Tuesday, February 24, 2009


Depression in Women

Here are the facts about depression in women. In the U.S. about 15 million people experience depression each year. The majority of them are women. Unfortunately, nearly two-thirds of those women do not get the help they need.

Depression in women is very common. In fact, women are twice as likely to develop clinical depression as men. And as many as one out of every four women is likely to experience an episode of major depression at some point in life.

Depression is a serious disease that can be hard to understand and diagnose. Here’s what you need to know to recognize the symptoms of depression:

What is depression?

Depression is a serious and pervasive mood disorder. It causes feelings of sadness, hopelessness, helplessness, and worthlessness. Depression can be mild to moderate with symptoms of apathy, little appetite, difficulty sleeping, low self-esteem, and low-grade fatigue. Or it can be major depression with symptoms of depressed mood most of the day, diminished interest in daily activities, weight loss or gain, insomnia or hypersomnia (oversleeping), fatigue, feelings of guilt almost daily, and recurring thoughts of death or suicide.

What are the symptoms of depression in women?

Symptoms of depression in women include:

Ø persistent sad, anxious, or "empty" mood

Ø loss of interest or pleasure in activities, including sex

Ø restlessness, irritability, or excessive crying

Ø feelings of guilt, worthlessness, helplessness, hopelessness, pessimism

Ø sleeping too much or too little, early-morning awakening

Ø appetite and/or weight loss or overeating and weight gain

Ø decreased energy, fatigue, feeling "slowed down"

Ø thoughts of death or suicide, or suicide attempts

Ø difficulty concentrating, remembering, or making decisions

Ø persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

What are the symptoms of mania in women?

Mania is a highly elevated mood that sometimes occurs with bipolar disorder. Moods in bipolar disorder swing from the lows of depression to the highs of mania. Even though mania is an elevated mood, it is serious and needs medical assessment and treatment.

The symptoms of mania include:

Ø abnormally elevated mood

Ø irritability

Ø decreased need for sleep

Ø grandiose ideas

Ø greatly increased talking

Ø racing thoughts

Ø increased activity, including sexual activity

Ø markedly increased energy

Ø poor judgment that leads to risk-taking behavior

Ø inappropriate social behavior

Why is depression in women more common than depression in men?

Before adolescence, the rate of depression is about the same in girls and boys. However, with the onset of puberty, a girl's risk of developing depression increases dramatically to twice that of boys.

Experts believe that the increased chance of depression in women may be related to changes in hormone levels that occur throughout a woman's life. These changes are evident during puberty, pregnancy, and menopause as well as after giving birth, having a hysterectomy, or experiencing a miscarriage. In addition, the hormone fluctuations that occur with each month's menstrual cycle probably contribute to premenstrual syndrome, or PMS, and premenstrual dysphoric disorder, or PMDD -- a severe syndrome marked especially by depression, anxiety, cyclical mood shifts, and lethargy.

What increases the chances of depression in women?

According to the National Institutes of Health, factors that increase the risk of depression in women include reproductive, genetic, or other biological factors; interpersonal factors; and certain psychological and personality characteristics. In addition, women juggling work with raising kids and women who are single parents suffer more stress that may trigger symptoms of depression. Other factors that could increase risk include:

Ø family history of mood disorders

Ø history of mood disorders in early reproductive years

Ø loss of a parent before age 10

Ø loss of social support system or the threat of such a loss

Ø ongoing psychological and social stress, such as loss of a job, relationship stress, separation or divorce

Ø physical or sexual abuse as a child

Ø use of certain infertility treatments

Ø use of certain oral contraceptives

Women can also get postpartum depression after the birth of a baby. Some people get seasonal affective disorder in the winter. Depression is one part of bipolar disorder.

Can depression in women run in families?

Yes. Depression can run in families. When it does, it generally starts between the ages of 15 and 30. A family link to depression is much more common in women.

How does depression in women differ from depression in men?

Depression in women differs from depression in men in several ways:

Ø Depression in women may occur earlier, last longer, be more likely to reoccur, be more likely to be associated with stressful life events, and be more sensitive to seasonal changes.

Ø Women are more likely to experience guilty feelings and attempt suicide, although they actually commit suicide less often than men.

Ø Depression in women is more likely to be associated with anxiety disorders, especially panic and phobic symptoms, and eating disorders.

Ø Depressed women are less likely to abuse alcohol and other drugs.

How are PMS and PMDD related to depression in women?

As many as three out of every four menstruating women experience premenstrual syndrome or PMS. PMS is a disorder characterized by emotional and physical symptoms that fluctuate in intensity from one menstrual cycle to the next. Women in their 20s or 30s are usually affected.

About 3% to 5% of menstruating women experience premenstrual dysphoric disorder, or PMDD. PMDD is a severe form of PMS, marked by highly emotional and physical symptoms that usually become more severe seven to 10 days before the onset of menstruation.

In the last decade, these conditions have become recognized as important causes of discomfort and behavioral change in women. While the precise link between PMS, PMDD, and depression is still unclear, chemical changes in the brain and fluctuating hormone levels are both thought to be contributing factors.

How are PMS and PMDD treated?

Many women who suffer with depression along with PMS or PMDD find improvement through exercise or meditation. For individuals with severe symptoms, medicine, individual or group psychotherapy, or stress management may be helpful.

Does depression in women occur during pregnancy?

Pregnancy has long been viewed as a period of well-being that protected women against psychiatric disorders. But depression in women occurs almost as commonly in pregnant women as it does in those who are not pregnant. The factors which increase the risk of depression in women during pregnancy are:

Ø having a history of depression or PMDD

Ø age at time of pregnancy -- the younger you are, the higher the risk

Ø living alone

Ø limited social support

Ø marital conflict

Ø uncertainty about the pregnancy

What is the impact of depression on pregnancy?

The potential impact of depression on a pregnancy includes the following:

Ø Depression can interfere with a woman's ability to care for herself during pregnancy. She may be less able to follow medical recommendations and to sleep and eat properly.

Ø Depression can cause a woman to use substances such as tobacco, alcohol, and/or illegal drugs, which could harm the baby.

Ø Depression can make bonding with the baby difficult.

Pregnancy may have the following impact on depression in women:

Ø The stresses of pregnancy can cause depression or a recurrence or worsening of depression symptoms.

Ø Depression during pregnancy can increase the risk for having depression after delivery (called postpartum depression).

What are my options if I'm depressed during pregnancy?

Preparing for a new baby is lots of hard work. But your health should come first. Resist the urge to get everything done, cut down on your chores, and do things that will help you relax. In addition, talking about things that concern you is very important. Talk to your friends, your partner, and your family. If you ask for support, you will find you often get it.

If all else fails and you're still feeling down and anxious, consider seeking therapy. Ask your doctor or midwife for a referral to a mental health care professional.

How is depression in women treated during pregnancy?

Growing evidence suggests that many of the currently available antidepressant medicines are safe for treating depression during pregnancy, at least in terms of the potential short-term effects on the baby. Long-term effects have not been properly studied. You should discuss the possible risks and benefits with your doctor.

How is postpartum depression in women treated?

Postpartum depression, or depression following childbirth, can be treated like other forms of depression. That means using medicines and/or psychotherapy. If a woman is breastfeeding, the decision to take an antidepressant must be made with her doctor.

Does the prevalence of depression in women increase at midlife?

Perimenopause is the stage of a woman's reproductive life that begins eight to 10 years before menopause. During this time the ovaries gradually begin to produce less estrogen. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the decrease in estrogen accelerates. At this stage, many women experience menopausal symptoms.

Menopause is the period of time when a woman stops having her monthly period and experiences symptoms related to the lack of estrogen production. By definition, a woman is in menopause after her periods have stopped for one year. It is a normal part of aging and marks the end of a woman's reproductive years. Menopause typically occurs in a woman's late 40s to early 50s. However, women who have their ovaries surgically removed undergo "sudden" menopause.

The drop in estrogen levels during perimenopause and menopause triggers physical and emotional changes -- such as depression or anxiety and changes in memory. Like at any other point in a woman's life, there is a relationship between hormone levels and physical and emotional symptoms. Some physical changes include irregular or skipped periods, heavier or lighter periods, and hot flashes.

How can I cope with symptoms of menopause?

There are many ways you can ease menopause symptoms and maintain your health. These tips include ways to cope with mood swings, fears, and depression:

Ø Avoid tranquilizers.

Ø Eat healthfully and exercise regularly.

Ø Engage in a creative outlet or hobby that fosters a sense of achievement.

Ø Find a self-calming skill to practice -- such as yoga, meditation, or slow, deep breathing.

Ø Keep your bedroom cool to prevent night sweats and disturbed sleep.

Ø Seek emotional support from friends, family members, or a professional counselor when needed.

Ø Stay connected with your family and community and nurture your friendships.

Ø Take medicines, vitamins, and minerals as prescribed by your doctor.

Ø Take steps such as wearing loose clothing to stay cool during hot flashes.

How is depression in women treated?

There are a variety of methods used to treat depression, including medications such as antidepressants and psychotherapy. Family therapy may be helpful if family stress adds to your depression. Your mental health care provider will determine the best course of treatment for you. If you are uncertain who to call for help with depression, check out the following list from the National Institute of Mental Health:

Ø community mental health centers

Ø employee assistance programs

Ø family doctors

Ø family service/social agencies

Ø health maintenance organizations

Ø hospital psychiatry departments and outpatient clinics

Ø local medical and/or psychiatric societies

Ø mental health specialists such as psychiatrists, psychologists, social workers, or mental health counselors

Ø private clinics and facilities

Ø state hospital outpatient clinics

Ø university or medical school affiliated programs

Sunday, February 22, 2009

Anorexia and Bulimia Nervosa

Eating Disorders Treatment, Symptoms of Eating Disorders

Eating disorders are some of the most destructive illnesses today. Although a commonly used term, the meaning is often a source of confusion for many people. Basically, eating disorders happen to people whose diet patterns have gone awry somewhere along the way and ultimately lead to eating habits that are damaging and dangerous.

Eating disorders are a very serious problem, and those suffering from them need to get the proper treatment in order to be able to resume leading normal, healthy lives. Depending on where you live and the severity of the eating disorder, there are various options available for treatment. Those suffering from severe anorexia or bulimia will most likely find an inpatient treatment most beneficial.

Eating disorders are characterized by critical disturbances in eating behaviors. A person afflicted with this problem may voluntarily resort to an unhealthy reduction in food intake or may abnormally take in more food than necessary. Feelings of guilt and extreme concern over weight or body shape likewise accompany this malady.

Driven by the compulsive need to avoid weight gain, many eating disorder sufferers consume large quantities of laxatives in order to rid the body of the food they eat. Laxatives are a readily available form of medication normally taken to treat constipation. Indeed, sufferers of bulimia and anorexia often complain about constipation and feeling bloated.

Eating disorders are not a problem with food; however it is a problem with mental health. When a person looks into the mirror, he or she does not like the way they look and think they are fat even though they are stick boney.

There are eating disorder treatment options which can be used to offset the physical and emotional damage caused by eating disorders. Although common among troubled teens, eating disorders affect women and men of all ages including small children.

Anorexics often have the feeling that calorie intake and weight is the only thing they can control in their lives. Many have very low self esteem and some even feel they don't deserve to eat. People with anorexia usually won't seek help for themselves because they fear being forced to eat and get fat. It is possible, however, for anorexia to be treated and cured.

Bulimia nervosa is an eating disorder that consists of repeated bouts of binge eating. A person who is a binge eater has an uncontrollable urge to eat excessive amounts of food. This person will believe that he or she is overweight even when they are not. Some of these people induce vomiting, also known as purging, or use laxatives or diuretics to get rid of all of the food that was eaten during binging. Other people might fast and/or exercise excessively instead.

Factors Which Cause Eating Disorders

Eating disorders is not caused by a single factor, there are many factors that can play a role in the appearance of these disorders like cultural and family pressures, emotional and personality disorders and also genetic and biological factors.

Similar personality traits like low self-esteem, dependency, and problems with self-direction are present to people with eating disorders. Specific personality disorders or behavioral characteristics that might put people at higher risk for one or both of the eating disorders have been determined by researchers.

The following personality disorders like avoidant personalities and dependent personalities mostly in anorexia and borderline and histrionic personalities mostly in bulimia and narcissism which can be present in anorexia and bulimia too have been reported by studies. Patients with bulimia or anorexia can present one of these personality traits. The more important factor in determining treatment choices may be the patient's specific personality disorders even if they are anorexic and bulimic.

Avoidant personalities are present to people with anorexia. The symptoms which characterize this personality disorder are: being a perfectionist, being emotionally and sexually inhibited, having less of a fantasy life than people with bulimia or without an eating disorder, not being rebellious, or usually perceived as always being "good", being terrified of being ridiculed or criticized or of feeling humiliated.

Behavioral and eating pattern can be developed by the person with both anorexia and avoidant personality disorder. So for some individuals the only way to obtain love is achieving perfection, with all that involves. Trouble-free and attaining some ideal image of thinness make part of the drive for perfection. In this case the individual is driven to demand nothing, including food. A sense of being even more imperfect and a renewed sense of striving for perfection precede the failure to achieve love. Anorexic patients have a total lack of self but generally people with eating disorders are not typically suicidal. Through process of not-eating they try to revenge on those whose love is always out of reach.

Borderline personalities can be present to people with bulimic anorexia. The following characteristics can be present to these people like: frantically fearful of being abandoned, unable to be alone, difficulty to control their anger and impulses, prone to idealize other people and unstable moods, thought patterns, behavior and self-images. Emotional weapons like temper tantrums, suicide threats, and hypochondriasis can be used by the people with borderline personalities for causing chaos around them. The difficulty in treating bulimia can be the severity of this personality disorder and it can be more important than the presence of psychological problems, such as depression.

The following personality traits like inability to soothe oneself, inability to empathize with others, need for admiration, hypersensitive to criticism or defeat can be present to people with bulimia or anorexia which are often highly narcissistic. Depression and anxiety disorders can be present to patients which have eating disorder but also can be present in families of these patients. It is unknown if emotional disorders, especially obsessive-compulsive disorder (OCD), are causes of the eating disorders.

About 69% of patients with anorexia and 33% of patients with bulimia have obsessive-compulsive disorder which is an anxiety disorder. It is believed that eating disorders are variants of OCD. In compulsive behavior, repetitive, rigid, and self-prescribed routines that are intended to prevent the manifestation of the obsession, may be present obsessions which are recurrent or persistent mental images, thoughts or ideas. Generally women with anorexia and OCD may become obsessed with exercise, dieting, and food. Compulsive rituals like weighing every bit of food, cutting it into tiny pieces, or putting it into tiny containers are often developed at these patients. Other anxiety disorders like phobias, panic disorder and post-traumatic stress disorder (PTSD) have been associated with bulimia and anorexia.

At people with eating disorders, especially anorexia, depression is present which is more severe in darker winter months. Also the patients with bulimia suffer from a specific form of bulimia which is worse in winter. May seems to be the peak month for suicide because the onset of anorexia appears to peak in this month. An eating disorder is rarely cured by treating and relieving depression. Social, psychologic or possibly biologic factors can cause a distorted view of one's body called body dysmorphic disorder which can be associated with anorexia or bulimia but can also appear without any eating disorder. In this case emotional disorders, including obsessive-compulsive disorder and depression are commonly to people with this disorder. A disorder in which people have distorted body images involving their muscles has been reported by experts and it is present to men which believe that are "puny" and results in excessive body building, preoccupation with diet and social problems.

Another factor which is present in triggering and perpetuating eating disorders is negative family influence. Children with insecure attachments are present in family with parents who fail to provide a safe and secure foundation in infancy. Mothers play an important role in their child's life. So mothers of people with bulimia are critical and detached and mothers of anorexics tend to be over-involved in their child's life. People with either eating disorder have parents with alcoholism or substance abuse. It seems that psychiatric disorders are present to parents of people with bulimia than parents of patients with anorexia. A higher incidence of sexual abuse is often present to women with bulimia. People with bulimia have an obese parent or have been overweight themselves during childhood. Parents can influence their children's eating habits and prevent weight problems and eating disorders through a healthy eating habits themselves.

Genetic factors play an important role in anorexia. From this point of view twins had a tendency to share specific eating disorders (anorexia nervosa, bulimia nervosa and obesity). A genetic propensity toward thinness caused by a faster metabolism and reinforced by cultural approval, an inherited propensity for obesity and inherited personality traits are some inherited traits that might make someone susceptible to eating disorders. Culture pressures is other factor which can lead to anorexic people.For example clothes for thin bodies, TV programs which present anorexic young models. Excessive exercise plays a major role in many cases of anorexia at athletes. Young female athletes and dancers may present the following problems:eating disorders, amenorrhea (absence or irregular menstruation) and osteoporosis.

The most common factor present in eating disorders which include chemical abnormalities in the thyroid, the reproductive regions, and areas related to stress, well-being and appetite are hormonal problems. A result of malnutrition or other aspects of eating disorders is the change of these chemicals. The limbic system is a small area of the brain where many of these abnormalities begins. Also hypothalamic-pituitary-adrenal axis (HPA) is a specific system with an important role in eating disorders. In brain is found a small structure that controls our behavior, like eating, sexual behavior and sleeping, and regulates body temperature, emotions, secretion of hormones, and movement called hypothalamus. An extension of the hypothalamus downwards called the pituitary gland controls thyroid functions, the adrenal glands, growth and sexual maturation. Major emotional activities like anxiety, depression, aggression and affection are controlled and regulated by amygdala,a small structure which lies deep in the brain.

Stress hormones called glucocorticoids are produced by the HPA system, including the primary stress hormone cortisol which is very important in marshaling systems throughout the body (including the heart, lungs, circulation, metabolism, immune systems, and skin) to deal quickly with any threat. The inhibition of neuropeptide Y (NPY), a powerful appetite stimulant that also has anti-anxiety properties is one of the specific effects. Certain neurotransmitters (chemical messengers) that regulate stress, mood and appetite and are being heavily investigated for a possible role in eating disorders are released by the HPA system. Serotonin, norepinephrine and dopamine are the three hormones that are important. So norepinephrine is a stress hormone, serotonin is involved with both well-being and appetite and dopamine is involved in reward-seeking behavior. Low levels of leptin, a hormone that appears to trigger the hypothalamus to stimulate appetite have been observed in people with anorexia and bulimia.

The reproductive hormones that are severely depleted in anorexics are produced by the hypothalamic-pituitary system. Some experts believe that these reproductive abnormalities are a result of anorexia and others have shown that menstrual disturbances occurred before severe malnutrition set in and remained a problem long after weight gain in 30% to 50% of people with anorexia.

There are many factors who contribute at development of anorexia. Unfortunately teenage females are the most affecte

Does Your Teenager Have An Eating Disorder?

One of the most difficult jobs that a parent can experience is the important task of raising a healthy, confident, and goal oriented teenager into early adulthood. However, all too often our young children run into serious problems along the way through being a teenager. One such problem that may stay below the parent's “radar” are eating disorders.

Are you worried that your teenage son or teenage daughter may have some type of eating disorder that they are trying to keep from you and the rest of the family? This type of disorder can be quite common during the teen years, especially with teenage girls. Although we do see teenage boys go through some eating problems as well.

Like adults, eating disorders in children are usually a combination of factors - physical and emotional. On one hand, dieting in young children is instrumental in eating disorder development; on the other hand, it can be a method of weight control for obese children. The family eating environment and influence of parents are important factors in childhood eating disorders.

With so much emphasis on looks and popularity today and mixed with the already insecure feeling that teenagers have as their bodies are changing, developing an eating disorder may be an underlying problem in your teen’s life. It is important to understand and educate yourself on the two major types of eating disorders that many of our youths may be going through.

If you suspect that your teenage son or daughter has any type of problem at all, first talk to your doctor. Not to be hesitant about trying to correct the problem by yourself at first.

Eating disorders always stem from another underlying problem and so by focusing on food as the issue, you will more than likely make things worse for your teen instead of helping him or her. In fact, studies have shown that early discovery and treatment of eating disorders will provide the best chance of recovery.

What eating disorders should you be concerned about?

Anorexia Nervosa

With this first eating disorder, your teen may experience excessive weight loss due to self-starvation. As ironic as it seems, most teenagers prone to this type of eating disorder are typically involved in sports such as dance or gymnastics, where their body size and weight play an important role in success.

Bulimia Nervosa

The second eating disorder described here involves very frequent episodes of binge eating which is almost always followed by purging the food through self induced vomiting. It doesn't sound pretty but if your teenager has this eating disorder then they are probably practicing this with most, if not all of their meals due to intense feelings of guilt and shame about food.