(no subject)

[johnpalmer]

I hate it when I hear certain kinds of news.

Did you know that a study just *proved* that pregnancy isn't a cure for depression?

Really! It's true! Some pregnant women are depressed. Pregnancy is not a universal, 100% effective, antidepressant!

Someone, *please*, tell me there's more to this than I've heard.

Or, at least tell me that they did this study because they knew they had to prove to some idiots the plain, simple, and obvious truth. *Please* tell me that it wasn't a matter of having to think about what the answer would be.

Comments

[wolfette]

If you're female, depressed and childless, the assumption of many is that the depression will be cured by having children.

[kightp.livejournal.com]

Of course, if you're female and childless, some idiotspeople will tell you anything wrong with your life will be cured by having children.

[johnpalmer.livejournal.com]

Nod. Because you can't get a supply of childlike goofiness anywhere else.

Life is better today, love... I have a pineapple.

[kightp.livejournal.com]

You and your sex toys. (-:

[johnpalmer.livejournal.com]

"It's not a sex toy. It's a pineapple."

[kightp.livejournal.com]

*eyebrow waggle* You say that now ...

[johnpalmer.livejournal.com]

Yeah... must be that biological clock ticking. That idea seems *just* reasonable enough that it's impossible to dismiss.

Uhm... I think there's more to it, John.

[wyang.livejournal.com]

If this is the same study I heard about earlier this week, the study was about the treatment of depression in pregnant women. The study had to do with the frequency of going off treatment ("to protect the baby") and the relapse of serious symptoms. I grant that it's not really rocket science to think that if someone was getting ongoing treatment for depression, becomes pregnant, and stops treatment, that relapses would presumably be fairly common... but it's interesting that in a statistically significant percentage of the studied population, a lack of continued treatment did not bring about relapse!

While pregnancy is clearly not a universal antidepressant, there are some big biochemical reasons to study depression in pregnant women. There's a release of endorphins that starts relatively early in pregnancy, which (on its face) might have a positive effect even in individuals who are depressed. Not really understanding the chemistry or biology of depression--and having minimal information about the developmental and long-term effects of anti-depressants on embryonic development--I'm pretty sure the intent was to study the impact of pharmacological treatment in a specialized population who are undergoing other biochemical changes, to hopefully learn more about the underlying pharmacology and biochemistry.

-Bill

Re: Uhm... I think there's more to it, John.

[kightp.livejournal.com]

Yup, Bill's got it right. NPR reported on this last night; Here's the JAMA article (http://jama.ama-assn.org/cgi/content/full/295/5/499) (shouldn't require registration, but I can't always tell because the university has a site license; if you can't get to it let me know and I'll send you a copy).

In addition to investigating the veracity of an old wives' tale (that hormonal changes during pregnancy are somehow protective of the woman's mental health) - and, evidently, debunking it - the study lays the groundwork for women and their doctors to assess the relative risks to the pregnant woman of going off meds versus risks to the fetus if she stays on them.

Which is a fairly important thing for women who suffer from depression and are contemplating pregnancy to know, since at least one major antidepressant (Paxil) recently added a warning that it may increase the risk of birth defects.

Like Bill, I find the unexpected findings interesting, and worth further study.

Re: Uhm... I think there's more to it, John.

[johnpalmer.livejournal.com]

Well... I grant that there's more to it than my intentional oversimplification. At the same time, on CNN, one of the doctors who was interviewed said that during her (early 80s) psychiatric residency, she was told more-or-less what I stated... that pregnancy was supposed to protect against depression.

And yeah, pregnancy, lots of hormones, oxytocin, endorphins, etc., and sure, it was a good idea to study what happens when women go off of antidepressants, and get an idea of the risks of depression and all. But the article even suggests that there was common wisdom that preganancy would protect against depression.

And it just strikes me as crazy that no one had thought to try to prove that (or gather evidence against it) until now, and that they'd still feel an obligation to mention that a lot of doctors have been taught differently. It's a good study, I'm glad they did it, and the specific issue (risks of stopping medication) was a good thing to study.

It's just, I'm surprised the introduction doesn't read "It's well established that pregnant women can suffer from depression (2-3 journal cites from 20+ years ago)..."

Re: Uhm... I think there's more to it, John.

[kightp.livejournal.com]

And it just strikes me as crazy that no one had thought to try to prove that (or gather evidence against it) until now, and that they'd still feel an obligation to mention that a lot of doctors have been taught differently.

Heh. Welcome to my world. If you ever want to see my head explode, ask me for my rant on the state of medical knowledge about women's health, especially outside of the reproductive realm.

(I just heard another knee-slapper on NPR tonight: >a href="http://www.npr.org/templates/story/story.php?storyId=5183596">women with heart problems have different symptoms than men. Women have been saying that for decades, but the standard medical model for diagnosis and treatment of heart disease is based almost entirely on studies of men. Whaddya know, it turns out that we are physiologically different, in ways that matter to our health.)

[lblanchard.livejournal.com]

Well, there's knowing something intuitively or by unsystematic observation, and then there's sitting down to make a study of it.

I'm involved in a study right now, regarding tourism in Philadelphia, that is going to produce precisely the answers everyone had predicted. But it's one thing to think you know something, and another to be able to prove you know something, especially when you're looking for funding or sponsorship. The ol' scientific rigor, you know.

Stop by and check my LJ...

[johnpalmer.livejournal.com]

Nod. I am someone's done this bit of research. It still scares me how long some ideas can stick around medicine's store of conventional wisdom.

[lblanchard.livejournal.com]

You mean it won't?

[ducks and runs]

I left you something purple on my LJ.

[kightp.livejournal.com]

I saw it, and it made my eyes burn ...

I'd look so much better in that outfit than he does.