Depression Stalking Younger WomenIt is the second-leading cause of hospitalization< January 21, 2003 > Serious depression is on the rise—but it is mostly younger women who are being affected. Among the study's conclusions: Depression was the second-leading cause of hospitalization for women aged 18 to 44, with some 205,000 admissions in 2000. The number one reason for hospitalization for women in this age group was obstetrical care and childbirth. The researchers also found that depression was the seventh most frequent cause of hospitalization for women of all ages. Interestingly, other statistics recently released by AHRQ show that depression does not even make the top 10 list of health concerns for men. "The findings are simply an indication of where we need to look, where we need to concentrate our research to not only understand why women appear to be at such high risk [of depression], but in learning more about how we can reduce those risks," says study author Dr. Claudia Steiner. Steiner is senior research physician with the AHRQ, which is part of the US Department of Health and Human Services. The new report cites the number of women hospitalized in the year 2000, and includes the reason for admission, discharges, and any surgeries or procedures performed. Overall, the top three reasons women of all ages were hospitalized in 2000 were physical trauma related to childbirth (785,000); pneumonia, (581,000); and congestive heart failure, (581,000). In all age groups, a total of 361,000 women were hospitalized for depression. For women aged 18 to 44, reasons for hospitalization other than depression and childbirth included fibroid tumors (139,000); gall bladder disease (117,000); back problems (85,000); and asthma (70,000). The new report on women contrasts sharply with other AHRQ reports on male hospitalization statistics for the year 2000. The top three reasons for hospitalization for men were coronary artery disease, heart attack, and stroke. The AHRQ reports state that of the 646,416 hospital admissions for depression in the year 2000, 61.9 percent were women, and 39.1 percent were men, up from 38 percent in 1997. The disparity between gender-based mental health statistics seems enormous. But if you look behind the numbers, men and women may be more alike than the research indicates, says reproductive psychiatrist Dr. Shari Lusskin. "Generally speaking, women seek treatment for depression and men do not. But that doesn't mean men don't suffer with depression, because they do," says Lusskin, a clinical professor of psychiatry at New York University Medical Center. The proof, she says, is in the bottle—alcohol and medicine, that is. "In men, you see far more treatment of alcoholism and drug abuse. But the underlying reason for these problems is still usually depression, even though the hospital admission forms may not have this on record," Lusskin says. Previously released AHRQ statistics support her thinking. The agency found that while some 300,000 men were hospitalized for drug and alcohol abuse in 2000, just 138,000 women needed treatment for a similar problem. Lusskin says it is important to pay attention to what the new report is saying about women and depression—and use it to learn more about where to concentrate research and treatment efforts. "Hopefully, researchers will use many of the statistical findings in this paper to recognize populations that are under-served, and identify women that need more medical attention, particularly new mothers, whose postpartum depression problems too often go unrecognized and untreated for a very long time," Lusskin says. The new report, titled "Care of U.S. Women In Hospitals, 2000," is the third in a series published by AHRQ based on year 2000 health data collected on seven million patients from 1,000 hospitals nationwide. Always consult your physician for more information. Depressed Women Prone to Menopausal SymptomsThose with history of severe depression at greater risk Depressed women begin perimenopause—the period of hot flashes and mood swings that comes just before menopause—earlier than non-depressed women, new research says. Researchers followed 332 women aged 36 to 45 with a history of major depression, and 644 without depression. None of the women had gone through menopause yet. Women with a history of depression had a 20 percent greater chance of having perimenopausal symptoms during the 36 months of the study than the non-depressed women. Women who were depressed at the time of the study and women who had the most severe history of depression were twice as likely to begin perimenopause. And women who were depressed and taking antidepressants had nearly three times the risk of having symptoms of perimenopause during the study. The researchers believe the added risk has little to do with the antidepressants. Instead, they believe women taking antidepressants may have particularly severe depression that is not alleviated by medicine. During perimenopause, a relatively new term, women often experience typical menopause symptoms: mood swings, hot flashes, and sleep disruptions due to their fluctuating hormones. Previous research has shown women with a history of depression are at greater risk of relapsing during perimenopause, says Bernard Harlow, lead author of the study that appears in the current issue of Archives of General Psychiatry. "What's happening is these women with a history of depression are sitting in a period of flux," says Harlow, an associate professor of obstetrics-gynecology at Harvard Medical School and an associate professor of epidemiology at the Harvard School of Public Health. "It's a very vulnerable period of time for women susceptible to mood disorders. It is really horrible. It would be better for them to get into the menopause and be done with it," he says. In the study, women were considered to have symptoms of perimenopause if they had a change in menstrual flow amount or duration; if they missed a period for three months or more; or if they had a seven day or longer change in their menstrual cycle length. (For example, a woman who used to get her period every 28 days was now getting it every 35 days.) A woman is considered to be in menopause when she has gone one year without a period. Harlow and his colleagues also did blood tests on the women every six months to measure their hormone levels. They found depressed women had lower levels of estrogen and higher levels of follicle stimulating hormone and lutenizing hormone than non-depressed women. One indicator that the ovaries are withering is an increase in follicle stimulating hormone and lutenizing hormone, which are produced by the pituitary gland. The ovaries and the pituitary gland work in harmony: follicle stimulating and lutenizing hormone from the pituitary signals the ovaries to produce more estrogen. If the ovaries do not produce enough estrogen, levels of follicle stimulating and lutenizing hormone increase, Harlow says. However, Harlow notes, measuring hormone levels is a somewhat unreliable method of determining whether a woman is menopausal because during perimenopause, the levels fluctuate wildly—a woman can have levels typical of a much younger woman one day and a much older woman the next, he says. "It's a crap shoot as to whether you're going to catch the hormone level at the high end or the low end," Harlow says. "The menstrual cycle is a much better indicator of changes." Some experts agree the study is one of the first to look at the role depression plays in perimenopause and demonstrates the important link between reproductive hormones and depression—something that has only recently begun to be studied. This study also shows the importance of getting early treatment for depression and for continuing to seek more effective treatments if antidepressants do not reduce symptoms. Only about 60 percent of women who are depressed seek treatment, according to the study. Harlow and his colleagues set out to determine if depressed women began actual menopause sooner, but the study period was not long enough. They are conducting follow-ups to determine that now. Always consult your physician for more information.
Online Resources(Our Organization is not responsible for the content of Internet sites.) American Psychiatric Association American Psychological Association Archives of General Psychiatry National Institutes of Mental Health (NIMH), part of the National Institutes of Health (NIH) The National Women's Health Information Center |
For more information on depression and perimenopause, please visit the Women's Health information module on this Web site. Knowing When to Seek Treatment For DepressionKnowing when to seek treatment for depression and other mental health disorders is important for parents and families. Many times, families, spouses, or friends are the first to suspect that their loved one is challenged by feelings, behaviors, and/or environmental conditions that cause them to act disruptive, rebellious, or sad. This may include, but is not limited to, problems with relationships with friends and/or family members, work, school, sleeping, eating, substance abuse, emotional expression, development, coping, attentiveness, and responsiveness. It is also important to seek treatment as soon as possible. Treatment for depression and other mental health disorders is available. What Is Perimenopause?Perimenopause refers to the transitional period of time before menstruation actually stops, which is marked by changes in the menstrual cycle, along with other physical and emotional symptoms. Perimenopause can actually last up to 10 years and during this time the following processes are occurring within a woman's body:
What Are the Symptoms of Perimenopause?The following are the most common symptoms of perimenopause. However, each woman may experience symptoms differently. Symptoms may include:
The symptoms of perimenopause may resemble other conditions or medical problems. Always consult your physician for a diagnosis. |
