Pregnancy and depression

During pregnancy, up to 70% of women experience depressive symptoms and 10% to 16% fulfill the DSM-IV diagnostic criteria for MD.[37] These prevalence rates are very similar to those in the general population, suggesting that pregnancy per se does not increase the risk of depression. A large prospective controlled study evaluated 182 pregnant and 179 nonpregnant women using Research Diagnostic Criteria for major and minor depression.[38] The rates of depression were equal in both groups, again suggesting that pregnancy does not affect the risk of depression.


In women from the second trimester through 9 weeks postpartum, the highest level of depressive symptomatology occurred at weeks 34 to 38 of gestation. As shown in Table 5, several risk factors for depression during pregnancy have been identified. Various medical disorders, such as anemia, gestational diabetes, and thyroid dysfunction, may also contribute to depressive symptoms in pregnancy.


Management of MD during pregnancy may include nonpharmacologic interventions, such as cognitive therapy or electroconvulsive therapy (ECT), and/or antidepressant medications. ECT is a relatively safe and effective treatment for MD in pregnant women, particularly in high-risk situations, such as mania and psychotic depression.[40,41] Pharmacologic interventions mainly include the use of antidepressant agents.


A meta-analysis failed to find any evidence for teratogenicity for antidepressants during pregnancy.[42] Recurrence rates for patients with MD during pregnancy are estimated to be as high as 50% within 6 months following discontinuation of antidepressant treatment.[43,44] Therefore, antidepressant prophylaxis in these patients may be reasonable. Adjustment of antidepressant dosages during pregnancy may be needed, because antidepressant levels have been reported to decrease during pregnancy, possibly as a result of pregnancy-associated altered volume of distribution.

Why women are more depressed?

Biologically, the hypothalamic-pituitary-adrenal (HPA) axis is the part of the nervous system that regulates levels of cortisol and other hormones in the stress responses of both males and females. Some researchers have suggested that women are more likely to have a dysregulated HPA stress response. This dysregulation may consequently make females more prone to becoming depressed in response to stress.


Adolescent females and adults also appear more likely than their male counterparts to cope with stress inwardly rather than relieving themselves of the distress outwardly, research shows. Depression can and should be treated with psychotherapy, medication when appropriate, or changes in the affected person’s environment, Nolen-Hoeksema said. “Fortunately, depression can be reduced by targeting several different biological, social or psychological problems a woman might have,” she added.


What the hell do ANY of you bitches have to be depressed about in our matriarchal society? Especially you adolescent bitches? Don’t you know that “sisterhood is powerful”? Don’t you see how society panders to you at the expense of males? Don’t you know that “there’s never been a better time to be a girl”? Go out and play soccer or something. But actually, I would rather that you simply remained depressed. MAN, it makes my day to find out how unhappy females are! I never thought that I would ever have occasion to say this Women who “attempt suicide” are expecting to get sympathy and attention for themselves whereas a man who suicides generally does so to spare others any trouble over him.


Finally, don’t commit a Pargism by confusing higher rates of *reporting* depression with higher rates of depression. In fact, people who suffer but _cannot express it_ are suffering more deeply. They need more help, not less. Isn’t it bad therapy to identify _only_ the woman as a victim? Yes. But it’s good politics. Why? Singling out the woman allows us to make her feel special. But special as what? Special as a victim.

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Help for my depressed daughter

Emily felt equally helpless when her parents were each struck down by illness. In 1997 her mother, who is 60 this month, was seriously ill after contracting amoebic dysentery while filming in Zimbabwe and the following year her father, now aged 69, had a major heart attack. ‘When Mum was really ill I think she realized for the first time exactly what I had been going through. She was so fatigued she wondered if she would ever get better again and I felt terrible because I couldn’t help her,’ says Emily.


‘It was a real strain for Dad supporting us both, and then when he had his heart attack, it was a terrible shock.’ However, no matter how much she loved her parents, Emily knew subconsciously that her depression was somehow linked to the protective, cotton wool existence her mother and father had lovingly built around her. ‘It was me who decided to go into hospital that last time, as an in-patient rather than an outpatient, although I don’t think I even admitted to myself the real reason,’ says Emily, who insisted she made her own way there by taxi.


‘I was scared about going in there because I thought it would be full of loonies, but the minute I arrived I felt wonderful. They put me on a ward with girls my own age and for the first time in years I felt like my own person – independent. It was almost as if I’d left home to go to college, it was very exciting. Every day I was doing art and drama therapy, assertiveness training, and taking part in discussion groups. ‘I remember one Sunday the father of one of the girls smuggled in a copy of The Blair Witch Project and we sat around on bean bags being scared out of our wits.


It felt like one of those adolescent sleep-over parties. It was something I’d never experienced before and it was so liberating. From the moment I went into hospital I felt phobic about going home. It wasnt that I didn’t love my parents, I loved them enormously, but our house held so many unhappy memories for me. At home I felt like a little vulnerable china doll and I didn’t want to feel like that anymore’.

The anxiety disorder education program

The Anxiety Disorders Education Program will build upon NIMH’s previous education efforts through the Panic Disorder Education Program and the Depression/Awareness, Recognition and Treatment (D/ART) program, which together have reached millions of people with information about panic disorder and depression. The program, which will target members of the public, primary care and other medical professionals, and mental health professionals, will incorporate messages about the major anxiety disorders and their co-occurrence with depression, alcohol and drug abuse, and other mental disorders.


Strategies in the new program will be based upon extensive audience research with people with anxiety disorders, their families, and health professionals, and incorporate the theme line, “Anxiety Disorders. Frightening. Real. Treatable.” Educational components will include media relations, public service announcements, partnerships with professional and voluntary organizations, worksite education, professional seminars and exhibits, an NIMH anxiety disorders Web site, and outreach to minorities and youth.


Brief Facts About Anxiety Disorders: Panic Disorder – Characterized by panic attacks, sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying. Obsessive-Compulsive Disorder – Repeated, intrusive and unwanted thoughts or rituals that seem impossible to control.


Post-Traumatic Stress Disorder – Persistent symptoms that occur after undergoing a traumatic experience such as war, rape, child abuse, natural disasters or crashes. Nightmares, flashbacks, numbing of emotions, depression and feeling angry, irritable, distracted and being easily startled are common. Phobias – Extreme, disabling and irrational fear of something that really poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives.


Generalized Anxiety Disorder – Chronic, exaggerated worry about everyday routine life events and activities, lasting at least six months. Almost always anticipating the worst even though there is little reason to expect it; accompanied by physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.

Depression is not only dependant to your genetics

As the FAME 2000 International Fibromyalgia Conference was nearing a close last month in Los Angeles, one of the presenters said: “Given the amount of research that shows physical abnormalities in fibromyalgia, anyone who still believes this illness is ‘all in your head’ should have their head examined!” Indeed, despite increasing research distinguishing Fibromyalgia Syndrome (FMS) and Chronic Fatigue Syndrome (CFS) from psychiatric disorders, the role of psychological factors is still being hotly debated.


Dr. Muhammed B. Yunus, M.D., one of the presenters at FAME 2000, has been researching the clinical characteristics of FMS for over a decade. Many of his published studies have challenged the notion that this syndrome is nothing more than a problem of stress, anxiety, or depression. He argues that while psychological factors may aggravate symptoms, they also camouflage the real cause of FMS, which he believes involves aberrant neurotransmitter mechanisms. Yet some doctors still cling to the belief that FMS/CFS is psychological in nature.


Dr. Yunus calls this “Disturbed Physician Syndrome” (DPS). Says Yunus, “DPS people are trouble because of their preoccupation that FMS patients are psychologically disturbed. It is not the FMS patients who are disturbed, it is the physicians who are psychologically disturbed because they ignore the data, and whatever data there is, they manipulate it to say what they want it to say.” In fact, psychologist Phyllis Chesler, who suffers from CFS herself, points out that the process of struggling for acknowledgment and understanding is, in itself, highly stressful.


She writes, “I believe people with poorly understood illnesses are subjected to a level of stress that’s more than a healthy person can take.” She notes that rheumatoid arthritis and multiple sclerosis were initially seen as manifestations of psychological stress, but are now recognized as bona fide physical diseases. Research is increasingly showing that CFS and FMS are real, not psychosomatic. Findings such as abnormal levels of brain chemicals have been discovered in people with these illnesses. While many unanswered questions remain, this research may eventually lead to the discovery of an underlying cause (or causes), as well as promising treatments.

Relationship between CFS and Depression Studied

A recent study set out to identify the relationship between CFS and depression. Researchers at Edinburgh University in the UK evaluated brain scans from 30 people with CFS, 12 diagnosed with depression, and 15 healthy subjects. They concluded that both CFS and depression may be neurological and due primarily to increased blood flow in the right thalamus, which is responsible for processing sight, sound, touch, and more importantly, pain. However, there is one detail that separates CFS from depression – CFS sufferers also have an increase in blood flow to the left thalamus.


The researchers believe that this lack of activity in the left thalamus may have something to do with the fact that depression alone involves more psychological problems than does CFS. Past studies have indicated that the onset of CFS is not related to depression, and that increased depression can reactivate latent viruses, decrease the body’s immune response, and stimulate the production of certain cytokines linked to some CFS-like symptoms.


Dr. Jacob Teitelbaum, author of From Fatigued to Fantastic, states “Although many CFS patients feel depressed because of their illness, only a small minority have depression causing their fatigue. Findings from this most recent study may bring a sense of relief to CFS sufferers who often have to convince people that their disorder is real and that their symptoms are not just in their minds. The discovery of the increased blood flow unique to CFS patients may potentially lead to the discovery of additional physical changes responsible for developing CFS.

Cerebral perfusion in CFS + Depression

These researchers measured regional cerebral perfusion at rest using high resolution single-photon emission tomography (SPET). The subjects were in 30 patients with CFS (CDC criteria ‘94) 20 with major depressive disorder (MDD) and 15 healthy controls. Other measures included Hospital Anxiety and Depression Scale (HAD), the Hamilton Depression Rating Scale (HAM-D), and the Chalder Fatigue Scale. Fourteen of the patients were taking some sort of medication, mostly antidepressants.


Both the CFS and depression patients had increased blood flow in the right thalamus. The CFS patients also showed increased perfusion in the left thalamus but there was no reduction in prefrontal perfusion as seen in the depressed group. The researchers conclude that abnormal cerebral perfusion patterns in CFS subjects who are not depressed are similar but not identical to those in patients with depressive illness.


Thalamic overactivity may be a correlate of increased attention to activity in CFS and depression; reduced prefrontal perfusion in depression may be associated with the greater neuropsychological deficits in that disorder. They did not measure blood flow in the brainstem, so there was no opportunity to replicate the findings of Costa et al 1995 (SPET) and Tirelli. et al 1998 (PET) . The hypoperfusion which these papers documented has not been found in any other patient group. What baffles me is that the abstract of this report notes that their CFS patients “were not depressed” (according to the HAD and SADS) but the discussion on limitations refers to this group as having “high levels of depression”.


Given the earlier comments plus the HAM-D scores, this is a surprising statement. Can anyone enlighten me? Another oddity is the suggestion that the thalamic overactivity in CFS and depression “reflect” increased attention to motor and cognitive tasks. This may well be true but the abstract notes that the scans were completed at rest, not while performing cognitive tasks. Why should increased blood flow to the thalamus reflect an activity which the patients were not engaged in? And if they had performed tests just prior to the scans, why did the researchers not analyse the data for correlations

Harm that depression medication can cause

These molecules won’t be stacked in your brain forever and you dopaminic(yes dopaminic) receptors won’t be blocked for your entire life. Yes maybe it will take months or even years but you’ll get your life back again and your spirit will be stronger than ever. This is a short conversation betwean me and my ex doctor: ME :I have read that a lotof people have the same problems as mine with the SSRIs. DOCTOR :yes but it is not proved that such drugs are so dangerous for some people.


ME:If it isn’t proved this means that nobody knows how they work, and if it is not known how they work, how do they know that such meds help people?! DOCTOR:Trust me I know what I’m doing. ME:sure. END of conversation. Well I finally made it back to the computor to write this as I have been puking my guts out trying to come off this crap. I have been on it for three years and can’t get off it. At least now I know for sure what it is. Maybe that will help me this time, that is if I can sleep or not beat the shit out of someone. I was on 60mg no body told me about withdrawals.


I even had a doctor say I was just going through extreem depression because there is no withdrawals from Paxil. They don’t even tell the freakin doctors. This shit is awful. Sorry for any mispelled words as my head is throbbing. Time to lay down folks that’s all the energy I have. Good luck to all we need it. Kevin Ray Why in the world would you let any human being suffer this way? Someone goes to you for help and ends up going thru hell. Is money that important to you people that you will intentially let so many suffer? You don’t have a HEART. My husband and children are suffering because you didn’t give any warning about Paxil withdrawal. Burn in Hell

Frustrated over the drug company that manufactures depression medicines

I’m seriously worried about some of the things I am seeing on here. I know we are all frustrated with this drug and the company that makes it, but threatning to blow up the building? No wonder the Dr’s put some of us on drugs so easily. If we are going to lose control without some substance, there are deeper problems than just the side effects. People, There is hope. I’ve spent this weekend drinking tons of water and just taking it easy trying to regain enough composure for another week at work.


You cannot let this take control of you. You can do it, don’t let your emotions go ballistic. Control is the key. If you stay in control, you’ll get through this the way I am. Some one should definitely be held responsible for allowing so many people to take Paxil without proper warning of the severe withdrawal! I find it hard to believe that it was ever approved by the FDA. It has done much more harm than good! Those of us who have had to experience this multitude of physical and psychological problems due to taking the Paxil DESERVE some compensation. It will not take away the pain we have been through and continue to go through every minute of the day, but someone NEEDS to pay!!! I’m still waiting to know what the long-term effects of usage will be. Seems to me that electric shocks, vertigo, severe memory loss, etc. definitely indicate some type of brain damage!


As punishment, each and every one of you responsible for the manufacturing, releasing and promoting of this drug should be made to take massive quantities of it, then cut off abruptly so that you may too know how truly horrible it is!! I have been on Paxil 30mg for about 4 years due to severe Panic Attacks that consequently induced depression. Eventhough Paxil helped tremendously, doctors and the general public are not aware of its side effects while you are on it and when you come off it.


I have spoken to many people on it, all have experienced significant weight gain of 25 pounds or more. Severe sexual disfunction-unable to reach orgasms in both men and women. A general apathy over things-you simply feel desensitized. A few have lost marriages/relationships as a consequence of these symptoms thus inducing depression again. I have attempted to

Depression — Book List TEST

This posting contains a list of books compiled from the personal recommendations of the members/readers/participants of the Walkers-in-Darkness mailing list, the newsgroup, and the Depression Recovery Network support group on AOL. Patty Duke’s very personal account of her struggle with manic-depression. Duke writes every other chapter, while Hochman writes about the more clinical aspects of manic-depression.


A detailed overview of the history, causes and treatment of mood disorders. Offers stey-by-step, self-help guidance for taking responsibility for your own wellness; using charts to track and control your moods; find appropriate mental health professionals; build a support system, increase your self-confidence and self-esteem; using relaxation, diet, exercise and full-spectrum light to stabilize your moods; and avoid coditions that can exacerbate you moods swings.


“An essential tool to assist people struggling with depression and mania to gain insight to actively enter a lifelong journey of healing and wellness.” A psychiatrist explores some of the implications of anti- depressants, and especially of Prozac’s unusual effects on the personality. Kramer also discusses the recent research on depression, as well as several other issues which seem linked to depression. Good basic text on the various aspects of depression and manic/depression.


Considered by some to be a “classic” in the field. The writings of depressives, for both depressives and those who need to understand them. Shervert Frazier, M.D., former director of the National Institues of Mental Health says: “A ground breaking book that…reveals the impact of depression on the lives of everyday people. This little book is must reading for sufferers, those associated with depression, and mental health professionals”