Download
1 / 35

Women and Mood - PowerPoint PPT Presentation


  • 51 Views
  • Uploaded on

Women and Mood . Di Thompson, MD Medical Director, Behavioral Health and Integrative Services Penrose-St Francis. Everything was fine until she turned twelve!. Adolescence/first period PMS Pregnancy Post-partum Peri -menopause.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Women and Mood ' - nova


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Women and mood

Women and Mood

Di Thompson, MD

Medical Director, Behavioral Health and Integrative Services

Penrose-St Francis


Everything was fine until she turned twelve
Everything was fine until she turned twelve!

Adolescence/first period

PMS

Pregnancy

Post-partum

Peri-menopause

Women and Modd– January, 2014


Let s start with teen age girls matej sternen september 20 1870 june 28 1949
Let’s start with Teen-age GirlsMatejSternen (September 20, 1870 – June 28, 1949)

January, 2014


National Survey on Drug Use and Health show that among 13 to 17 year olds the prevalence of depression among girls is nearly 3 times as high as that for boys…what’s going on here?

Presentation Title – Women and Mood– January 2014


  • The hormonal changes eventually culminate in the first menstrual cycle

    • Depending on how this has been described to the young women, the event can have a positive or negative effect:

    • Option 1: Shameful, unsanitary and threats about pregnancy

      • Anorexia, Depression

    • Option 2: Celebration of womanhood, appreciating the body as mysterious and wonderful

      • Self Respect

Women and Mood– January 2014


Pms versus pmdd american psychiatric association dsm 5 2013

  • Symptoms of PMS menstrual cycle

    • Physical and Emotional

  • Symptoms of PMDD-must total 5 or more

  • 1 or More:

    • Marked Lability

    • Marked Irritability

    • Marked Depressed Mood

    • Marked Anxiety

  • 1 or More:

    • Decreased Interest in Activities

    • Difficulties with Concentration

    • Lethargy, Fatigability

    • Change in Appetite

    • Overwhelmed or Out of Control

    • Physical: breast tenderness, muscle pain, bloating

PMS versus PMDD (American Psychiatric Association [DSM-5]. 2013)

Women and Mood– January 2014


Hormones and behavior any theories
Hormones and Behavior…any theories? menstrual cycle

Women and Mood– January 2014


Treatment for pms and pmdd
Treatment for PMS and PMDD menstrual cycle

  • PMS

    • Bloating: decrease intake of salts, over-eating

    • Breast tenderness and headaches: Tylenol, Motrin

    • Mood: assess for underlying depressive disorder

Women and Mood– January 2014


Premenstrual dysphoric disorder

Premenstrual menstrual cycleDysphoric Disorder

SSRI’s: 60-70% vs. Placebo 30%; intermittent vs. continuous (Dimmock, 1998)

Oral Contraceptives: frequently used but little data; 35% better and 21% worse (Sanders, 2001)

Calcium: 48% efficacy for physical and emotional symptoms-except fatigue vs. 30% placebo. 600mg (Thys-Jacobs, 1998)

Women and Mood– January 2014


Is there a pill to stop the food cravings

  • Cravings and Serotonin menstrual cycle

    • Slight drop in serotonin = increase in carb cravings; the body uses carbs to make serotonin. Simple sugars (ie Snickers Bar)are metabolized more quickly than complex carbs, so they offer a quick serotonin fix and another drop.

    • Vicious Cycle: PMS means higher stress level… cortisol. If cortisol is high and serotonin is low, cravings may include both carbs and fats.

Is there a pill to stop the food cravings?!

Women and Mood– January 2014


Advice for your patients

  • Eat complex menstrual cyclecarbs: whole-grain breads, pasta, and cereals.

  • Avoid processed sugar: Simple sugars increase insulin secretion, insulin levels shoot up enough, your appetite for carbs and fats increases.

  • Try foods high in essential fatty acids: Salmon, Sardines, salmon, flax seeds and walnuts allow for slower but steady absorption of carbs, this stabilizes the blood sugar, and can stop cravings

  • Drink plenty of water: 8 glasses of water a day can reduce bloating.

  • Shun salt to reduce bloating and fluid retention

Advice for your patients

Women and Mood– January 2014


How about those food cravings

  • Avoid processed fat menstrual cycle; it decreases the absorption of carbohydrates that are needed to make more serotonin.

  • Limit coffee and cola because caffeine intake may cause irritability and to ease breast soreness, advises the American Association of Family Physicians (AAFP).

  • Drinking just prior to menses may increase symptoms of depression, according to the AAFP and it can disrupt the metabolism of carbohydrates.

How about those food cravings?

Women and Mood– January 2014


Metabolism on mars and venus

Metabolism on Mars and Venus

Women and Mood– January 2014


Am j psychiatry 2000 157 1445 1452
Am J Psychiatry more2000;157:1445-1452

Women and Mood– January 2014


Pregnancy blues and post partum depression rihard jakopi 12 april 1869 21 april 1943
Pregnancy, Blues and Post Partum Depression moreRihardJakopič (12 April 1869 – 21 April 1943)

Women and Mood– January 2014


First the good news

First the good news…

Women and Mood– January 2014


Then the postpartum mood issues

Then… the postpartum mood issues

Women and Mood– January 2014


The blues hormones and toothpaste commercials

  • Not a psychiatric disorder during pregnancy and 30% during the postpartum period.

  • Psychoeducation is crucial

  • Education should involve significant others

  • MatejSternen (September 20, 1870 – June 28, 1949)

The Blues, hormones and toothpaste commercials

Women and Mood– January 2014


Post partum depression hormones history and current issues

Post Partum Depression: hormones, history and current issues during pregnancy and 30% during the postpartum period.

An estimated 9-16 percent of postpartum women will experience PPD.

Among women who have already experienced PPD following a previous pregnancy, prevalence estimates increase to up to 41 percent

Women and Mood– January 2014


Post partum depression and major depression

  • Anhedonia, sleep disturbance, irritability, and thoughts of hurting oneself or one’s child;

  • lead to difficulty in providing developmentally appropriate care to infants;

Post-partum Depression and Major Depression

Women and Mood– January 2014


The issue is just not confined to mom

  • Children of mothers with PPD can: during pregnancy and 30% during the postpartum period.

    • become withdrawn, irritable, or inconsolable;

    • display insecure attachment and behavioral problems;

    • experience problems in cognitive, social, and emotional development;

    • have a higher risk of anxiety disorders and major depression in childhood and adolescence.

The issue is just not confined to mom

Women and Mood– January 2014


Treatments

  • Treat Early during pregnancy and 30% during the postpartum period.

  • Antidepressant medications

  • Talk Therapy

Treatments

Women and Mood– January 2014


The next hormone shift menopause
The next hormone shift…Menopause! during pregnancy and 30% during the postpartum period.

HOT FLASHES

MOOD

WEIGHT

LIBIDO

Women and Mood– January 2014


MENOPAUSE during pregnancy and 30% during the postpartum period. : 12 CONSECUTIVE MONTHSPERIMENOPAUSE: IRREGULAR MENSES, FLUCUATIONS, UP TO 6 YEARS BEFORE AND ENDS WHEN NO MENSES FOR 1 YEARPREMATURE MENOPAUSE: AGE 40 OR YOUNGER

WHAT IS MENOPAUSE?

Women and Mood– January 2014


Estrogen is mother s little helper

PROMOTES BONE GROWTH during pregnancy and 30% during the postpartum period.

PREVENTS VAGINAL ATROPHY

INCREASES FUNCTION OF NEUROTRANSMITTERS

AIDS IN TEMERATURE REGUALATION

ESTROGEN IS MOTHER’S LITTLE HELPER!

Women and Mood– January 2014


Hot flashes and the hypothalamus
HOT FLASHES AND THE HYPOTHALAMUS during pregnancy and 30% during the postpartum period.

Women and Mood– January 2014


The size of a pea

The size of a pea… during pregnancy and 30% during the postpartum period.

The hypothalamus is the body’s thermostat.

The hypothalamus responds to various temperature receptors throughout the body and makes adjustments to maintain a constant core temperature.

For example, on a hot day, temperature receptors located in the skin send signals to the hypothalamus to cool the body by increasing the sweat rate.

ESTROGEN is one of the receptors!

Women and Mood– January 2014


The during pregnancy and 30% during the postpartum period. Peri-Menopause Menopause antidote

  • HOT FLASHES

    • Weight Loss/weight gain

    • Breathing

    • Exercise

    • Medications

Women and Mood– January 2014


Mood libdo and weight
MOOD, LIBDO and WEIGHT during pregnancy and 30% during the postpartum period.

Women and Mood– January 2014


Treatments are no different than at any other stage
Treatments are no different than at any other stage during pregnancy and 30% during the postpartum period.

  • Psycho-education

  • Psychotherapy

  • Exercise

  • Medication

Women and Mood– January 2014


How did i gain 5 pounds when nothing else has changed

  • ANTIDOTES

    • Exercise

    • Lifestyle

    • Medical issues: Thyroid, medications

    • Mood: Atypical depression

“How did I gain 5 pounds when nothing else has changed?”

Women and Mood– January 2014


Libido mood estrogen it s all connected

  • Desire during pregnancy and 30% during the postpartum period.

  • Physical changes

  • Emotional changes

  • SWAN study 2400 women …

  • Lower estrogen:

  • Lower testosteron

  • Lubricants

  • Moisturizers

    • cling to vaginal wall, mimic natural secretions,longer term effects-3-4 days ie Replens, Lubrin

  • Low dose vaginal estrogen

  • Non-FDA

    • Bupropion

    • Sildenafil (Viagra)

    • DHEA

Libido: Mood, Estrogen…it’s all connected!

Women and Mood– January 2014


Women at different stages mood and hormones always intertwined

Women at different stages… during pregnancy and 30% during the postpartum period. Mood and Hormones always intertwined

Pre-teens, PMS, PDD, Pregnancy, Postpartum, Perimenopause

Women and Mood– January 2014


Women and Mood– January 2014


ad