Posted by on May 13, 2014 - 2:11pm

Collaborative depression care adapted to women's health settings appears to improve depressive and functional outcomes and quality of depression care, according to a report online in the journal Obstetrics and Gynecology. Researchers at the University of Washington randomized 102 women to 12 months of collaborative depression management and 103 women to usual obstetric care at two obstetric care sites. All of the women met criteria for major depression, dysthymia, or both. Participants were age 39 on average, and 56 percent had a diagnosis of posttraumatic stress disorder.

The collaborative care model is team-based care that involves psychiatrists, other clinicians, and depression care managers who meet weekly to review patient progress and provide treatment recommendations. The care manager follows up with patients.

Posted by on May 13, 2014 - 1:45pm

On Monday, May 12, 2014, Dr. Katherine Wisner, Director of the Asher Center for Research and Treatment of Depressive Disorders at Northwestern's Feinberg School of Medicine, was a featured television guest on WCIU, The U. Dr. Wisner discussed sex differences in mental health (particularly in depression and anxiety). She stated that women are twice as likely to have an episode of depression or anxiety than men. This increased risk for women begins at puberty and can be particularly elevated during menstrual cycles and after childbirth. In fact, 5% of women have very severe mood problems right before their period; this is called premenstrual dysphoric disorder (PMDD), and can cause women to become highly irritable with fluctuating moods. Furthermore, Dr. Wisner stated that 1 out of 7 postpartum women undergo depression, as the hormone fluctuation leaves women very vulnerable to depression.

Dr. Wisner emphasized that it is important for women to seek treatment if they feel that they may be suffering from depression or anxiety, as there are treatments available that do work. No women should have to feel depressed or anxious, and it is therefore important to understand how your body and your mind work together for your overall health. Click here to watch the full WCIU feature with Dr. Katherine Wisner.


Posted by on April 22, 2014 - 9:53am

Depression, especially in pregnancy, is a sensitive subject.  It impacts the woman, her child and her family and it affects between 14 and 23% women during pregnancy.  Because of hormonal changes during pregnancy, a woman may not realize she is suffering from depression.  A new, comprehensive guide about this condition that discusses symptoms and treatment to help  women and their family members understand and cope with this issue is now available from the a site called PsychGuides.   For a helpful resource visit   Living with Depression during Pregnancy

Also, if you live in the Chicago area, the Asher Center for the Study and Treatment of Depression and Mood Disorders  has just opened at Northwestern Medicine that provides expertise in hormone-related depression.

Posted by on January 2, 2014 - 11:23pm

Do hormone levels in postmenopausal women affect cognitive function? New research sheds light on the postmenopausal brain.

In a recently published study, researchers found that estrogen levels after menopause may have no impact on cognitive skills, but progesterone levels might. Progesterone had some association with global cognition and verbal memory among newly postmenopausal women.

643 healthy postmenopausal women were part of the study, ranging from 41 to 84 years old. Neuropsychological tests were done to assess cognition and memory, and hormone levels were determined including estradiol, estrone, progesterone, and testosterone. The findings showed no association between estrogen and cognitive skills. However, women with higher levels of progesterone had better outcomes on the verbal memory and global cognition tests, particularly in those who had started menopause less than six years prior. None of the hormones appeared to have any association with depression or mood either.

More research must be done to confirm the new findings regarding progesterone levels. Also, there is no way to directly measure hormone concentrations at the brain level, but this research implies that estrogen therapy may not have a significant effect on cognitive skills. To learn more about when hormone therapy is beneficial , visit Northwestern's menopause website here.


Source reference: Henderson VW, et al "Cognition, mood, and physiological concentrations of sex hormones in the early and late menopause" PNAS 2013; DOI: 10.1073/pnas.1312353110.

Posted by on July 25, 2013 - 11:00am

It turns out the love hormone oxytocin is two-faced. Oxytocin has long been known as the warm, fuzzy hormone that promotes feelings of love, social bonding and well-being. It’s even being tested as an anti-anxiety drug. But new Northwestern Medicine® research shows oxytocin also can cause emotional pain, an entirely new, darker identity for the hormone.

Oxytocin appears to be the reason stressful social situations, perhaps being bullied at school or tormented by a boss, reverberate long past the event and can trigger fear and anxiety in the future.

That’s because the hormone actually strengthens social memory in one specific region of the brain, Northwestern scientists discovered.

If a social experience is negative or stressful, the hormone activates a part of the brain that intensifies the memory. Oxytocin also increases the susceptibility to feeling fearful and anxious during stressful events going forward.

(Presumably, oxytocin also intensifies positive social memories and, thereby, increases feelings of well being, but that research is ongoing.)

The findings are important because chronic social stress is one of the leading causes of anxiety and depression, while positive social interactions enhance emotional health. The research, which was done in mice, is particularly relevant because oxytocin currently is being tested as an anti-anxiety drug in several clinical trials.

“By understanding the oxytocin system's dual role in triggering or reducing anxiety, depending on the social context, we can optimize oxytocin treatments that improve well-being instead of triggering negative reactions,” said Jelena Radulovic, the senior author of the study and the Dunbar Professsor of Bipolar Disease at Northwestern University Feinberg School of Medicine.  The paper was published July 21 in Nature Neuroscience.

To read more about this story and oxytocin click HERE

Posted by on January 16, 2013 - 3:07pm

Mental disorders are the cause of more than 37% of disabilities worldwide, with depression being the leading cause of disability among people aged 15 and older, according to the World Health Organization’s Global Burden of Disease and Risk Factors (2006).  Compared to men, women have twice the rate of depression, with a specific risk at puberty, premenstrually, postpartum, and in the perimenopause.  A striking 21% (1 of 5) women and 12% of men will have at least one episode of major depressive disorder in their lifetimes. 

About 5% of women experience premenstrual dysphoric disorder, a recurrent period of marked irritability and mood instability in the 1-2 weeks before menses.  Depression during pregnancy and after birth occurs in about 14% of mothers.  During the menopausal transition, depression affects between 12-23% of women 40-59 years old.  Many treatment options are available to restore stable mood and reclaim function.  The Assessing Stress, Health, Emotion, and Response (ASHER) Registry Clinic at Northwestern University is targeting  this problem.  Their initial focus will be on the clinical care of women with reproductive related depressive episodes.

Source:  Asher Center for Research and Treatment of Depressive Disorders
Department of Psychiatry and Behavioral Sciences
Northwestern University Feinberg School of Medicine


Posted by on January 16, 2013 - 2:57pm

You might feel blue around the winter holidays, or get into a slump after the fun and festivities have ended. Some people have more serious mood changes year after year, lasting throughout the fall and winter when there’s less natural sunlight. What is it about the darkening days that can leave us down in the dumps? And what can we do about it?

NIH-funded researchers have been studying the “winter blues” and a more severe type of depression called seasonal affective disorder, or SAD, for more than 3 decades.  Still, much remains unknown about these winter-related shifts in mood.

“Winter blues is a general term, not a medical diagnosis. It’s fairly common, and it’s more mild than serious. It usually clears up on its own in a fairly short amount of time,” says Dr. Matthew Rudorfer, a mental health expert at NIH. The so-called winter blues are often linked to something specific, such as stressful holidays or reminders of absent loved ones.

“Seasonal affective disorder, though, is different. It’s a well-defined clinical diagnosis that’s related to the shortening of daylight hours,” says Rudorfer. “It interferes with daily functioning over a significant period of time.” A key feature of SAD is that it follows a regular pattern. It appears each year as the seasons change, and it goes away several months later, usually during spring and summer.

SAD is more common in northern than in southern parts of the United States, where winter days last longer. “In Florida only about 1% of the population is likely to suffer from SAD. But in the northernmost parts of the U.S, about 10% of people in Alaska may be affected,” says Rudorfer.   “Some people say that SAD can look like a kind of hibernation.  People with SAD tend to be withdrawn, have low energy, oversleep and put on weight. They might crave carbohydrates,” such as cakes, candies and cookies. Without treatment, these symptoms generally last until the days start getting longer.

Shorter days seem to be a main trigger for SAD. Reduced sunlight in fall and winter can disrupt your body’s internal clock, or circadian rhythm. This 24-hour “master clock” responds to cues in your surroundings, especially light and darkness. During the day, your brain sends signals to other parts of the body to help keep you awake and ready for action. At night, a tiny gland in the brain produces a chemical called melatonin, which helps you sleep. Shortened daylight hours in winter can alter this natural rhythm and lead to SAD in certain people.

NIH researchers first recognized the link between light and seasonal depression back in the early 1980s. These scientists pioneered the use of light therapy, which has since become a standard treatment for SAD. “Light therapy is meant to replace the missing daylight hours with an artificial substitute,” says Rudorfer.

In light therapy, patients generally sit in front of a light box every morning for 30 minutes or more, depending on the doctor’s recommendation. The box shines light much brighter than ordinary indoor lighting.

Studies have shown that light therapy relieves SAD symptoms for as much as 70% of patients after a few weeks of treatment. Some improvement can be detected even sooner. “Our research has found that patients report an improvement in depression scores after even the first administration of light,” says Dr. Teodor Postolache, who treats anxiety and mood disorders at the University of Maryland School of Medicine. “Still, a sizable proportion of patients improve but do not fully respond to light treatment alone.”

Once started, light therapy should continue every day well into spring. “Sitting 30 minutes or more in front of a light box every day can put a strain on some schedules,” says Dr. Teodor Postolache of U of Maryland. So some people tend to stop using the light boxes after a while. Other options have been tested, such as light-emitting visors that allow patients to move around during therapy. “But results with visors for treating SAD haven’t been as promising as hoped,” Postolache says.

Light therapy is usually considered a first line treatment for SAD, but it doesn’t work for everyone. Studies show that certain antidepressant drugs can be effective in many cases of SAD. The antidepressant bupropion (Wellbutrin) has been approved by the U.S. Food and Drug Administration for treating SAD and for preventing winter depression. Doctors sometimes prescribe other antidepressants as well.

Growing evidence suggests that cognitive behavioral therapy (CBT)—a type of talk therapy—can also help patients who have SAD. “For the ‘cognitive’ part of CBT, we work with patients to identify negative self-defeating thoughts they have,” says Dr. Kelly Rohan, a SAD specialist at the University of Vermont. “We try to look objectively at the thought and then reframe it into something that’s more accurate, less negative, and maybe even a little more positive. The ‘behavioral’ part of CBT tries to teach people new behaviors to engage in when they’re feeling depressed, to help them feel better.” A preliminary study by Rohan and colleagues compared CBT to light therapy. Both were found effective at relieving SAD symptoms over 6 weeks in the winter. “We also found that people treated with CBT have less depression and less return of SAD the following winter compared to people who were treated with light therapy,” Rohan says.

If you’re feeling blue this winter, and if the feelings last for several weeks, talk to a health care provider. “It’s true that SAD goes away on its own, but that could take 5 months or more. Five months of every year is a long time to be impaired and suffering,” says Rudorfer. “SAD is generally quite treatable, and the treatment options keep increasing and improving.”

Source:  NIH News in Health

Posted by on October 3, 2012 - 11:47am

The following is written verbatim from the the Lesbian Community Cancer Project:   Within the last decade, the relationship between mental health and sexual orientation has been researched more comprehensively. Studies have found that women who engage in same-sex sexual behavior and/or identify as lesbian, gay, bisexual or queer (LGBQ), are at greater risk for mental health concerns than women who do not engage in same-sex sexual behavior. Specifically, women who identify as LGBQ often experience feelings of depression, anxiety and stress based on living in a stigmatized and homophobic culture, and may engage in risky behaviors (e.g., alcohol, drug, or tobacco use) to relieve these emotions. These risky behaviors are ultimately associated with negative psychological, health and job-related outcomes.

LGBQ women are also at increased risk of interpersonal victimization (i.e., verbal, physical and sexual abuse) compared to their heterosexual counterparts. As a result, LGBQ women may experience internalized homophobia (i.e., negative feelings or attitudes towards oneself for identifying as LGBQ, based on living within a homophobic society), which is also linked to depression, anxiety, stress and greater alcohol/drug use. For individuals who identify as trans-masculine or trans-feminine, the risks of mental and behavioral health concerns increase significantly.

It is important to know that, while these mental health concerns may be overwhelming or discouraging, these feelings and stressors are not your fault. Remember that places like Howard Brown Health Center (HBHC) are here for you, and provide health and wellness services that are specialized for the LGBTQ community.

Reference:  The Impact of Minority Stress on Mental Health and Substance Use Among Sexual Minority Women by Keren Lahavot and Jane M. Simoni.

Posted by on August 8, 2012 - 9:25am

Results of a recent study in Preventive Medicine showed that compared to men, women are at greater risk for comorbid metabolic syndrome, depression and high homocysteine levels, thus prompting researchers to conclude that women must become more active in order to decrease their risk for disease.

Researchers analyzed data from the 2005-2006 National Health and Nutrition Examination Survey, which included 1,146 people in various regions.  Those studied were older than 20 years old and not pregnant.  Participants wore an accelerometer (a device that measures both intensity and frequency of physical activity) for at least four days, ten hours per day to measure physical activity.  To measure depression, participants completed a survey and underwent a depression evaluation. Researchers measured homocysteine via non-fasting blood samples.  They also measured waist circumference, triglycerides, HDL-cholesterol, systolic and diastolic blood pressure, glucose, folate and vitamin B-12 in order to assess metabolic syndrome.

Defined by the American Heart Association/National Heart, Lung, and Blood Institute, patients have metabolic syndrome when diagnosed with three or more of the following: high waist circumference (≥102 cm for men, ≥88 cm for women), high levels of triglycerides (>150 mg/dL), low levels of HDL cholesterol (<40 mg/dL for men and <50 mg/dL or those taking cholesterol lowering medications), high blood pressure (≥130 mm Hg systolic or ≥85 mm Hg diastolic or those under medication lowering blood pressure) and high fasting glucose levels (≥100 mg/dL or those taking insulin or pills for diabetes).  These conditions increase the risk of cardiovascular disease, stroke and diabetes.

Results of the study revealed a stronger association between physical activity and comorbid metabolic syndrome, depression and high homocysteine for women compared to men. Researchers concluded that there was an inverse association between regular exercise and the three co-morbidities. The results prompted researchers to prescribe physical activity not only to reduce the conditions involved with metabolic syndrome, but also to reduce depression, which indirectly reduces metabolic syndrome since depression can aid in forming conditions of metabolic syndrome.

According to the Illinois Women’s Health Registry, when asked how women would classify their levels of activity throughout the day, 16% reported as very active, 59% as moderately active, and 24% as sedentary. At the very minimum, the CDC recommends 150 minutes of moderate exercise per week, or 21.4 min/day.  Female participants included in the study exercised 4.3 minutes less per day than recommended by the CDC, and one in four Illinois women report no exercise.  To reduce the chance of metabolic syndrome and the other co-morbidities, women must start exercising more.

Additional Sources:

Accelerometers in Obesity


Posted by on July 27, 2012 - 6:46am

The onset of puberty is associated with an increase in depression among adolescents, particularly among adolescent girls. According to the 2008 to 2010 National Surveys on Drug Use and Health, an annual average of 1.4 million girls aged 12 to 17 (12.0 percent) experienced a major depressive episode (MDE) in the past year—a rate nearly 3 times that of their male peers (4.5 percent). The percentage of girls who experienced MDE tripled between the ages of 12 and 15 (from 5.1 to 15.2 percent). About one third of girls aged 12 to 14 with MDE received treatment for depression in the past year compared with about two fifths of those aged 15 to 17.

Given the young age at which MDE begins to increase among girls, prevention and intervention efforts targeting adolescents in middle school may help ameliorate depression onset, as well as reduce depression recurrence through the life course. For more information about ways that health professionals can address the mental health needs of adolescent girls and women, please visit

Source: National Survey on Drug Use and Health (NSDUH), July 19, 2012.