Psychotherapy Found as Effective for Depression as Medication

•February 25, 2016 • Leave a Comment

Abstract: A nice meta-analysis of treatments for major depression by primary care clinicians. The authors point out multiple limitations of their studies, but for what it’s worth, once again cognitive behavioral therapy (CBT) looks as good as antidepressants, and does not cause side effects. A problem with CBT is that it is expensive, time consuming, and not always available.

This meta-analysis again confirms the effectiveness of psychotherapy for depression. However, I don’t agree with their last sentence that therapy is expensive (health insurance companies often cover this treatment), time consuming (as short-term psychotherapy is quite effective) or difficult to find (most psychologists are well versed in CBT, as well as other strategies and techniques in treating depression).

Great News for Perinatal Disorders!!

•February 19, 2016 • Leave a Comment

I couldn’t resist posting this great news:))

BRINGING POSTPARTUM DEPRESSION OUT OF THE SHADOWS
More than 1 in 10 new mothers experience postpartum depression, which can last for months or even years. It can increase anxiety, guilt and self-blame.
We also know that there are often implications for the estimated 400,000 infants born each year to mothers who experience postpartum depression – poor bonding between the mother and infant can have negative effects on the child’s development and behavior.
But there is good news – this is a treatable condition and we’re working to pass a bill to get more mothers the care that they need.
The bipartisan Bringing Postpartum Depression Out of the Shadows Act of 2015, of which I am a cosponsor and strong supporter, would provide federal grants to assist states in their efforts to identify and treat maternal depression.
We want these mothers to know that they are not alone and that there is absolutely hope.
To learn more about my work on your behalf, please visit my website.
For more photos and videos, please join me on social media:

It is an honor to represent you in Congress.
Sincerely,

Bob Dold
United States Congressman
P.S. I’m committed to working on issues to keep women, children and families healthy.

Early Recognition Of Symptoms During Pregnancy Equals Better Outcomes

•September 24, 2015 • Leave a Comment

In my practice offering therapy for perinatal mood and anxiety disorders (PMAD), women who are experiencing significant anxiety or depression during their pregnancy or after the birth of their babies, I am always left with the question: Could this have been diagnosed earlier and would this result in quicker recovery?

For example, if during pregnancy the OB/GYN had used screening advocated by the American Psychological Association, perhaps the most serious affects of PMAD could be avoided, or at least ameliorated. By adding just two depression-screening questions to the physician’s check-in forms, the medical team and patient could have had a head start in dealing with this potentially debilitating illness.

I have found that if we treat these symptoms during pregnancy, my patient and I are often able to lessen or eliminate symptoms and then have an opportunity to set up a postpartum plan, which can be very effective in decreasing the likelihood of a postpartum depression. Although I can’t guarantee it will prevent the illness in every case, it certainly seems to make a difference.

A recent article confirms my belief. The American College of Obstetricians and Gynecologists estimates one in seven women experience depression during pregnancy or within 12 months of delivery. Hormones, stress, infertility, isolation and previous experiences with depression or anxiety can jumpstart PMAD.

Although many women report a range of mental health issues while pregnant — from suicidal thoughts to unrelenting unhappiness, less than 20 percent report these symptoms to others. Far too often, their medical team, partner, family members, and friends are left in the dark.

“Cultural expectations” that pregnancy and having a child will be the most significant and happy occurrence, leading to a lifetime of bliss, can contribute to feelings of guilt and shame when hopelessness trumps happiness.

And if the pregnancy is unplanned, such as with teen pregnancy or even later in life, this may add another layer of stress and panic.

What I’ve found to be the most effective in helping women navigate depression and severe anxiety during pregnancy and after the birth of their child, is to get into treatment early with a mental health professional specializing in perinatal issues.

It is also essential that they have a good support network, by sharing with partners, friends and family, and perhaps participating in a support group. The combination of therapy, supportive relationships, and sometimes medication, will help reduce the severity of symptoms and lead to a better long-term outcome for mother and baby.

Netflix Leads the Way In Providing Paid Maternity Benefits

•August 7, 2015 • 1 Comment

Many of us who are concerned with the health of new mothers have long been disturbed at our country’s poor record on paid maternity leave. According to a recent article, the embarrassing news is that we are the only country in the world, aside from Papua New Guinea that doesn’t guarantee paid maternity leave.

But things may be changing. Netflix, the Internet streaming company that led the way we watch old and new television shows, is doing the same by offering its employees unlimited paid maternity and paternity leave for the first year after a child’s birth.

I’m particularly hailing this step because in 2013 researchers from the University of Maryland School of Public Health found that women who had shorter maternity leaves were much more likely to develop depression after their child’s birth. It makes sense that these new mothers are overwhelmed with worries about the health of their baby, spending enough time with their child, and all of the expenses that accompany newborns.

The U.S. Family and Medical Leave Act of 1993 (FMLA) mandates 12 weeks of paid leave for new mothers, but that’s not enough to provide them with sufficient recovery, and crucial emotional bonding time.

Other studies concur with UMSPH and say that new mothers who take extended time off after their child is born are better equipped to fight stress, depression, fatigue, and illness during this major passage in their life.

Researchers found that women who took more than 12 weeks of leave experienced more energy, improved mental and physical health, and a stronger bond with their child — and importantly, their children benefited significantly.

While opponents of paid leave argue that it’s an economic burden, states where experiments with paid leave have been in place for some time found there is no evidence this policy is bad for business.

My personal hope is that other companies will follow Netflix lead, and be proactive in supporting not only new mother’s mental health, but also the health of the entire family.

http://www.medicaldaily.com/netflix-allow-one-year-paternity-and-maternity-leave-how-will-benefit-parents-and-346278

Health Tap: A Unique Way to have a Virtual Consult or Office Visit

•July 7, 2015 • Leave a Comment

About two or more years ago, I joined HealthTap, an interactive Web site, in which users can gain free medical advice from doctors in various specialized areas of medicine by posing their questions on the site.

The mission of HealthTap is to measurably prolong the life expectancy of humankind and help everyone Feel Good by providing immediate access to top medical experts and their trusted health advice anytime, anywhere.

Over the last few years, I have been responding to questions from all over the country and even all over the world about various mental health issues, such as depression, anxiety, perinatal mood disorders, sexual issues and relationship problems.

According to my most recent perusal of the site, I have helped 273,699 people since I started using some free time to respond to questions regarding mental health. I have created four checklists to provide tips for dealing with anxiety and coping with stress, and I have a following of 254 people, as well as 176 medical colleagues.

All in all, it’s been an wonderful way to share my areas of specialization and I’ve enjoyed this pro bono work and volunteer opportunity.

Most recently, HealthTap has created a new service in which patients can (for a small fee)
gain virtual consults and office visits with medical specialists. I have decided to participate in order to give my own patients the opportunity to do virtual consults in-between sessions or if distance is prohibitive. Additionally, this feature allows me to consult with patients all over the world. (Note: nationally I can only provide virtual consults with Illinois residents due to my state licensure restrictions).

Connect with me on my Virtual Practice on Health Tap.

https://www.healthtap.com

Visit the Virtual Practice of Dr. Susan Feingold on HealthTap

Antidepressants During Pregnancy: Yes, No or Maybe

•June 5, 2015 • Leave a Comment

I recently read a magazine article in The New York Times written by Andrew Solomon, and titled, “The Secret Sadness of Depression.” Perhaps you read it, too. The story’s subtitle was: “Pregnant women often fear taking the antidepressants they rely on. But not treating their mental illness can be just as dangerous.”

The article covered a topic that frequently arises in my therapeutic sessions with patients. And, because there is no definitive answer of the short or long-term effects of pregnant women taking antidepressants, the question continues to puzzle us.

In my mind, it comes down to a risk-benefit analysis between patient and mental health provider. As with any medication, there are some (yet at times only minimal) risks. However, in some cases, like the one profiled in the article, these types of medications might have been life saving.

If pressed, I’d have to come down on the side of this statement by one of the experts cited, “Untreated depression can take a heavy toll; this isn’t a matter of being depressed for nine months, but of a potential escalation that can result in a lifetime of struggle.”

The tragedy examined in the magazine article involved Mary, a 37-year-old woman who had struggled with depression for much of her life — a fact few of her friends or colleagues knew. Prior to pregnancy, she had dealt with her depression with a combination of therapy and antidepressant and antianxiety medications.

Although Mary was delighted when she learned she was pregnant, she expected the experience to be blissful. And because she had read about the potential danger for a growing fetus with a mother’s use of antidepressants, she opted to discontinue her use of the medication.

Despite being monitored by a psychiatric nurse practitioner, Mary couldn’t shake the idea that something was wrong with the fetus. She spiraled downward, until finally near the end of her fifth month of pregnancy, she resumed taking antidepressants. But, it may have been too late, for at six and a half months pregnant, she jumped to her death.

The question for her medical team was: if Mary had stayed on her medications without a break, or even gone back on them sooner, would she have survived? However, this is an impossible question to answer.

The positive effect of this story is its spotlight on a condition known as antenatal depression, or depression suffered during pregnancy, which affects up to 15 percent of expectant women. The author says, “For more than half of the women who develop postpartum depression, the condition is simply an escalation of pre-existing depression; addressing the antenatal problem would ameliorate the postpartum one.”

He goes on to say, “We have not acknowledged how appropriately anxiety-ridden pregnancy is, how traumatic the change in identity that accompanies prospective motherhood can be.”

Gratefully, studies on the effects of antidepressants on the fetus are numerous and ongoing. Perhaps at some point, there will be definitive evidence to help patients and medical personnel make an informed decision regarding their use during pregnancy.

But currently, I will reiterate my beginning comments: this is a decision to be made between patient and their mental health provider. And to keep in mind, not treating mental illness can be life threatening and a dangerous choice.

Nashville deals with issue of Postpartum Depression

•May 21, 2015 • Leave a Comment

Here’s a recent article that appeared in the Huffington Post about how the TV series, Nashville dealt with the issue of postpartum depression.

http://www.huffingtonpost.com/2015/05/15/nashville-postpartum-depression_n_7289162.html?1431706211

 
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