Depression women

Kl, a 27-year-old woman, was admitted to the cardiology unit from the emergency department after she called 911 claiming that she had severe chest pain. Upon arrival in the ED it was noted that her blood pressure was slightly elevated at 143/92 mm Hg, and that she was diaphoretic. She was in otherwise good physical condition, with no previous cardiac history. After a urine toxicology screen was positive for cocaine she admitted that she had smoked several rocks of crack an hour prior to having the chest pain. She said she almost never uses crack, but she s currently really depressed because she has lost her job. 

Hypomania and use with other antidepressants One case has been reported of concurrent use of hypericum with an SSRI. Gordon (1998) reported a case of a 50-year-old woman taking 600 mg/day of hypericum for chronic depression. She had discontinued taking Paxil 10 days prior to hypericum and experienced no ill effects at that time. However, she added 20 mg of paroxetine to her regimen of hypericum to improve her sleep. She presented with lethargy, nausea, and weakness, but vital signs and mental status were normal. Following discontinuation of medications, she returned to normal status the next day. 

For reasons that are not entirely clear, insomnia is also more common in women than men. There are particular times when a woman is especially vulnerable to insomnia, including pregnancy, the transition into menopause, and the premenstrual phase of the menstrual cycle. This, of course, suggests that it is changes in the female reproductive system that somehow alter sleep. Depression and anxiety are also more common in women at these times, and insomnia is a common symptom of these psychiatric illnesses. 

The person I admire most is my sister. I call her Wonder Woman. A professional who copes daily with the most stressful and potentially depressing situations, she is the strongest person I know. 

Like several other interviewees, this woman understood her depression not only as an undeniable part of who she was, but also as a teacher, offering valuable skills (and, in her case, even a career) that carried more meaning than the improved moods achieved by medication. 

Joe and Fm a depressive. After all the introductions, a young woman suggested that it would be far better if people said, Hello, my name is so and so and I suffer from depression. She wanted people to stop thinking about themselves exclusively in terms of their illness. There is great power in such a consciousness shift. The point is eloquently made by an interviewee who told me ... 

Case Example A 29-year-old woman presented for consultation on referral from a psychiatrist who had seen her in psychodynamically oriented psychotherapy for approximately 10 years. The primary difficulty was intermittent interpersonal strife with fellow workers and supervisors. Thus, although quite competent, she had switched positions frequently because of these difficulties. Her history indicated that she had never experienced a full depressive, hypomanic, or manic episode, but that these problems seemed to coincide with intermittent periods of irritability. As a result, she was placed on a trial of lithium, with therapeutic blood levels. Within several weeks of treatment initiation, her difficulties with fellow coworkers and supervisors ceased, and during 1 year of follow-up, she did not have a recurrence of these problems. 

Case Example A 28-year-old woman had been stable on lithium treatment for several years. When she became pregnant, her lithium was discontinued, and within a few weeks she was hospitalized for a severe exacerbation of mania unresponsive to CPZ in doses up to 1,200 mg/day. After a course of ECT she became euthymic and was adequately maintained on lower doses of CPZ (i.e., 50 to 100 mg/day) for the remainder of her pregnancy. The delivery and the immediate postpartum period went well, but lithium was not resumed because she opted to nurse her infant. Several weeks later, she was rehospitalized for an episode of depression, which also responded to a course of ECT. She then agreed to discontinue nursing her child and resume lithium. The patient was doing well at follow-up 1 year later. 

Figure 14—28 also indicates the two riskiest periods in a woman s life cycle for the onset of a first episode of depression or for the recurrence of a major depressive... 

FIGURE 14-28. Several issues of importance in assessing women s vulnerability to the onset and recurrence of depression are illustrated here. These include first onset in puberty and young adulthood premenstrual syndrome (PMS) and menstrual magnification as harbingers of future episodes or incomplete recovery states from prior episodes of depression and two periods of especially high vulnerability for first episodes of depression or for recurrence if a woman has already experienced an episode, namely, the postpartum period and the perimenopausal period. 

A 23-year-old woman with ulcerative colitis and no previous psychiatric disorders developed emotional lability, euphoria, persecutory delusions, irritability, and increased motor and verbal activity 3 weeks after starting to take betamethasone 4 mg/day. She improved within a few weeks with bromperidol 3 mg/day. After 10 months she became unable to speak and eat, was mute, depressive, and sorrowful, and... 

Five women using the Norplant system developed major depression, two of whom also developed obsessive-compulsive disorder and one of whom also developed agoraphobia (28). They had no prior psychiatric history but developed major depression within 1-3 months after insertion of Norplant. The depression worsened over time and in all cases resolved within 1-2 months after removal of Norplant. There was no recurrence of depression after 7-8 months in four cases available for follow-up. In addition to major depression, obsessive-compulsive disorder developed in two women and symptoms of agoraphobia developed in one woman during Norplant treatment, which resolved after removal. 

A 44-year-old woman with no previous history of widespread pain, depression, or anxiety developed a diffuse pain syndrome consistent with fibromyalgia after leuprorelin treatment. Her symptoms increased in severity with three successive monthly injections, and persisted for several months (53). 

A severely depressed woman developed a mixed affective state after taking melatonin for 7 days in a clinical trial... 

A previously fit 19-year-old woman had severe ST segment depression and increased troponin concentrations after a bolus dose of oxytocin 5 units (8). 

A 28-year-old woman took an extract of C. sativum for 7 days to augment lactation while breastfeeding. She developed severe stomach pain and diarrhea and 15 days later resented with dark skin, depression, dehydration, and amenorrhea. A diagnosis of adrenal dysfunction was made, the herbal remedy was withdrawn, and she was treated with dexamethasone, prednisolone, and an oral contraceptive. Her symptoms resolved within 10 days. 

A 28-year-old woman with bipolar depression developed clinical and biochemical evidence of hyperthyroidism, ascribed to thyroiditis, while taking gabapentin (4800 mg/day) in a clinical trial (429). The condition cleared after withdrawal, and subsequent exposure to a lower dose of gabapentin (1500 mg/day) was uneventful. 

A depressed 27-year-old woman taking mirtazapine developed hyperprolactinemia and galactorrhea after taking olanzapine 10 mg/day for 5 weeks (582). 

A woman with a 2-week history of insomnia took zopiclone 7.5 mg nightly and over the next 9 days became confused, lethargic, and depressed, culminating in an overdose of six zopiclone tablets. Her previous medical history included hypertension and two episodes of diuretic-induced SIADH. Her serum sodium was 129 mmol/1 and 4 days later fell to 113 mmol/1. Her serum osmolality was low (240 mmol/kg) and her urine sodium was 20 mmol/1. The serum sodium returned to normal 12 days after withdrawal of zopiclone. 

Overall, the DEA has reported more than 72 deaths and 5,500 emergency room overdoses associated with GHB, and serious ill effects related to GBL and related drugs, GHB and BD, in at least five children under 18 years of age. All five children had vomiting and became unconscious, and most had respiratory depression and dangerous slowing of heart rate. As GBL crosses the placenta, a pregnant woman exposes her unborn baby to its dangerous effects. 

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