Posts Tagged "depression"

Looking through the window: depression and menopause

Posted by Liz on Dec 27, 2010 in depression | 2 comments

There’s a new term that’s being kicked around in medical circles: ‘windows of vulnerability.’

It appears that a growing body of evidence supports the fact that during times of hormonal flux or reproductive cycle “events,” women become increasingly vulnerable to mood swings, anxiety and depression. And while this is certainly not news for many women, it still requires some attention because among the many windows that women may go through, the menopausal transition is evidently one of the most complex. The reason? This is a time when hormones interact with aging, sexuality, life stressors, self-esteem and general health issues.

The subject of depression and menopause is not new to this blog, nor are statistics suggesting that as many as 20% to 40% of women are believed to suffer major depression or at the very least, depressive symptoms during the peri/postmenopausal years. Moreover, women may have as much as a two- to four-times increased risk of developing depression as they transition from pre- to perimenopausal status. Among the multiple factors at play, estrogen is one of the most important; estrogen has been shown to promote the amount of the mood neurotransmitter serotonin available to the body, thereby providing an important antidepressant effect. However, a recent review suggests that the role that hormones like estrogen play in depression is directly related to their wide fluctuations rather than the fact that they are becoming deficient.

So, why is this important? For one, it highlights that hormone replacement is not the only answer for depression during menopause but rather, that it’s critical to pay attention to timing, i.e. when preventive strategies, including exercise, behavioral therapy and antidepressants might yield the greatest long-term benefits. Yet, it also suggests that estrogen-based therapies may indeed have a role in depression during menopause. And, since estrogen alone therapy has been shown to up the risk for ovarian cancer except for in women who’ve had hysterectomies, it also helps supports the need to explore the role plant-based estrogens in treating menopausal depression; fortunately, S-equol has already shown promise in this regard.

Feeling the window of vulnerability? There’s no time like the present to insure that you aren’t simply looking through the window but actually seeing that there’s hope and help on the other side. There are a lot of resources and strategies available to address depression during this time of life. While depression may be a “menopause-associated risk,” like others, it can be successfully ameliorated.

Thank you to Dr. Claudio Soares from McMaster University for an excellent review of depression in menopause and the inspiring, succinct “windows of vulnerability” terminology.

Omega-3s and depression

Posted by Liz on Nov 12, 2010 in depression | 4 comments

According to recent estimates, more than 20% of women undergoing menopause have major depressive disorder. In fact, mood disorders and depression affect a disproportionate amount of women in the peri- and postmenopausal stages compared to women in pre-menopause. Moreover, these mood disorders tend to occur in conjunction with hot flashes.

While researchers have yet to discover the cause of the depression/mood surge during menopause, they continue to explore therapeutic strategies that might help to take the edge off. And surprisingly, numerous studies actually point to the value of omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — for alleviating depression. Besides wellbeing, one of the reasons this is so important is that research has linked depression with other serious conditions including heart disease and stroke. The one thing that all these conditions have in common is that they are believed to be caused, at least in part, by an inflammatory response by the body. One particular action of omega-3 fatty acids is that they have been shown to lower inflammation, which makes them potentially useful in treating disease.

So, can omega-3s help stave off depression in menopausal women? In a very small study published in the online edition of Menopause, peri- or postmenopausal taking daily omega-3 fatty acids  (Lovaza, 2 g daily) for 8 weeks had significant declines in depression scores, number of daily hot flashes and hot flash interference scores.  During the course of the study, 70% of women responded, and those whose depressive symptoms declined also experienced declines in hot flashes, indicating both a connection between the two and a possible role for omega-3s in menopause.

However, this study was very small, enrolling only 20 women and more evidence is needed with larger numbers of women before omega-3s can be recommended as a treatment for mood and hot flashes during menopause. Moreover, it’s essential to note that a thorough analysis of scientifically sound studies has recently pointed to the EPA component as driving as much as a 56% reduction in depressive symptoms, that is, if the supplements used contain more than 50% of standardized EPA or pure EPA. Therefore, when it comes to fish oils, the ratio of EPA to DHA may play an important role.

I’m excited because this study brings us another step closer towards demonstrating that menopausal symptoms can indeed, be effectively alleviated without hormonal therapy.

Little Girl Blue

Posted by Liz on Apr 26, 2010 in depression | 0 comments

[youtube=http://www.youtube.com/watch?v=FVpDOIPx_sY]

Depression in the perimenopause and postmenopausal years is no joke. I’ve written about it several times on this blog and will continue to do so until experts figure out an effective, acceptable strategy for combating the blues.

As I’ve noted before, researchers are not quite sure of the exact reasons for the depression surge during the transition,  (e.g. dramatic surge and declines in hormones, vasomotor issues, sleep issues, life stress and prior history). However, they do acknowledge that many women tend to suffer the blues during this time.

In the latest bit of research, published in the online edition of the journal Menopause, researchers found that over 40% of women studied (out of a pool of 685) suffered from symptoms of depression. What was more interesting, however, is that depression was almost twice as likely to develop in the peri/post menopausal stages than before menopause. (Note that other studies have found this likelihood to be as high as 4 times during the perimenopause). Moreover:

• Women who reported having had experienced some sort of negative event in their were 3.6 times likelier than those who hadn’t to develop depression
• Weight appeared to play a role, with obese women twice as likely as those of normal weight to develop depressive symptoms

Although I’ve discussed some potentially effective strategies for combatting the menopausal blues (e.g., exercise, chamomile, antidepressants, red clover, St. John’s Wort, soy isoflavones), none are a quick fix or a ‘one size fits all.’

Personally, I’ve noticed that fluctuating hormones coupled with elevated stress tends to heighten depression at specific times, while at other times, it’s easier to deal with. Pile it on and well, I become a pile of mush. My strategy entails an insane amount of physical activity, deep breathing, therapy and admittedly, some medication. Still, I’ve found that while I can usually keep the blues at bay, they do tend to crop up at the most inopportune moments.

What do you do to chase the blues away? Have they gotten worse or stayed the same during your transition? What advice do you have to offer for other readers? I’d love to hear!

Chamo chamo chamomile-on

Posted by Liz on Apr 16, 2010 in anxiety, depression, herbal medicine | 2 comments

[youtube=http://www.youtube.com/watch?v=JmcA9LIIXWw]

Is chamomile the ultimate chameleon, good for both anxiety in depression?

Back in February, I posted information about a small study that showed that a daily chamomile tablets (containing 220 mg of pharmaceutical grade extract) significant reduced anxiety and improved well-being among postmenopausal women. Thanks to a fellow reporter and Twitter colleague Miriam Tucker, I learned that the researchers of this study presented findings at a recent Anxiety Disorders of American meeting that might be of equal interest, i.e. that benefits of chamomile might extend to depression as well.

In a second part of this study, the researchers looked at the effect of chamomile on the same women who currently suffered from anxiety and depression, who had a past history of depression or who had never had depressive symptoms. Although the results were not as striking as in the first study, they did see what they characterized as meaningful reductions in depression ratings among women who had both anxiety and depression. Across all the groups, the researchers observed significant declines in depressed mood, guilt and thoughts of suicide).

Women entering perimenopause have twice the risk for developing depressive symptoms than during other phases of their lives. Researchers have also shown that attitude towards menopause can also increase the risk. While various interventions including antidepressants, exercise and maybe even moderate intake of red wine may help, it’s wonderful to know that scientists are seriously looking into the role of chamomile and studying it under controlled conditions to prove or disprove its power over our moods.

Is chamomile the ultimate panacea when it comes to mood swings and the blues? Perhaps not. But it may provide a wonderful option to women and men alike, who are seeking solutions out of the medicine cabinet.

Wednesday Bubble: heart disease, depression and menopause

Posted by Liz on Dec 30, 2009 in depression, heart disease | 1 comment

Today’s Bubble is not exactly bursting with good news. On the other hand, it more a matter of erring on the side of caution.

Depression in menopause and midlife is a common occurrence. Although researchers are not quite sure of the exact reasons for its surge during the transition,  (e.g. declining hormone, life stress, prior history), many women tend to suffer the blues during this time. In addition to physical activity or herbs, many practitioners recommend that women incorporate a low-dose antidepressant into their daily strategy. Yet, while this might help to maintain mood balance, researchers are starting to question whether or not using antidepressants may increase the risk for dying from heart disease during menopause. Yikes! So, we are given drugs to help boost our moods during menopause but they may end up killing us in the long run? Somehow the old adage, ‘what doesn’t kill you makes you stronger’ doesn’t make me feel better this time.

In a study that appears in the Archives of Internal Medicine, researchers examined information collected from over 136,000 women who had participated in the Women’s Health Initiative Study who either were or were not taking antidepressants over a period of about 6 years. The findings? Women who used SSRI antidepressants had a 45% increased risk of stroke, and a 32% increased risk of death.  This risk remained even after researchers took other heart disease risk factors into account, such as diabetes, high cholesterol and smoking.

Here’s the rub: depression is a known risk factor for heart disease and death from heart disease, and has also been linked to an increased risk for stroke. So, researchers are not certain if it’s the chicken (depression) or the egg (antidepressants) that is accounting for these study results.

So, what can you do? Should you throw away the pills?

Not so fast. Speak to your doctor. Get tested for known heart disease risk factors, such as overweight, high blood pressure, high cholesterol, family history, diabetes and of course, smoking. Incorporate heart healthy changes into your life, such as physical activity, a better diet, yoga, meditation and laughter. And then figure out if the benefits of antidepressants are worth the risks. These data are early and inconclusive. Just something to be mindful of if you are in menopause.