Mood disorders are common in women, and can have a serious impact on quality of life. While gentle fluctuations in mood are normal, and most people experience some degree of "moodiness," mood disorders that interfere with the ability to function in a productive way, or interfere with the ability to find pleasure in life are significant mood disorders.
Primary mood disorders occur without any particular reason. In other words, they do not have a situational cause. Secondary mood disorders occur as a result of some sort of stress. Potential stressors include menstrual cycle (PMS), menopause, chronic illness and the death of a loved on. There are many stressors that can lead to significant mood disorders.
This is a generalized feeling of being "down in the dumps" for a prolonged period of time. Often this will progress to major depression.
Major Depression
This is characterized by a depressed mood and/or loss of interest or pleasure in nearly all activities for at least two weeks. There is also fatigue, alterations in sleep pattern, difficulty in making decisions, and possibly thoughts of suicide. Women have a 25% possibility of developing major depression at some time during their life.
Bipolar Disorder
This disorder is generally characterized by alternating depression and manic episodes.
Secondary Mood Disorders: Multiple stressors can result in secondary mood disorders. Listed below are several common secondary mood disorders that may be identified and treated by your gynecologist.
Seasonal affective disorder
This usually refers to depression or bipolar disorders which occur in the fall or winter but not is the spring or summer.
Menstrual related mood disorders
Up to 75% of all women have symptoms associated with their menstrual cycles. PMS is defined as the occurrence of symptoms severe enough to interfere with some aspects of life and occurring with predictable relationship to menses. These symptoms include:
Depression Angry outbursts Irritability Anxiety Confusion Social withdrawal Breast tenderness Abdominal bloating Headache Swelling of extremeties
PMDD or premenstrual dysphoric disorder is a more severe form of PMS in which multiple of the above symptoms are present in the week prior to menses and are relieved by the onset of menses.
Menopause related mood disorders
Peri-menopause and menopause are not typically associated with a first episode of mood disorder, however in women who have had mood disorders in the past, this is commonly a time when such disorders may recur.
Treatment of Mood Disorders Any person with a primary mood disorder should be under the care of a psychiatrist. However, certain secondary mood disorders can often be effectively managed in conjunction with a primary care physician or gynecologist.
General measures that will be beneficial in coping with mood disorders and promoting optimal health include:
Dietary changes
Reduce fat, caffeine, sodium and alcohol
Increase Vitamin B6, Vitamin E, Calcium and/or Magnesium
Regular aerobic exercise
Regular sleep
Relaxation techniques
Stop smoking
Pharmacological treatment for menstrual related mood disorder and mood disorders associated with peri-menopause and menopause include the following:
Hormonal contraceptives (Pill, Patch, etc.) are often quite effective in reducing symptoms of PMS and/or PMDD. Hormonal contraceptives work to stabilize hormonal levels throughout the menstrual cycle, as during a non-medicated or "natural" cycle, it is normal for hormonal levels to fluctuate. In addition, hormonal contraceptives can be utilized to reduce the number of menstrual cycles that a woman has, thus reducing the number of premenstrual episodes experienced. If you are experiencing premenstrual symptoms, discuss you hormonal contraceptive with your physician, as certain combinations and types of hormonal contraceptives are more effective than others at reducing premenstrual symptoms.
Serotonin reuptake inhibitors/SSRIs, and other types of antidepressants: The current most effective treatment for PMS/PMDD is the use of SSRIs (Prozac, Zoloft, Paxil and others). These medications are extremely effective in reducing premenstrual symptoms with minimal potential side effects. In addition, these medications can be taken continuously, or just during the premenstrual time period.
