A fascinating piece of research has just come out from the Society for Women's Health Research that highlights that vast differences of opinion between women and physicians on the use of medication to treat depression during and after pregnancy, as well as women's lack of understanding of the risk factors for postpartum depression:
Only 10 percent of women think it is safe for women to take medication for depression while they are pregnant, compared to 68 percent of doctors, according to a new survey of women and physicians released today by the Society for Women’s Health Research. Even after pregnancy, in the postpartum period, only half of women think it is safe for women to take medication for depression, compared to 97 percent of doctors.
“This survey shows a tremendous disconnect between doctors’ beliefs about managing depression and the perceptions held by women,” said Sherry Marts, Ph.D., vice president of scientific affairs for the Society, a Washington, D.C., based advocacy organization. “The health care community needs to do a better job communicating with women about depression. We need to carefully explain the full range of treatment options for mood disorders and the pros and cons of taking medications during pregnancy and after pregnancy so that women can make better informed choices.”
African American women and women 18-34 in the survey were even more likely than others to say that it is not safe to take depression medications during pregnancy or the postpartum period.
“Many pregnant and postpartum women falsely think that depressive symptoms, and even clinical depression, are part of the normal experiences of being pregnant and delivering a baby,” said Kimberly Yonkers, M.D., an associate professor of psychiatry and obstetrics and gynecology at the Yale University School of Medicine in New Haven, Conn. “Moreover, they often assume that these symptoms will spontaneously go away when that is not always the case. There are a range of treatments available to women and we need to get the message out and encourage depressed women to access care for their emotional symptoms.”
The survey also revealed that women underestimate, compared to doctors, their risk for depression at specific life stages where they undergo a hormonal transition. The gap is largest for perimenopause and menopause. Only 47.5 percent of women thought perimenopause is a time of heightened risk for depression, compared to 83.2 percent of doctors. Even fewer women, 39.5 percent said menopause presents unique depression risks, while 77.8 percent of doctors noted this time of risk. Women’s recognition of depression risk at puberty and in postpartum was better.
“Women’s bodies undergo changes in hormone levels during key life cycle transitions from puberty to menopause,” said Marts. “Most women navigate these transitions with minimal mood disturbances, but some women experience mood disorders such as depression or bipolar disorder. We need more research to understand the underlying mechanisms in the brain where mood disorders are triggered by hormone changes. Women need to be aware of this issue and talk to their health care providers about their individual risk factors, warning signs and treatment options if needed.”
When asked about the major symptoms of depression, women focused on emotional symptoms and most neglected to mention the physical symptoms that can accompany depression, such as trouble sleeping, fatigue, changes in appetite or pain. Only 38.2 percent of women noted at least one physical symptom that can be a sign of depression, compared to 86.4 percent of doctors.
Regarding risk factors for postpartum depression, less than one percent of women mentioned family history, previous depression problems or genetics as a risk factor, compared to more than half (53.8 percent) of doctors.
The survey of 1,000 U.S. women 18 and older was conducted through a national telephone omnibus survey, Oct. 4-14, 2007, and the results are weighted to be representative of the total population. The survey of doctors took place Oct. 11-17, 2007, via the Internet. Both surveys were conducted by International Communications Research (ICR) of Media, Pa. The margin of error for the full women’s survey is plus or minus 3.1 percent. It is 4.4 percent for the survey of doctors, which included family practitioners, general practitioners and internal medicine specialists. Support for the survey was provided to the Society by Novartis through an educational grant.
