Approximately 10-15% of women will experience mood symptoms that meet criteria for a Major Depressive Episode during the postpartum period. However, as many as 50% of women may experience some level of depressive symptoms during the postpartum period. Recent evidence suggests that even depressive symptoms that do not qualify for a diagnosis of postpartum depression [...]

It is well established that women are at increased risk for developing depression compared to men.  It has been hypothesized that this vulnerability to depression may be hormonally mediated, and several longitudinal studies have documented an increased risk of depressive symptoms during perimenopause or the menopausal transition.  Based on the results of two prospective cohort [...]

There have been multiple studies suggesting that depression during pregnancy increases the risk for preterm labor.  Most studies do not attribute this increase in risk to antidepressant exposure, but to the effects of the depression itself.  The mechanism is believed to be related to increased levels of corticotropin releasing hormone (CRH) which is triggered by [...]

Recent changes expanded the scope of mental health parity in the Commonwealth of Massachusetts, which requires insurance companies to cover specified diagnoses on a “nondiscriminatory basis”. This means that copayments, deductibles, coinsurance, unit of service limits- such as hospital days and outpatient visits, and/or annual or lifetime maximums are no greater for mental disorders when [...]

Ms. A is a 27-year-old woman who is seven weeks pregnant and is currently taking duloxetine (Cymbalta).  She has a history of recurrent major depressive disorder (MDD) and has had a good response to duloxetine at 60 mg per day.  She has had four previous episodes of major depressive disorder (most untreated) and has been [...]

While many women who smoke successfully quit smoking during pregnancy, most of these women return to smoking within 12 months of delivery.  Several studies have suggested that certain factors may increase the risk of postpartum relapse, including unwanted pregnancy, multiparity, and stressful life events.  Two recent studies indicate that postpartum depressive symptoms may also increase [...]

About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus.   A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.
This study examined sleep patterns in 18 healthy, full-term infants [...]

Women with bipolar disorder are at increased risk for recurrence of illness during pregnancy.  Therefore, many women with bipolar disorder elect to continue treatment with medications during pregnancy after weighing the risks and benefits of various treatment options with their physicians.  Lamotrigine (Lamictal) is an anticonvulsant used to treat bipolar disorder. While the safety data [...]

Several weeks ago, the U.S. House of Representatives passed the Melanie Blocker Stokes MOTHERS Act by a significant bipartisan minority.  The bill is now off to the Senate, where it sits in the Health, Education, Labor and Pension committee awaiting markup.
While the bill was passed in the House and has gained the support of many organizations [...]

Maguire and Mody’s report, GABAA R Plasticity during Pregnancy: Relevance to Postpartum Depression, in the July 2008, Neuron, provides evidence that an abnormal Gamma-aminobutyric acid (GABAA) receptor subunit in pregnant mice may be a useful model for postpartum depression.  The report describes how GABAA receptors, specifically, the delta-subunit-containing GABA receptor, are a preferred target for [...]

The risk of depression after removal of both ovaries (also called bilateral oöphorectomy or surgical menopause) is a major factor for women to consider when they confront medical problems that require removal of the uterus (called a hysterectomy).  Many women are advised to consider having their ovaries removed when they are having the uterus removed.  [...]

Most obstetricians are now familiar with the potential for what has become known as neonatal distress syndrome (or “adaptation” syndrome) following third trimester exposure to SSRIs.  Some patients still worry about the possibility of their baby developing neonatal distress syndrome, especially if anything unusual happened during the post-delivery experience of an earlier pregnancy.  Women may [...]

Parental use of physical punishment early in childhood may be associated with subsequent maladaptive behaviors such as child aggression and impaired social information processing. There are links between certain childhood behaviors and risk for parental use of physical punishment, although cause and effect are difficult to establish with these associations.  Higher rates of physical punishment [...]

Mood disorders and symptoms during pregnancy and the postpartum period are not uncommon and affect women across the world.  In spite of relatively high rates of depression among childbearing women, there are often inadequate resources for treatment, particularly in poorer countries. In countries lacking resources, health care is often managed by community health workers or [...]

While some side effects such as nausea, dizziness, and headaches associated with selective serotonin reuptake inhibitor (SSRI) antidepressants tend to decrease or resolve over time, other side effects such as sexual dysfunction rarely remit spontaneously.  Treatment of sexual side effects in women is especially important when about 30-70% of patients taking antidepressants may experience sexual [...]

Happy holidays from the Center for Women’s Mental Health! As we finish up 2008, we thank you for your support and interest in our program over the past year.
The following are the ten most widely read posts from our blog over the past six months:
1. Use of Wellbutrin (Bupropion) During Pregnancy – February 20, 2007
2. [...]

Premenstrual worsening of mood is common among women with depression, but little is known about how often women with bipolar disorder experience worsening of their mood premenstrually. In a study by Payne et al. (2007), premenstrual symptoms were reported by twice as many women diagnosed with mood disorders (mixture of  Bipolar Disorder and Major Depressive [...]

Exercise plays a vital role in achieving and maintaining good health.  Along with numerous other health benefits, recent studies have shown that exercise alleviates symptoms of depression and may be useful in treating mild to moderate major depressive disorder (MDD).  A study by Dunn and colleagues (2005) examined the efficacy of exercise as a treatment [...]

A new study reported in Human Reproduction supports what many other studies have found, that untreated depression during pregnancy increases the likelihood of delivering before 37 weeks gestation.
In this prospective cohort study from by De-Kun Li and colleagues at the Kaiser Foundation Research Institute, women were screened for depression during the first trimester, at approximately [...]

While postpartum depression is common among new mothers, our ability to reliably detect this illness remains poor.  Recent studies have indicated that most obstetricians report that they screen for postpartum psychiatric problems at routine follow-up visits but typically do not use standardized instruments to assess for postpartum depression.  Unfortunately, studies which have measured the success [...]

This Friday, October 10, is Screening for Mental Health’s National Depression Screening Day, an effort to raise awareness for depression and its treatment.
The risk for depression is nearly twice as high in women as in men, and reproductive-aged women are at highest risk for developing depression.  Numerous research studies suggest that untreated depression can have [...]

Infertility and its treatment have been shown to be a trigger for both depression and anxiety.  Women with pre-existing histories of depression and anxiety who have been stable on medication may find themselves with worsening symptoms brought on by the stress involved in the process of infertility treatment.  Many women find the process an emotional [...]

A recent population-based case-control study published in the American Journal of Obstetrics & Gynecology used Washington State birth certificates linked to hospital discharge data to evaluate the association between hospitalization for a psychiatric illness before delivery and risk of postpartum suicide attempt. The study compared women hospitalized for a postpartum suicide attempt (n [...]

Selective serotonin reuptake inhibitors (SSRIs) account for approximately 62% of all antidepressants prescribed in the United States. There have been several recent studies suggesting that SSRIs may lower bone mineral density in individuals over the age of 65. However, depression itself has been shown to decrease bone mineral density and has also been [...]

St. John’s wort (Hypericum perforatum) is an herbal preparation which has been shown, in some studies, to be effective for the treatment of mild to moderate depressive symptoms. St. John’s wort is now one of the most commonly used herbal products in the United States and is widely used in Europe.
Despite the prevalence of [...]

Depo-Provera (DMPA), also known as the birth control shot, is a highly effective form of contraception that lasts for 3 months, and thus requires only 4 injections per year. DMPA contains a long-lasting form of depot medroxyprogesterone acetate that works as a contraceptive agent by preventing the ovaries from releasing an egg each month. [...]

Recently, the Massachusetts House of Representatives passed the Mental Health Parity House Bill 4423, which mandates that insurers and government programs cover mental health in the same capacity that they cover physical health. The Bill was introduced by Representative Ruth Balser (D-Newton).
This bill builds on the first Mental Health Parity House Bill (2000) which [...]

We commonly see women in our consultation service who have histories of depression and are planning pregnancy. They frequently have questions about alternative treatments for depression while pregnant. Given that many women are taking omega-3 fatty acids prior to pregnancy, the question arises whether they should discontinue them during pregnancy. An additional question [...]

While many studies have looked at the impact of postpartum depression in mothers on their children, there is very limited data on postnatal depression in the fathers and the potential impact it may have on their children.
Researchers at the University of Oxford recently examined predictors of postnatal depression in the fathers and studied the link [...]

It has been postulated that psychological stress in the mother, if present at a critical time of brain development, can permanently alter a child’s response to stress and may have long-term negative consequences.  In response to stress, blood flow to the uterus is restricted and the fetus receives fewer nutrients, which may result in lower [...]

While genetic factors are clearly important in determining a child’s risk for attention deficit hyperactivity disorder (ADHD), recent studies have investigated the link between exposure to certain maternal behaviors during pregnancy, such as smoking and alcohol use, and the risk of developing behavioral problems related to attention deficit hyperactivity disorder in childhood. While multiple studies [...]

Many women have concerns about the side effects of oral contraceptives (birth control pills). Potential side effects include bloating, breast tenderness, and weight gain. In addition, some women may experience depression or mood swings, side effects that may influence a woman’s decision to start taking a birth control pill, particularly if she has [...]

In 2006, GlaxoSmithKline (GSK) elected to change product label warnings for the antidepressant paroxetine (Paxil), advising against the use of this drug by women who are pregnant. This decision was based on preliminary studies which suggested an increase in the risk of cardiovascular malformations among infants exposed to paroxetine in utero. A recent [...]

Previous studies have linked postpartum depression (PPD) to numerous risk factors, including depression during pregnancy, a history of depression prior to pregnancy, as well as marital problems, recent stressful events, and inadequate social supports.
Research conducted at the University of Utah in Salt Lake City now suggests that obesity may place women at increased risk of [...]

Over the past few years, multiple reports have raised questions regarding the safety of selective serotonin reuptake inhibitor (SSRI) antidepressants during pregnancy. Chambers and colleagues reported that exposure to SSRIs late in pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). In the general population, PPHN affects about [...]

Depression during pregnancy is common. While concerns have been raised regarding the potential teratogenic and long-term neurobehavioral effects of psychotropic drug use during pregnancy, what is often overlooked is the fact that untreated maternal depression may also put the unborn baby at risk.
Maternal depressive symptoms during pregnancy have been shown to be associated with a [...]

Epidemiologic studies suggest that about 10% to 15% of women suffer from clinically significant depressive symptoms during pregnancy. Little is known, however, about the prevalence of depression among women with high risk pregnancies. A recent study published online in the Journal of Clinical Psychiatry suggests that this population may be at significant risk for [...]

Seeking women between 18-45 with PMS who have been diagnosed with depression. If you are between 18 and 45 and:

Suffer with PMS

Currently being treated with an antidepressant

You may be eligible for a research study at Massachusetts General Hospital evaluating how a birth control pill helps with premenstrual mood symptoms. Women who participate will receive study [...]

Electroconvulsive therapy (ECT) is one of the most effective treatments for depression, with response rates that are consistently higher than those observed in clinical trials of antidepressants. Furthermore, ECT may be more effective than medications for treatment-refractory depression. The American Psychiatric Association (APA) recommends ECT for patients who have had previous positive response [...]

Although pregnancy has often been concerned a time of emotional well-being, several recent studies have indicated that women are vulnerable to depression during pregnancy. Analyzing data from the Kaiser Permanente Northwest HMO, researchers assessed the prevalence of depression before, during, and after pregnancy in a group of 4,398 women with pregnancies ending in a [...]

Vagus Nerve Stimulation, or VNS, has been available for the treatment of epilepsy since 1997 and was approved by the FDA for the adjunctive treatment of refractory depression in 2005. VNS relies upon the use of a surgically implanted device which delivers periodic stimulation to the vagus nerve. How VNS therapy works is [...]

Both antidepressant medications and cognitive therapy have been shown to be effective for the treatment of depression; however, the question remains as to whether one treatment is preferred over the other. Subjects enrolled in The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (men and women with major depression, ages 18-75) were initially treated [...]

Most women experience some degree of sleep disturbance during pregnancy, and for a significant number of women sleep disruption may be quite severe. There are many different causes for sleep disturbance during pregnancy, and choosing the appropriate intervention relies on an accurate diagnosis of the problem.
Certain sleep disorders, such as restless leg syndrome and [...]

Depression is common during pregnancy, affecting 10% to 15% of women. While psychotherapy is an attractive option for the treatment of depression during pregnancy, all women do not respond to this intervention and many require pharmacotherapy. Thus far, no antidepressants have yet been approved by the FDA for use during pregnancy. Although data accumulated over [...]

The transition to menopause has typically been considered a time when women may be more vulnerable to mood changes. There have been inconclusive data, however, as to whether women with no lifetime history of depression transitioning to menopause are at increased risk for developing an episode of major depression.
In a recent study, Drs. Lee Cohen [...]

While pregnancy has traditionally been considered a time of emotional well-being, recent data indicate that about 10% to 15% of women experience clinically significant depressive symptoms during pregnancy. Furthermore, women with a history of major depression appear to be at high risk for recurrent illness during pregnancy particularly in the setting of antidepressant discontinuation. In [...]

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 [...]

Over the past 15 years, multiple studies have addressed the reproductive safety of the selective serotonin reuptake inhibitors (SSRIs). Data on the overall teratogenicity of SSRIs come from relatively small cohort studies and larger international programs, and they have cumulatively supported the reproductive safety of fluoxetine (Prozac) and certain other SSRIs. However, several recent studies [...]

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:
Of the 101 women studied, nearly [...]

Many women imagine new motherhood as a time of total fulfillment, days filled with mother-infant bonding and boundless joy. In reality, however, many women experience significant mood changes following childbirth. Between 50 and 85% of new mothers experience a brief postpartum period of tearfulness and anxiety, termed the “maternity blues.” But some 10 to 15% [...]

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 [...]

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Non-pharmacologic interventions, including interpersonal psychotherapy, have been shown to be effective for the treatment of PPD. In addition, several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) and the serotonin norepinephrine reuptake inhibitor venlafaxine (Effexor). In [...]

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 [...]

Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. Although it is difficult to reliably predict which women in the general population will experience postpartum mood disturbance, it is possible to identify certain subgroups of women who are more vulnerable to postpartum affective illness. Women who have [...]

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 [...]

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 [...]

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) sertraline, fluoxetine, and fluvoxamine for the treatment of this disorder. In a recent report, Cohen and colleagues have demonstrated the efficacy of venlafaxine for the treatment of [...]

Women who take antidepressants for their depression must make a difficult decision when they plan to become pregnant. Should they continue their medication during pregnancy? Or should they stop? Although [...]

Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression [...]