As you may or may not know, next week is National Women’s Health Week, a time when you’ll likely see promotions reminding women to get their mammograms or to visit their doctors for annual checkups. While there are many health issues that are unique to women, one that often doesn’t get the attention it deserves is a woman’s mental health. For instance, women are more likely than men to experience depression, anxiety disorders, post-traumatic stress disorder and eating disorders. There are both biological and environmental factors that contribute to the differences in men and women when it comes to mental health concerns. Biologically, hormones such as estrogen and progesterone influence brain functioning and response to stress. Prior to puberty, boys and girls have equal prevalence of depression rates. After puberty, girls are twice as likely as boys to struggle with depression. Also, periods of hormone fluctuation can pose specific risks to a woman’s mental health. For example, during perimenopause, premenstrually and during the postpartum period, women are at particularly high risk for worsening of depression and anxiety.
Despite the differences in men’s and women’s mental health issues, psychiatrist Dr. Julia Wood from Blount Memorial Parkway Psychiatric Service says the treatments aren’t all that different. “Generally speaking, we use the same psychotherapies and medications,” Wood said. “However, because the onset of psychiatric disorders often takes place during women’s reproductive years, pregnancy poses a unique dilemma to treating them. Most women would prefer to take no medication, or certainly as little medication as possible, during pregnancy. Yet, between 10 and 20 percent of women are on some type of antidepressant or other medication to treat a mental health condition during their reproductive years,” Wood explained.
Because of this, Wood says it’s important for women to take steps to protect themselves. “I advise all women of reproductive age to plan ahead for pregnancy,” she said. “First, this means taking measure to prevent pregnancy such as using contraception. Second, it means thinking ahead in terms of medication. While some women who are experiencing milder forms of depression or anxiety may be able to come off medication, others may be better advised to continue using medication through their pregnancy. If a woman wants to try to stop medication during pregnancy, I suggest she make these changes prior to conceiving in case there is a relapse of illness,” she added.
As for which medications are safe to consume during pregnancy, Wood says you always should consult your doctor. “In 1975, the Food and Drug Administration (FDA) came up with a way to categorize medications according to their reproductive safety. This system, which essentially ranks medication Category B, C, D or X depending upon safety data, is lacking, and the FDA currently is revising the way in which mediation is labeled to help both doctors and pregnant women have more information about the risks of various medication during pregnancy. Ideally, women can work with their doctors to weigh the potential risks of a particular medication during pregnancy against the risks of tapering off that medication,” she explained. “This means considering a woman’s history of mental illness, as well as the relative risks of the medication she is taking,” she added.
Dr. Wood sees patients at Parkway Psychiatric Service, located at 451 Blount Memorial Physician Office Building in Maryville. For more information or to schedule an initial appointment, call Parkway Psychiatric Service at 865-980-5377.