Depression is very common in women throughout their life cycles: Almost one out of every three women will experience depression or anxiety in her life. Hormonal changes that occur in pregnancy and the postpartum period, as well as during and after menopause, are thought to contribute.
As a primary care doctor, some of the symptoms that raise my concern are insomnia, lability (frequent and/or excessive emotional displays of mood), and a reduced ability or inability to engage in life (whether that’s work, family, or social and recreational activities). Sadness, teariness (frequent crying episodes), and extreme fatigue can also be signs.
When I suspect a patient may be depressed, I order blood work and check the results. It’s important to be sure that metabolic causes, such as low thyroid function or deficiencies of vitamins D or B12, are not playing a role. I also review all of the patient’s medications, since some drugs, including beta blockers (used to treat hypertension), steroids (used to treat inflammation and pain), benzodiazepines (used to treat anxiety and relax muscles), and anticonvulsants (used to treat epilepsy), can cause depression in some patients. If no modifiable cause of depression is identified, I refer the patient to a psychiatrist, psychiatric nurse practitioner, or psychologist for further evaluation and treatment.
As a patient, it’s important to realize that depression is treatable with therapy and/or medications. If your doctor doesn’t ask you about your sleep, mood, or energy level, let him or her know if you are experiencing problems. If your doctor doesn’t find an external cause, ask for guidance and referral to a mental health professional.
—Editor-in-Chief Orli R. Etingin, MD
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