Estrogen-Depression Connection , livre ebook

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What You Need to Know About Hormones and Depression

Research has shown a strong connection between estrogen levels and depression throughout a woman''s lifetime. We now understand that abrupt hormonal changes can take a toll on women''s moods and even cause serious depression. But the good news is that there is a lot women can do to moderate the effect of these changes.

The Estrogen-Depression Connection explores this issue and offers practical advice and tips for managing mood changes throughout all the major stages of a woman''s life-from puberty and menstruation to pregnancy and postpartum, and from perimenopause to menopause. It explains in easy-to-understand terms what women can do right now to help balance these estrogen fluctuations through diet and lifestyle changes, alternative therapies, and medication.

Get the information you need:•Learn how estrogen affects each stage of a woman''s life•Cope with postpartum depression and menopause•Find the best medical and alternative treatments


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Date de parution

01 janvier 0001

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0

EAN13

9781608825097

Langue

English

Poids de l'ouvrage

1 Mo

Publisher’s Note
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. The authors, editors, and publisher have exerted every effort to ensure that any drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in this publication may have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.
Distributed in Canada by Raincoast Books
Copyright © 2007 by Karen Miller and Steven Rogers New Harbinger Publications, Inc. 5674 Shattuck Avenue Oakland, CA 94609 www.newharbinger.com
Cover and text design by Amy Shoup; Acquired by Melissa Kirk; Edited by Elisabeth Beller
All Rights Reserved
PDF ISBN: 9781608825097
___________________________________________________________________________________
Library of Congress Cataloging-in-Publication Data
Miller, Karen J.  The estrogen-depression connection : the hidden link between hormones and women’s depression / Karen J. Miller and Steven A. Rogers.  p. cm.  ISBN-13: 978-1-57224-483-2  ISBN-10: 1-57224-483-6 1. Menopause--Hormone therapy--Complications. 2. Estrogen--Physiological effect. I. Rogers, Steven A. II. Title.  RG186.E8893 2007  618.1’75061--dc22 2007005747
Table of Contents
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . v i Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v i i i Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CHAPTER 1 Estrogen & the Female Brain . . . . . . . . . . . . . . . . . . . . . . 4 What Is Estrogen? • Estrogen & Early Braîn Organîzatîon • Estrogen & the Braîn After Bîrth • Other Bîochemîcal Effects of Estrogen • Cîrcadîan Rhythms • Estrogen & Men • Conclusîon
CHAPTER 2 Puberty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 7 The Sad Truth • Puberty & the Emergence of Depressîon • Why the Rîse în Depressîon în Women? • The Face of Adolescent Depressîon • Conclusîon
CHAPTER 3 Premenstrual Syndrome & Premenstrual Dysphorîc Dîsorder . . . . .3 7 Sound Famîlîar? • What Is PMS? • Depressîon, PMS & PMDD • Why Depressîon Develops în PMS & PMDD • Conclusîon
CHAPTER 4 Postnatal & Postpartum Depressîon . 8. . . . . . . . . . . . . . . . .5 The Stîgma of Postpartum Depressîon • Three Syndromes of Postpartum Depressîon • Why Does Thîs Happen? • Conclusîon
CHAPTER 5 The Three Stages of Menopause5. . . . . . . . . . . . . . . . . . . .7 Stages of Menopause • Perîmenopausal Transîtîon • Menopause & Postmenopause Transîtîon • Symptoms of Menopause • The Blues: Depressîon & Menopause • Beyond the Deinîtîon & Numbers • Addîtîonal Rîsk Factors for Depressîon • Cognîtîve Changes Durîng Menopause • Conclusîon: Reframîng Menopause
CHAPTER 6 Tradîtîonal Treatment Approaches. . . . . . . . . . . . . . . . . 1 0 3 . Choosîng Hormone Replacement Therapy • Estrogen: Human & Synthetîc • A Combînatîon Approach • Choîces • Male Hormones • An Alternatîve: Antîdepressants • Seekîng Treatment • Conclusîon
iv
CHAPTER 7 Impact of Tradîtîonal Treatment1 1 9 . . . . . . . . . . . . . . . . . . . Depressed Postmenopausal Women • An Experîment: Estrogen’s Lînk to Well-Beîng • An Observatîon: Estrogen’s Lînk to Well-Beîng • Summîng It Up • Bottom Lîne • Impact on the Braîn • Mood & Memory Connectîon • Real-Lîfe Connectîons • Wîndow of Opportunîty • Mîsleadîng Informatîon • Estrogen, Depressîon & Health • Addîtîonal Beneits of HRT • Conclusîon
CHAPTER 8 Alternatîve Approaches to Hormone Replacement Therapy . . . . . 1 4 5 Alternatîve Choîces • Checkîng on Ellen • More of Eastern Medîcîne • Lîfestyle Changes • Mînd-Alterîng Approaches • Western Medîcîne Agaîn: Symptom Specîic • Addîtîonal Resources • Conclusîon
CHAPTER 9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 7 0 Acceptîng the Estrogen-Depressîon Connectîon • The Take-Home Message • Makîng It Personal • Conclusîon: Destîgmatîzîng Depressîon References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 8 1
v
Acknowledgments
irst, I would like to thank Dr. Gary Small and Dr. Susan Bookheimer for F countless opportunities to explore and expand my career in neurosci ence. Their mentorship and modeling inspires me daily to be a better neu ropsychologist. I am also thankful to Drs. Jarvik, Rasgon, and Bauer for the introduction into the world of hormones and their impact on the brain. My passion has been born, fueled, and inspired by these psychiatrists. Next I am thankful for my eighthfloor family at UCLA: Andrea, Debby, Linda, Prabha, Gwen, Tree, and Pauline, who have provided moral support over the years and countless stories about the impact of estrogen on real women. I am grateful to Dr. Jeanne Kim and her assistance with the reference list for this book. I am eternally thankful for the support and inspiration of my friends, clients, grad uate students, and my family, especially John, Jean, and Jack, who have forgone many lazy Sundays in order for me to accomplish my career goals. Finally, I am most appreciative of my coauthor Dr. Steve Rogers, who has proven to be my dearest colleague and friend in this bookwriting journey. —Karen J. Miller, Ph.D.
he heart and soul of this book comes from my experience with female T patients who have been gracious enough to share their stories and whose honesty has taught me more about estrogen and depression than I could learn from a textbook. They have helped me bridge the gender gap in ways I could not have imagined. I am deeply indebted to Dr. Nancy Vogt for teaching me what it means to truly listen, for helping me understand that theory is less important than presence, and for helping me to take what is fragmented in others and make it whole. I am deeply appreciative of Dr. Po Lu, who gra ciously provided space and encouragement for me to work on this project, despite needing help on several of his own. He has also provided unquestion ing support and taught me a more holistic view of the person, where biology cannot be separated from psychology. I cannot thank my mom, nor my wife, Christina, enough for their love and sacrifice. My wife’s patience and encour agement is the stuff of fairy tales, and so much of her own blood and sweat has been mixed into my career that it has become truly impossible to differentiate her effort from mine. And most of all, I want to thank my amazing coauthor, Dr. Karen Miller. She is a supervisor who became a mentor who became one of my closest friends. She has shaped my life in ways she could never fully appreciate, and there is no one else I would want to share this journey with. For that, and for her, I am eternally grateful. —Steven A. Rogers, Ph.D.
s vii Acknowledgment
Foreword
hanks to advances in medical technology, women are living longer than T ever before in history. And with this increase in life expectancy comes a longer time period during which the average woman will live in an estrogen deficient state. The growing interest in the mental effects of estrogen probably stems in part from the increased number of postmenopausal women in our aging society. Emerging scientific evidence (Kawas et al. 1997; Small 1998) from basic laboratory research, epidemiologic studies, and clinical trials is begin ning to clarify the interaction between brain estrogen and mental states, and the millions of postmenopausal women who must face decisions about their choices regarding estrogen exposure will benefit from this information. In this volume, Drs. Miller and Rogers provide a muchneeded account of one of the most interesting aspects of these interactions—the connection between estrogen and depression. Their approach offers a cuttingedge per spective on what we know and don’t know and translates the science into prose that will be accessible to a wide audience eager for accurate information.
Of course, any discussion of mood and aging also requires attention to cognition. As people age, they face an increased risk for memory loss and a variety of forms of cognitive impairment. Approximately 10 percent of women aged sixtyfive and above experience cognitive decline that interferes with daily functioning (Small 2002). To complicate matters, older depressed women frequently complain about poor concentration, so clinicians often have dif ficulty differentiating a primary mood disorder from a cognitive one in late life. Estrogen may mediate cognitive changes associated with aging. Studies of brain structures involved in memory show that estrogen facilitates the memory process by promoting better brain cell (neuron) activity. This promotion occurs because estrogen increases the communication between neurons, which is calledlongterm potentiationandneuronal transmission. Estrogen also improves the overall efficiency of the brain by augmenting cerebral blood flow and metabolism, as well as promoting cholinergic neurons. All of these are critical to normal cognitive functioning and have been observed to decline in people with dementia, suggesting that estrogen might be important in protecting the brain. Estrogen may also have an important impact on a person’s brain and overall health because it modulates inflammation, genetics (apolipoprotein E), and the metabolism of the amyloid precursor protein, all of which influence cognitive functioning. Although some epidemiological studies have suggested that estrogen supplementation might protect a woman from Alzheimer’s disease, clinical trials have not substantiated this link as yet. A variety of mechanisms may also explain estrogen effects on mood (Schneider et al. 1997). Estrogen decreases certain receptors, increases spe cific hormones and neurotransmitters, and inhibits the enzyme monoamine oxidase (MAOB), all of which have an impact on cognitive functions and mood.Specifically, in later life, depression is characterized by elevated levels of the enzyme MAOB. High levels of MAOB may result in less effective communication between brain cells as well as cell death due toneurotoxins. Our research group has conducted several studies in attempts to further elucidate this potential estrogendepression connection. The impact of estrogen therapy combined with antidepressants is of particular interest. In our study (Schneider et al. 1997) we looked at improvement of mood in a
Foreword ix
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