Physicians urged to watch for symptoms of depression

Art Nadler

Monday, May 5, 1997 | 11:59 a.m.

Statistics show that each year 20 million American adults suffer bouts of depression.

Women are twice as likely to be afflicted as men.

Identifying women who fall into this category can be difficult. That's why obstetricians and gynecologists might be their best line of defense.

"It makes sense for Ob/Gyns to be involved in treating depression," said Dr. Sharon Phelan, associate professor of the Department of Ob/Gyn at the University of Alabama in Birmingham. "Menopause, adolescence, motherhood -- these are times that can be difficult.

Phelan, speaking to journalists at a recent annual meeting of the American College of Obstetricians and Gynecologists in Las Vegas, said pregnant women are especially susceptible to depression. The fear of becoming a mother and changes in body metabolism can be overwhelming, she said.

"Perfect strangers will come up and pat you on the stomach," Phelan said of people's arrogance. "She is not allowed to say, 'Don't do that,' or tell them she is depressed."

Recent childbirth can also bring on postpartum depression, Phelan said, but it should pass within two weeks. The important thing to remember is to be patient with a new mother, while she is going through this period.

Phelan warns that if women frequently experience depression, getting pregnant will increase their risk of experiencing it again. They should only be worried if they experience five of nine conditions for more than two weeks, or if diagnosed as having a major depressive disorder. The symptoms are:

* Experiencing a depressed mood most of the day.

* Diminished interest and pleasure in daily activities.

* Significant weight loss or weight gain, or a marked decrease or increase in appetite.

* Inability to sleep, or too much sleep.

* Agitation and restlessness, or lethargic movements.

* Fatigue and loss of energy.

* Feelings of worthlessness, or feelings of excessive or inappropriate guilt.

* Diminished ability to think or concentrate.

* Recurrent thoughts of death or suicide, specific plans for suicide, or suicide attempts.

It's important, Phelan said, for Ob/Gyns to be able to recognize these symptoms and for women to feel they can confide in them when experiencing these feelings.

The Association of Professors of Gynecology and Obstetrics has recently produced an educational guide to help gynecologists deal with patients suffering depression. It's called "Depressive Disorders In Women: Diagnosis, Treatment and Monitoring."