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Early Puberty. Girls who go through puberty early (reaching the midpoint at 11 years or younger) are more likely to experience depression during adolescence than girls who mature later.
Premenopause. Premenopausal women (between the ages of 20 and 45) were most susceptible to depression, with 22% of this age group reporting symptoms of major depression. Premenstrual dysphoric disorder (severe depression before a period) specifically affects an estimated 3% to 8% of women in their reproductive years. [See Well-Connected, Report # 79, Premenstrual Syndrome.]
Postpartum Depression. Nearly every new mother experiences a short period of mild depression following childbirth (known as the "baby blues"). It is not considered postpartum depression, however, unless it persists beyond a week or two and is very severe. Studies have reported that between 8% and 20% of women have diagnosable postpartum depression within three months of delivery, with 5% in one study having suicidal thoughts. One study strongly suggested that the fluctuating levels of estrogen and progesterone accompanying childbirth may play a major role in postpartum depression, at least in women who are sensitive to such changes. Different studies have suggested that the following women may be at higher risk for postpartum depression are the following conditions:
It should be noted that many male partners of new mothers also suffer from depression surrounding the birth of a child.
Depression During Pregnancy. A 2001 study found that depression during pregnancy was more common than depression after pregnancy, with the highest depression scores occurring in week 32. The authors commented that depression during pregnancy is a neglected area, and that the effects of depression on the fetus are largely unknown.
Perimenopause. Depression often occurs around menopause (the perimenopausal period), when, in addition to hormonal changes, other factors (cultural pressures favoring young women, sudden recognition of aging, and sleeplessness) are involved. In one study, over half of perimenopausal women were diagnosed with major depression. (Women taking hormone replacement therapy during this period were just as likely to become depressed as those not on hormonal therapy, but the depression tended to be less severe.)
Postmenopause. One study suggests that average depression scores in women who were past menopause were nearly as low as those in premenopausal women. In fact, many women report that after menopause, previous bouts of depression, particularly when caused by seasonal changes or premenopausal syndrome recede or stop completely.
Cognitive therapy does not appear to be as beneficial as antidepressants for most patients with dysthymia.
Over time, such exercises help build confidence and eventually alter behavior. Patients may take either group or individual cognitive therapy. Cognitive therapy is a time-limited treatment, typically lasting 12 to 14 weeks. Extending this period, however, may help prevent relapse. In one study, therapy was continued for 10 additional sessions over the following eight months. This extended treatment significantly reduced the risk of recurrence. In fact, some experts believe that short-term therapy is not at all effective for patients with chronic or relapsing psychiatric disorders.
Reflection Exercise #12
Online Continuing Education QUESTION 26
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