Depression: Tailoring treatment to life stage

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March 2003 · Vol. 15, No. 3

Depression: Tailoring treatment to life stage

One in 4 women experiences at least 1 major depressive episode in her lifetime—almost invariably during the reproductive years. A psychiatrist and Ob/Gyn surveys the characteristic symptoms and appropriate treatment strategies specific to each age.

DIANA L. DELL, MD

Dr. Dell is assistant professor, department of psychiatry and behavioral science and department of obstetrics and gynecology, Duke University Medical Center, Durham, NC.

KEY POINTS

A woman is most biologically vulnerable to psychiatric illness during the postpartum period.
Antidepressant medications are not teratogenic.
Risks associated with untreated postpartum depression have the greatest short- and long-term ramifications for both the patient and her offspring.
Women may seek treatment only for premenstrual worsening of symptoms because they fail to recognize their ever-present depression.
Women with premenstrual exacerbation of underlying depression may be at elevated risk of suicide.

Most of us have heard the statistic: The rate of depression is twice as high in women as in men.

A closer look reveals that the higher rate in women occurs during the reproductive years, when the Ob/Gyn is often the primary care-giver.¹ Because Ob/Gyns are called upon to provide a wide range of general medical care, it is important that we know how to recognize and treat depression in our patients.

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INSTANT POLL
What nonhormonal menopause interventions have you found to be effective?