Tuesday, January 27, 2009

Screening for post-partum depression

For those of us who have abruptly run out of estrogen--before a period, after delivering a child or miscarrying, and entering menopause--it is no news that sudden declines in this hormone can precipitate anxiety and depression. Pediatricians at the University of Colorado have devised a quick and easy 3 question screen to identify women at risk for significant post-partum mood disorders.

Women are instructed to answer 'most of the time,' 'some of the time,' 'not very often,' and 'never' to the following statements:
  1. I have blamed myself unnecessarily when things went wrong.
  2. I have felt scared or panicky for not very good reason.
  3. I have been anxious or worried for not very good reason.
Dr. Stephen Stahl has pointed out a phenomenon he calls 'kindling' with respect to hormone-related mood swings, namely that a history of responding to hormone changes in a sad or anxious sort of way makes it more likely that a woman will have a similar response to such episodes in the future. I think this 3 question tool would be useful in identifying women having a rough go of it mood-wise through the other biggest hormonal challenge of a woman's life, namely menopause.


Lisa Marie said...

This is a very helpful post for me. I have been tracking my moods for quite some time and have detected a pattern in depression right before my period and lasting up to two weeks.

Now there are other factors that are contributing to the intensity of the depression and mood swings, such as the panic disorder I have, but this gives me hope that the hormones can be regulated so that I don't continue to suffer all they way past menopause!

Good post :)

Anonymous said...

When I first got a diagnosis of major depression....in perimenopause...I would have answered "never" to all three of those questions. I was unaware of my own feelings and negative self talk.

I also might add that none of the 5 doctors I consulted, including a psychiatrist, and 3 OBGYNs suggested that my depression might be hormone related.

Anonymous said...

Thank goodness a few doctors are breaking the mold in treating AND balancing hormones... Like DrShames in www.feelingfff.com
I wish more docs would do this, and help teens, also. I dont think people should suffer with this.

femail doc said...

LM and anon: I hope that more and more doctors will recognize the contribution of hormones to mood disorders. I've encountered any number of women in perimenopause and menopause with anxiety who have not had this issue addressed by previous health care providers.

Anon: I like the name of that book: "Feeling Fat, Fuzzy, or Frazzled?" I will order a copy and see what they have to say.