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Treatment available for women

by khsaue01 last modified Apr 02, 2009 02:33 PM

pregnancy | postpartum | menstrual | menopause | treatment

Medication

There are many effective, well-tolerated antidepressant medications. Antidepressant medications are an essential part of treatment for women who are moderately to severely depressed.  There are medications that are considered to be relatively safe in pregnancy as well as in women who are breastfeeding.  Several studies also indicate that antidepressants can be helpful in the treatment of premenstrual dysphoric disorder as well.

Hormone Replacement Therapy

This treatment can be useful for women who are struggling with menopause or perimenopausal symptoms. Some clinical studies indicate that estrogen may help with depression in the early stages of menopause. Although the usefulness of estrogen as an antidepressant has not been well established, it may be an important adjunct to other treatments for depression. Be sure to discuss the benefits and risks of hormone replacement therapy with your health care provider, including the potential benefits to your mood.

Get a physical examination

A thorough physical examination is important to rule out any physical illnesses that may cause depressive symptoms. As you get older, you may be more likely to develop some of these physical health problems. Certain medications can cause symptoms that mimic depression. Be sure to review all medications that you are taking with your health care provider.

Therapy

Therapy involves talking with a trained professional (psychologist, psychiatrist, clinical nurse or social worker) on a short term (12-20 weeks) or a long-term basis and can take many forms. One type of therapy, Cognitive Behavioral Therapy (CBT), offered at the University of Louisville Depression Center, targets negative thoughts and behaviors that tend to worsen depressed mood and teaches better ways of thinking and behaving. Some studies suggest that women with depression are more likely to engage in excessive rumination. This increased pondering and brooding causes the length and severity of depression. Therapy can help you address these negative ruminations.

Alternative medicine, herbal remedies and dietary supplements

There has been rising interest in the use of herbs and dietary supplements for the treatment of depression. St John's Wort (hypericum perforatum) has been the most common of these. However, scientific studies of these alternative forms of treatment have so far been short-term and not well controlled. There is no uniformity of dose or amounts and types of ingredients because the Food and Drug Administration does not regulate them. Be sure to tell your health care provider if you are taking an herbal or dietary supplement. Some of them may negatively interact with antidepressant medication or other medications you are taking.

Is there anything else that I can do?

Along with professional treatment, there are several other things that you can do to help yourself feel better.

Support

It is not uncommon for women in all stages of life to have double care-taking responsibilities – whether it be preparing for your first child, caring for the children you already have, or caring for elderly relatives. It is very important that you get support for yourself and communicate your needs to others. Ask for help with housekeeping, preparing meals and other daily tasks. Don't feel you have to do it all yourself.

Exercise

The benefits of exercise in depression are well documented. Be sure to discuss any changes you make in your exercise routine with your health care provider. Exercise helps treat depression by releasing the body's mood-elevating compounds, reducing the depression hormone cortisol, providing perspective on life, providing a feeling of accomplishment, enhancing self-esteem, and increasing levels of serotonin (a neurotransmitter found to be key in the development of depression). It doesn't matter what you do as long as you do something physical for 20 to 30 minutes three times a week or more. Even exercising as little as 10 minutes a day has been found to have beneficial effects. Walking is perhaps the most accessible form of exercise because it costs nothing and you can start immediately.

Stress Management

Depression can also be made worse by stress. Life changes, particularly loss and interpersonal role transitions, have been associated with depression in women. Identify stressors that you are putting on yourself (trying to be "perfect", doing too much). Set priorities and let unnecessary tasks wait.

Promote sleep

Inadequate sleep can make depression worse. Take care to keep your sleep cycle regular by going to bed and waking around the same time. Develop relaxing bedtime rituals such as reading or a warm bath. Take time to rest during bedtime hours, even if you aren't asleep. See our article “Getting a Good Night’s Sleep.

Dietary changes

Eating a well balanced diet and regularly scheduled meals is important. Decreasing refined sugar, caffeine, alcohol, and chocolate may help. Use of calcium, B vitamins (B6), and vitamin D may also decrease symptoms.

Spend time with others

Depressed women often withdraw from others because they mistakenly feel they would not be good company. Being with others is another way to gain perspective, which helps with the symptoms of depression. If you live alone, it is especially important to establish contact with others. Consider joining a support group for others experiencing problems with depression.

Make time to do what you enjoy

Depressed women sometimes temporarily lose the ability to enjoy themselves. Avoiding enjoyable activities only makes this worse. Continue doing pleasurable activities even if you don't feel like it. You will soon find that you have come to enjoy yourself again, at least for short periods.

Give yourself a break

You will feel like yourself again and better able to handle everyday pressures. Be realistic about the demands and expectations you make on yourself.

References:

Coyne JC, Pepper C, Flynn HA: The significance of prior history of depression in two populations. Journal of Consulting and Clinical Psychology 67(1):76-81, 1999

Hay AG, Banckroft J, Johnstone EC: Affective symptoms in women attending a menopause clinic. Br J Psychiatry 164(4):513-516, 1994

Rubinow DR, Schmidt PJ, Roca CA: Estrogen-Serotonin Interactions: Implications for Affective Regulation. Biol Psychiatry 44:839-850, 1998

Schmidt PJ, Rubinow DR: Menopause-related affective disorders: A justification for further study. Am J Psychiatry 148:844-852, 1994

Schwingl PJ, Hulka BS, Harlow SD: Risk factors for menopausal hot flashes. Obst Gyn 84:29-34, 1994

Weissman, M.M., Markowitz, J.C., Klerman, G.L. (2000). Comprehensive Guide to Interpersonal Psychotherapy. New York: Basic Books

Adapted with permission from the University of Michigan Depression Center Web site.

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