Women and mood disorders. Menarche to menopause.

Considering the multiple issues affecting women and their experiences with mood disorders, several clinical observations may be pertinent: Because women are very vulnerable to depression, physicians in all patient care related specialties need to be familiar with the diagnosis of depression and related mood syndromes. Early intervention may be far more critical than previously considered in preventing chronic, tragic outcomes for major depression, bipolar disorder, and even severe premenstrual depression. Both dysphoric mania (because of its poor prognosis) and rapid cycling bipolar disorder (because the majority of cases involve women) distinguish bipolar illness in women. In these situations, anticonvulsants such as carbamazepine or valproic acid may offer treatment advantages over lithium. Premenstrual depression is very strongly linked to traditional psychiatric mood syndromes and is likely to benefit from appropriate antidepressant therapy. The serotonin-specific reuptake inhibitors are especially attractive in this situation because of their low side effect profiles (including low weight gain percentages) and safety in overdoses. Previous experience with psychiatric illness, especially bipolar disorder, is often predictive of postpartum mood episodes. Aggressive early treatment is critical to prevent or successfully manage postpartum episodes. Menopause cannot yet be linked to a specific or unique mood syndrome.