TMS is an alternative treatment to medication for Pregnancy Depression

Perhaps another reason to consider transcranial magnetic stimulation, or TMS, therapy for depression in pregnancy, which treats maternal depression but avoids systemic fetal drug exposure:

“Untreated maternal depression was associated with slower rates of fetal body and head growth. Pregnant mothers treated with SSRIs had fewer depressive symptoms and their fetuses had no delay in body growth but had delayed head growth and were at increased risk for preterm birth. Further research on the implications of these findings is needed.”

– Conclusion from Maternal Use of Selective Serotonin Reuptake Inhibitors, Fetal Growth, and Risk of Adverse Birth Outcomes [Original Article] by El Marroun, H., Jaddoe, V. W. V., Hudziak, J. J., Roza, S. J., Steegers, E. A. P., Hofman, A., Verhulst, F. C., White, T. J. H., Stricker, B. H. C., Tiemeier, H.   Published online March 5, 2012. Arch Gen Psychiatry. doi:10.1001/archgenpsychiatry.2011.233.

If you found this post interesting, take a look on another recent post on pregnancy and depression.

"YOU CAN'T STOP THE WAVES, BUT YOU CAN LEARN TO SURF" - Jon Kabat-Zinn

Does Successful Depression Treatment Really Mean Perpetual Happiness?

“I just want to be happy.” Cynthia* shrugged her shoulders wearily.  “I mean, why is my depression treatment not working any more?

Cynthia had two prior severe depressive episodes but had been pleased over the past 3 years that her psychotherapy and medication were keeping her in check, enabling her to function well and enjoy her family and career.  In her mind depression treatment was working — until now.

“Lately, I feel this sense of despair, on the verge of tears and so worried. I thought the medication was supposed to make me happy.  What’s wrong with my depression treatment?”

I suggested that in order to understand what may be causing a worsening of her depression, she consider if there was anything going on in her life that might be causing her to worry and be more upset.

Cynthia tensed up and started wringing her hands nervously. “Oh things were going pretty well, but two weeks ago I lost my job and now that I’m home more, I’ve discovered that my son Charlie has been smoking marijuana  – I can’t believe he is using pot after all our warnings!  What else is he getting into!”?

“What would you think if you were not uncomfortable with your son’s behavior or you were okay with losing your job?” I asked.

Cynthia paused and looked around. “I guess that wouldn’t be normal…whatever that means.”

“Exactly.  Feeling upset and sad when you are faced with the loss of your job and problems with your son is understandable.”  I then asked, “Even though you’re upset and sad, are you doing what you need to adjust?

Cynthia paused.  “Well, my husband and I plan on meeting with Charlie for a talk.  And I’m sending out my resume daily and am already going to interviews.”

Is Depression Treatment Really Not working?

“So why do you think your depression treatment is not working?” I pressed.

“Because I’m not happy anymore,” tears were gradually falling down her cheeks. “I’m just so sad about this.”  She then went on to clarify that, while she was sad about her family and career situations, she was grateful that she had the support of her husband and her friends, and she was able to laugh and feel like her normal self most of the time.

All things considered, she was actually functioning quite well!

Successful psychiatric depression treatment, whether through psychotherapy, medication or an intervention such as transcranial magnetic stimulation (TMS), makes it possible to once again experience renewed energy, motivation and interest in life.  Nevertheless, when faced with life stresses and transitions, depression treatment should still allow patients to experience a full range of emotions — including appropriate sadness and worry in response to life’s challenges.  With successful treatment comes the ability to function productively and emerge intact and fully functional.

Authentic Living With Depression Treatment:  Surfing, Not Skating

The purpose of psychiatric treatment is to experience life healthfully, not to numb people against feeling the normal discomforts and challenges of life.

To expect life to be a simple skate across the lake is unreasonable.  Like an ocean, life involves waves of challenges, without which we would not appreciate happiness from good fortune or success.

Successful depression treatment — and mental health in general — is being able to ride the waves of life and to appreciate and enjoy life when given the opportunity.

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*Cynthia is a fictitious name.  This post reflects a common interaction I have had with multitudes of patients.

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DEPRESSION IN LOS ANGELES

According to a new report issued by the Los Angeles County Department of Public Health, nearly 14 percent of adults across the country report that in their lifetime they have been diagnosed with a depressive disorder. This is an increase of almost 50 percent from the nine percent who reported having a depressive disorder in 1999.

Although the increase is significant, health department officials note that the higher number of reports most likely reflects a greater awareness about depression, and not necessarily an actual increase in the number of people who suffer from depressive disorders.

Depression is a serious clinical illness that interferes with a person’s ability to function, and it can last for weeks, months or even years. Depression in Los Angeles, like in other areas of the country, places a serious burden on the health and well being of society.

Several other key findings from the report about depression in Los Angeles include:

• Rates of depression in Los Angeles increased across all racial and ethnic groups, but Asians and Pacific Islanders consistently reported the lowest rates. However, this may only point to a lower recognition of depression within this ethnic group.

• Depression in Los Angeles is incongruous between sexes, with women in LA County reporting higher rates of depression diagnoses than men. While both genders saw increases; it was greater for women (11 to 17 percent) than for men (7 to 10 percent).

• Other chronic conditions, such as diabetes and heart disease, often co-occur with depressive disorders. Depression in Los Angeles is also sometimes linked to risky health behaviors, such as heavy drinking and smoking.

The report highlighted various ways that healthcare providers, families, friends, and even elected officials and businesses can help address those suffering from depression in Los Angeles. Some of its suggestions include:

• Having culturally sensitive mental healthcare and linguistically diverse services available to the community suffering from depression in Los Angeles County.

• Promoting a stigma-free work environment.

• Advocating for treatment and insurance reimbursement guaranteeing equal coverage of physical and mental health conditions, including depression, in Los Angeles.

• Providing emotional support to friends and family suffering from a depressive disorder.

If you feel that you may need treatment for depression, West Coast TMS Institute in Sherman Oaks, Los Angeles is available to help you. Contact us if you feel you would like to seek treatment for depression; set up a psychiatric consultation and explore your options further.

If you found this blog on depression in los angeles interesting, or are generally interested in behavioral health issues, click on our following link on ADHD, Did Ferdinand the Bull Have ADHD?

Paternal Depression: How Depressed Fathers Impact Children

By Kira Stein, MD & Erin Yates, Bsc

The impact of prenatal and maternal depression on both mother and child has been well documented, with depressed mothers highly encouraged to seek treatment for their conditions. What many people don’t realize, however, is that depression on the part of a father, otherwise known as paternal depression, can be just as harmful and damaging. That’s why it’s critical for a father suffering from paternal depression to attain treatment not only for himself, but also for the health and wellbeing of his entire family.

Most people know about the link between mothers who are depressed or are suffering from postpartum depression and how it impacts their offspring. A few years ago, this issue reached popular culture when actress Brooke Shields spoke out about the struggles she had with postpartum depression and highlighted the importance of getting treatment. Research has clearly shown that early childhood interactions with mothers who suffer from ongoing mental issues increase the likelihood that their children will develop their own mental disorders down the line.

Only recently have researchers begun to look extensively into the negative effects of paternal depression, as well, and how depressed fathers can impact their children’s development. This makes sense, as about 9 percent of males are known to suffer from some sort of major depressive disorder. Thus, we must examine the experiences these males have when it comes to raising children.

Paternal depression beyond the newborn years

Although new fathers can suffer from symptoms of postpartum depression, they tend to interact less with their newborn babies than mothers. Therefore, paternal depression is more prominent when children are a little older, such as when they are considered toddlers and beyond.

Recently, a large-scale study was conducted on children aged 5-17 who had depressed fathers. The study found that significant emotional and behavioral difficulties were more likely in children when one or both parents also suffered from depression. And, while many people may assume that paternal depression would tend to be much less harmful to a child than maternal depression, the study also showed that it was only 4 percent less likely for a child to suffer from behavioral issues if only his or her father had depression. This demonstrates just how serious paternal depression can really be, and that it should be considered just as troublesome as depression in mothers.

Paternal depression and early development

In a different study that looked at younger children aged nine to 24 months, those with depressed fathers showed an increased risk for delayed speech and language skills, also displaying behavioral problems and defiance with authority figures. In addition, these children who had depressed fathers also showed more problems with peer-related issues and had trouble making and keeping friends.

These studies showcase what many researchers suspected—paternal depression can have a major negative impact on children. That’s why it is so critical for men suffering from depressive symptoms to seek treatment right way in order to avoid some of these negative effects on their children, which can last their entire lives.

If you feel that you may need treatment for paternal depression or depression in general, West Coast TMS Institute in Sherman Oaks, Los Angeles is available to help you. Contact us if you feel you would like to look into depression treatment, set up a psychiatric consultation and explore your options further.

References:

Dave, S., et al. Associations between paternal depression and behaviour problems in children of 4-6 years. Eur Child Adolesc Paychiatry. 2008;7(5):306-315.

Dave, S., et al. Major paternal depression and child consultation for developmental and behavioural problems. Br J Gen Pract. 2009;59(560):180-185.

Gross, HE., et al. Reciprocal models of child behavior and depressive symptoms in mothers and fathers in a sample of children at risk for early conduct problems. J Fam Psychol. 2008;22(5):742-751.

Paulson, J., et al. Early parental depression and child language development. J Child Psychol Psychiatry. 2009;50(3):254-262.

Weitzman, M., et al. Paternal depressive symptoms and child behavioral or emotional problems in the united states. Pediatrics. 2011;0000.

**If you liked learning more about paternal depression, click on our next blog - Depression Treatment: Your Heart and Mind Depends on It.

Pregnancy Anxiety and How It Affects Women

Having some anxiety during pregnancy is part of the experience. For many women, pregnancy is something they have looked forward to for their entire lives, and there are always uncertainties that may cause a degree of nervousness. When this nervousness becomes pervasive, however, it could be a sign of a more serious issue, such as pregnancy anxiety.

Basis for pregnancy anxiety

There is a biological basis for a good portion of the stress and anxiety that occur during pregnancy. This is primarily due to the hormonal changes that happen as the body prepares itself for pregnancy and birth. In recent years, there has been quite a bit of research done on cortisol, which is associated with stress and pregnancy anxiety. It is normal for cortisol levels to go up some during pregnancy, but excessive elevations could be related to complications.

The key to successfully dealing with pregnancy anxiety is to recognize that it is normal and that it can be managed.

Managing pregnancy anxiety

There are a number of things you can do to better manage pregnancy anxiety, including:

• Communication: The most important tool to managing pregnancy anxiety is to communicate. You’ll need support to get through it, and that support will likely come from family and friends.

• Lighten your load: Many women who are very active prior to being pregnant have trouble adjusting to the limitations that pregnancy often includes. Now is a good time to get rid of the notion that you can do it all. Some simple ways to do this are cutting back on chores or using sick days or vacation time when feeling overloaded or ill. Spending a day”or even an afternoon”resting and/or relaxing can make a big difference in avoiding pregnancy anxiety.

• Focus on health/exercise: Making choices for two can serve as the motivation to make some of those lifestyle changes you have been considering. One of the easiest ways to lessen the effects of pregnancy anxiety are relatively simple changes such as eating a balanced and healthy diet, drinking enough water, getting quality sleep and exercising.

• Limit “information overload”: It is good to be prepared, but everybody seems to have a slightly different opinion about pregnancy, and the amount of information can be overwhelming. Try to find a routine that works for you and stick with that. It’s more important to focus on how you’re feeling and what’s happening to you now. This will aid in preventing pregnancy anxiety.

• Medication: If the anxiety is severe enough or if there is a history of anxiety or depression, it may become necessary to treat pregnancy anxiety with prescription medications. Obviously, this is a discussion to be had with a doctor, but after years of research there is more evidence about these drugs and their effects on the developing fetus. There is a lot to consider when using drugs to ease pregnancy anxiety.

If you feel that you may be experiencing pregnancy anxiety or maternal depression, West Coast TMS Institute in Sherman Oaks, Los Angeles, is available to help you. Contact us at 818-855-1694 if you feel you may be experiencing pregnancy anxiety or depression, and would like to set up a psychiatric consultation.

If you found this post on pregnancy anxiety interesting check out our other posts on behavioral health including one on mood disorders.