Depressive Disorders - MGH Center for Women's Mental Health

New Research from the CWMH: Relapse of Major Depression during Pregnancy

Over the last decade, the number of reproductive-age women treated for depression has increased significantly. Given the incomplete information available regarding the reproductive safety of many antidepressant medications, many women choose to discontinue pharmacologic treatment during pregnancy. However, several studies estimate that about 10 to 15% of women suffer from depression during pregnancy (O'Hara et al, 1990; Evans et al, 2001). A recent study from the Center for Women's Mental Health indicates that the risk for depression is particularly high among women with histories of major depression (Cohen et al, 2006).

By MGH Center for Women's Mental Health|2020-11-26T08:41:14-04:00April 22nd, 2006|Depressive Disorders, Outcomes, Prevalence & Risk Factors, Psychiatric Disorders During Pregnancy, Research at CWMH|Comments Off

Escitalopram for Menopause-Related Depression and Vasomotor Symptoms

Every year more than 1.7 million women in the United States enter into menopause. During this time of hormonal fluctuations it is typical for women to experience hot flashes, night sweats and sleep disturbance. More recently, studies have identified an association between menopausal transition and an increased risk for developing depressive symptoms (Harlow et al., 2003; Freeman et al., 2004). It is not clear how physicians and patients should deal with menopause-related physical and emotional symptoms. While hormone therapy effectively treats insomnia and hot flashes, the results have been mixed in treating mood and anxiety symptoms. Moreover, the safety of long-term use of hormone therapy is not known.

By MGH Center for Women's Mental Health|2015-07-23T14:19:33-04:00December 30th, 2005|Depressive Disorders, Medication, Menopausal Symptoms, Treatment, Vasomotor Symptoms|Comments Off

Perimenopause: A Time of Risk for Depression

More than 50 percent of women experience some perimenopausal symptoms, including hot flushes, night sweats, and sleep disturbance, before reaching the menopause. A recent article from Aetna Intelihealth notes that many women may also experience depression. In a study form Dr. Claudio Soares, women with clinically confirmed perimenopause were interviewed:

By MGH Center for Women's Mental Health|2015-07-22T15:15:13-04:00October 22nd, 2005|Depressive Disorders, Menopausal Symptoms, Prevalence & Risk Factors|Comments Off

Neonatal Symptoms After In Utero Exposure to SSRIs

The increasing number of reproductive-age women taking antidepressants has raised concerns about the potential risks of using these medications during pregnancy. Literature accumulated over the last decade supports the use of certain selective serotonin reuptake inhibitors (SSRIs) and the older tricyclic antidepressants during pregnancy, indicating no increased risk of congenital malformation in children exposed to these medications during the first trimester of pregnancy. Still, questions remain regarding the purported risk for "toxicity" in newborns exposed to antidepressants around the time of labor and delivery. These concerns are not new. Twenty years ago, case reports suggested that maternal use of tricyclic antidepressants near the time of delivery was associated with problems in the newborn such as difficulty feeding, restlessness, or jitteriness.

By MGH Center for Women's Mental Health|2015-07-22T15:28:43-04:00July 27th, 2005|Anxiety Disorders, Child Outcomes, Depressive Disorders, Neonatal Symptoms, Pregnancy & Medications|Comments Off

Oral Contraceptives for the Treatment of Premenstrual Mood Symptoms in Women with Depression

About 3-5% of women of reproductive age suffer from premenstrual dysphoric disorder (PMDD), where they experience depressive symptoms, anxiety or irritability during the last one to two weeks (the premenstrual phase) of their menstrual cycle. In addition, many women who suffer from depression, including those who have been effectively treated with an antidepressant, report worsening of their depressive symptoms during the premenstrual phase of the menstrual cycle. Although this may be a consequence of sensitivity to fluctuating hormone levels, little is known about the efficacy of hormonal interventions, including oral contraceptives (OCPs), in the treatment of premenstrual worsening of depressive symptoms.

By MGH Center for Women's Mental Health|2016-03-28T13:51:33-04:00June 14th, 2005|Depressive Disorders, Hormone Therapy, PMS & PMDD, Treatment|Comments Off

Acupuncture for Depression During Pregnancy

Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, our understanding of how these psychotropic medications affect the developing fetus remains incomplete. For this reason, many women and their physicians would prefer to avoid the use of antidepressants during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for women who suffer from depression during pregnancy. In a recent study from Dr. Rachel Manber and her colleagues at Stanford University, the use of acupuncture is assessed in a group of pregnant depressed women.

By MGH Center for Women's Mental Health|2015-07-21T11:46:39-04:00February 14th, 2005|Alternative & Complementary, Depressive Disorders, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Infertility Treatment: A Trigger for Depression and Anxiety

While several studies have demonstrated high levels of psychological distress among women pursuing infertility treatment, few studies have assessed the prevalence of psychiatric illness in populations undergoing infertility treatment using standardized diagnostic instruments. In a recent study from Taipei Veterans General Hospital, a university-affiliated medical center in Taiwan, women attending an assisted reproduction clinic were assessed using the Mini-International Neuropsychiatric Interview (MINI) (Chen 2004) Of the 112 participants, 40.2% met criteria for a psychiatric disorder. The most common diagnosis was generalized anxiety disorder (23.2%), followed by major depressive disorder (17.0%) and dysthymic disorder (9.8%). Participants with a psychiatric disorder did not differ from those without illness in terms of age, education level, income, or years of infertility.

By MGH Center for Women's Mental Health|2015-07-21T11:30:27-04:00August 18th, 2004|Anxiety Disorders, Depressive Disorders, Infertility and Mental Health, Prevalence & Risk Factors|Comments Off

Bupropion and Breastfeeding

Data have accumulated over the last few years on the use of antidepressants in nursing mothers. It appears that all antidepressants are secreted into the breast milk; however, the amount of medication to which the nursing child is exposed appears to be relatively small. We have the most information is available for fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and the tricyclic antidepressants. In general, one should try to choose an antidepressant for which there are data to support its safety during breastfeeding. However, there are often situations where one may choose another antidepressant that has not been as well characterized. For instance, if a woman has not responded well to any of the above medications.

By MGH Center for Women's Mental Health|2015-07-21T10:41:36-04:00November 6th, 2002|Breastfeeding & Medications, Child Outcomes, Depressive Disorders|Comments Off

Light Therapy for Depression During Pregnancy

Depression during pregnancy (antenatal depression) is relatively common, affecting about 10% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, our understanding of how these psychotropic medications affect the developing fetus remains incomplete. For this reason, antidepressants are typically avoided during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for women at high risk for antenatal depression.

By MGH Center for Women's Mental Health|2015-07-20T11:00:36-04:00June 23rd, 2002|Alternative & Complementary, Depressive Disorders, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Depression and Preterm Labor

Although most people tend to think of pregnancy as a time of emotional well-being, depression is relatively common, affecting about 1 in 10 women. While there are obvious concerns related to the use of antidepressants during pregnancy and the effects of these medications on the developing fetus, less attention has focused on the impact of depression itself on the pregnancy. A recent study suggests that women with depression may be at greater risk for preterm labor.

By MGH Center for Women's Mental Health|2015-07-20T10:48:28-04:00April 30th, 2002|Depressive Disorders, Outcomes, Pregnancy Outcomes, Psychiatric Disorders During Pregnancy|Comments Off