Term
| do estrogen/progesterone affect the NTs? |
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Definition
| yes estrogen/progesterone can affect nor-epinephrine, serotonin, dopamine, GABA, histamine |
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Term
| t/f, women are more affected by emotions than men? |
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Definition
| t, women are very profoundly influenced by mood regulatory mechanisms within hypothalamus (more prone to depression/SADD/anxiety). male behavior is regulated more extra-cerebrally (more prone to alcohol abuse/dependence, anti-social behavior). |
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Term
| what % of women have insomnia around in their premenstrual time? |
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Definition
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Term
| what is premenstrual syndrome (PMS)? |
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Definition
| changes in emotion occurring in the late luteal phase which affect cognitive ability and are associated w/somatic complaints - sometimes to the point where they *interfere w/the person's daily life*. these include: irritability, depression, anger, fatigue, changes in libido, sensation of abdominal bloating, and menstrual cramps. w/in 1-2 days, once menstrual flow starts, these symptoms will abate (until the next month). |
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Term
| what is premenstrual dysmorphic disorder (PMDD)? |
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Definition
| similar to PMS symptoms, but more severe with irritability/anxiety being the most prominent. depression, labile effect, changes in appetite, loss of interest in normally appealing things, and the somatic symptoms: headaches/abdominal bloating/breast tenderness all may occur. PMDD is differentiated from basic personality traits as these symptoms do disappear w/oophorectomy. this is more rare, affecting ~ < 8% of women. |
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Term
| what is the difference between PMS and PMDD? |
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Definition
| in PMDD, daily function becomes very impaired (hard time attending school, work, usual family responsibilities) - but both are associated w/the late luteal stage of the menstrual cycle. |
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Term
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Definition
| *emotional tx: anti-depressants (SSRIs), short acting tranquilizers, short-term diuretic use (effective, but MOA unknown), and temporary stimulant use. *somatic tx: NSAIDs, OCPs, OMM (sacral inhibition), acupressure |
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Term
| what is the internal emotional reaction in pregnant women (when she knows she's going to be a mother)? |
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Definition
| feelings of love/needing to be loved - which can affect her self-image. pregnancy can also carry many ambivalent/mixed feelings. this is a real adjustment process for women (dealing w/biological and emotional change). pregnant women are referred to as "expectant" (not just expecting to be a mother, expecting to have a child, but expecting all other issues that register). |
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Term
| what may emotionally characterize the first trimester of pregnancy? |
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Definition
| constant cramping and n/v may discourage the woman from her enthusiasm for motherhood. |
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Term
| what may emotionally characterize the second trimester of pregnancy? |
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Definition
| the woman has the outer appearance of pregnancy, can hear fetal heart sounds and see the baby on US - pregnancy becomes more of a reality. |
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Term
| what may emotionally characterize the third trimester of pregnancy? |
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Definition
| "it's time to give birth" |
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Term
| can labor/delivery be complicated by the mother's apprehensions about it? what can help w/this? |
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Definition
| yes - particularly apprehensions about the pain involved. coaching the mother on the labor process can help diminish this (better sense of pain control). |
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Term
| as a mother holds her child for the first time, how could the fact the baby is not inside her anymore affect her? |
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Definition
| she may experience a sense of loss |
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Term
| what are some of the psychological changes associated w/childbirth? |
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Definition
| an increased sense of anticipation, energy, some anxiety, and a sense of "what to do" after completing the challenge of delivery. 80% of women will show mood changes post-partum and 20% may meet criteria for a major mood disorder. |
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Term
| what is the most common mood change after delivery? |
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Definition
| baby blues, which occurs over the first 5 days post-partum, then tapers off over 2 wks. baby blues consist of a *transient sense of sadness, being wiped out and spontaneous tearing. |
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Term
| what is post-partum depression? when can it start? symptoms? tx? |
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Definition
| when baby blues becomes a deeper depression - likely related in a large part to difficulty w/sleep maintenance due to a sense of hypervigilance as the newborn calls for the mother at night. post-partum depression *may start as late as 12 wks.* symptoms: profound depression, inability to experience pleasure, anorexia, sleep problems, suicidal thoughts, difficulty summoning energy to take care of necessary tasks, feelings of guilt w/no reason, and obsessive fear about the baby's safety. best tx: sleep for mom |
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Term
| what is post-partum psychosis? |
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Definition
| the worst post-partum reaction, a very severe form of mental disorder which can start as soon as 2-3 days after delivery (risk extends up to 4 mos). post-partum psychosis involves an *inability to perceive reality, including hallucinations, mania (not depression), delusions (may involve baby, demons, aliens, etc), and is a great risk for mother/baby. |
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Term
| what is the route by which changes in the brain effects changes in the rest of the body? |
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Definition
| the HPA axis (hypothalamus – pituitary – adrenals), from which all the peripheral responses, such as anorexia, irritability, hyper-reactivity, lassitude, fatigue, and metabolic changes derive. |
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Term
| what are the risk factors for any post-partum problems? |
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Definition
| family hx, severe depression during pregnancy, past psych hx, sexual abuse hx, significant PMS, unplanned pregnancy, sleep deprivation, and no adequate social support. |
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Term
| when are psych meds given to pregnant mothers? |
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Definition
| when they pose a realistic threat to themselves/the baby - *except lithium which can cause epstein's heart anomaly (esp in the 1st trimester)* |
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Term
| what are the options to treat a depressed nursing mother? |
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Definition
| bottle feed and give meds or just give meds and let her continue nursing (antidepressants are more present in amniotic fluid than mother's milk) |
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Term
| what are the categories of drug safety? |
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Definition
| A: no risk. B: no controlled studies, but no sense drug is harmful. C: demonstrated ADRs in animal models, no evidence in humans. D: known human fetal risk, may be life-threatening. X: proven harmful to fetus, 100% contraindicated for pregnant women (such as valproic acid) |
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Term
| why is menopause also called the "climacteric period"? |
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Definition
| b/c it can also occur in men |
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Term
| why is depression associated w/menopause? |
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Definition
| the *loss* of emotions connected with reproductive cycle - combined with other changes associated w/aging (loss of friends/family). people who invest everything in family will be affected more by this. |
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Term
| when is the incidence of major depression highest in women? |
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Definition
| in the menopausal/climacteric period |
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Term
| what symptoms are associated with menopause? tx? |
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Definition
| symptoms: night sweats, sleep disturbance, vasomotor instability, loss of libido, vaginal dryness, and dyspareunia . tx: black cohosh/antidepressants/counseling. |
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Term
| what is "instant menopause"? |
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Definition
| hysterectomy - one must adjust psychologically to what made surgery necessary and to loss of body part and to loss of reproductive ability. (breast sx can have a similar effect). |
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