PMS, they may actually be going through depression. When what a woman thinks of as PMS starts taking over a good part of each month, she should talk to a doctor about the possibility that she is actually experiencing depression. Before I was diagnosed with depression, I just assumed I had very bad (and lengthy) PMS.

Rape and Abuse

Women (and girls) are much more likely than men to be raped and physically or sexually abused. These experiences factor into many cases of depression. Low self-esteem, feelings of helplessness and self-blame are by-products of any form of abuse, and these can either cause or exacerbate depression. A woman who is the victim of any type of abuse should consider herself at risk for depression. I had my first bout of major depression a few months after my first rape.

Role in Society

The Lady of Shalott by John William Waterhouse

Studies have shown that because of social conditioning, women have a lower sense of their own self-worth and competence than men do. This is often reinforced in the workplace in the form of lower pay and discrimination in hiring and promotion. Add to this the fact that women still do most of the housework and child-rearing, and you have not only problems with self-image, but also multiple stresses. It is possible that these are both factors in greater prevalence of depression in women.

Special Considerations

Pregnancy and Depression

When it comes to whether or not depression is present during pregnancy, women’s experiences run the gamut. Some women who have had lifelong depression find that it eases off during pregnancy, and they have no need of their medication. However, some women who have never experienced depression find that they are vulnerable to it for the first time when they become pregnant.

Links

Coffee, Caffeine and Risk of Depression Among Women

Breakfast in Bed by Mary Cassatt

Postpartum depression is the cruelest form of depression, coming when it does. Your most joyful (albeit totally sleep-deprived) time becomes your most torturous. After I had my son, I was certainly sleep deprived, but my overwhelming emotion was wonder and absolute content. My parents told me that I was a natural mother. Certainly taking care of my son came much more easily than I had expected, and I had less self-doubt than I had anticipated.

Of course, with my history of depression, I went back on antidepressants right away (I decided not to breastfeed, since I also had to immediately start taking the medication for my Multiple Sclerosis again). I didn’t want to lose one minute of my time with my son to depression, and I knew that a mother’s depression could affect her infant. Luckily, I didn’t have one moment of postpartum depression. I didn’t even suffer from the “baby blues,” a milder form of postpartum depression, that usually starts a few days after the birth. The baby blues generally lasts less than 2 weeks, and is thought to be caused by the hormonal change and loss of endorphins after the birth.

Postpartum depression is different from the baby blues that occurs after about 75% of births. The baby blues is a mild form of depression, often with severe mood swings, that usually starts a few days after the birth. The baby blues generally lasts less than 2 weeks, and is thought to be caused by the hormonal change and loss of endorphins after the birth.

Postpartum depression, which occurs in 10-15% of births, is often mistaken for the baby blues, but it is much more severe and longer in duration. It usually starts within 6 to 8 weeks after the birth, although it can begin up to a year afterwards. Factors that are thought to contribute to or cause it are:

• the pregnancy was unplanned
• stress
• hormonal changes
• lack of a support system or a poor support system
• lack of sleep
• medical complications for the mother or baby, i.e., a difficult pregnancy or birth
• a prior depressive episode
• family history of depression
• predisposition to depression

Symptoms are:

• anxiety
• insomnia
• feelings of guilt and/or inadequacy
• difficulty making decisions
• difficulty concentrating
• sadness/weepiness

Some women with postpartum depression will also have postpartum psychosis, as in the case of Andrea Yates, but it is rare (1 in 1,000). If, however, you have any of the symptoms below, you must seek medical attention immediately.

• hallucinations (hearing voices or seeing things that are not there)
• delusions (having ideas that you believe despite all the evidence, i.e. that your baby is possessed)
• severe insomnia
• extreme anxiety and agitation
• suicidal or homicidal thoughts

There are a few factors that make it difficult for a woman and her family to recognize postpartum depression and get treatment. A woman who suspects that she might have postpartum depression often has trouble overcoming the sense of shame that her “failure” will engender. Woman are used to taking care of others and putting themselves last. Women with postpartum depression have to deal with not only the numbing paralysis of depression, but also the feeling that she should be a superwoman and not indulge herself by seeking help.

In addition, postpartum depression is underdiagnosed and underpublicized compared to other forms of depression. The American medical community has been slow to recognize it, and it was not added to the DSM, the official bible of psychiatry, until 1994. Because of this, women and their families must often be persistent about getting treatment in the face of skepticism from medical professionals who insist that a woman’s postpartum depression is just the baby blues or difficulty adjusting to the new situation. It is imperative for a woman who thinks she has postpartum depression to get treatment. Depression is very likely to interfere with the bonding of mother and child.

If a woman is diagnosed with postpartum depression, she has several ways to attack it in addition to medical treatment. Antidepressants are generally recommended as part of treatment, as they are the most effective form of treatment. Tricyclic antidepressants are thought to be the safest if the mother is breastfeeding.

Support groups with other mothers are extremely helpful. It is a relief for the mother to know that she is not alone. She can let go of the myth of the bliss of a new baby, and find out that she is not the only one with a messy house, a baby who seems to cry all the time, and a wardrobe that now seems to consist of only sweatpants and sweatshirts. Women in support groups can also share coping strategies.

Estrogen therapy is also used in the treatment of postpartum depression. A British study reported that women using an estrogen patch showed greater and more rapid relief than women using a placebo patch.

Therapy for the mother and her partner can be extremely helpful, especially if her depression has been of a long duration. The new father is often feeling overwhelmed about being a parent, and is trying to deal with the complexities of having a partner with depression.

A new mother who is suffering from postpartum depression should also try to fit time in to exercise, as it releases endorphins that lift the mood as well as making her feel better about her post-pregancy body. Along those lines, it is very important for her to find time for herself, to go see a movie, get together with a friend, or have a pedicure. Along those lines, it’s important not to feel that asking for help from family and friends means you can’t cope with being a mother. Your wellbeing is essential for you, your partner and your baby.

If you’re a new mother with postpartum depression, take comfort in the fact that you’re not alone, and there is treatment that can bring you and your life back to normal. You will be able to enjoy this new life and your baby, and regain the closeness you had with your partner.