The Baby Blues can occur in many new mothers in the days immediately following childbirth. It is characterized by sudden mood swings that range from euphoria to intense sadness. The "baby blues" may last only a few hours or as long as one to two weeks after delivery. The condition may disappear as quickly and as suddenly as it appeared without medical treatment.
Postpartum Depression (PPD) is described as intense feelings of sadness, despair, anxiety, and irritability. It disrupts a woman's ability to function, which is a sign that medical attention is necessary.
Postpartum Psychosis has a quick and severe onset, usually within the first three months after delivery. Women who suffer from postpartum psychosis may completely lose touch with reality, often experiencing hallucinations and delusions. Postpartum psychosis should be treated as a medical emergency. In many cases, women who are suffering from this condition are hospitalized.
(Source: Postpartum Depression, U.S. Department of Health and Human Services, Office on Women's Health, 2002)
Are there gender differences in the course of a depression?
Women have a higher one-year prevalence of the illness, may experience longer episodes, and have a lower rate of spontaneous remission than men. Older women are also more likely to have recurrent depressive episodes than older men. Women are two to three times more likely to develop double depression (clinical depression and chronic depression together).
Although men and women exhibit similar symptoms of depression, women report more atypical symptoms including anxiety, somatization (the physical expression of mental processes such as aches and pains with no physiological cause), increases in weight and appetite, oversleeping, and expressed anger and hostility.
How about gender differences in the treatment of depression?
Psychotherapy is an effective treatment for depression. Studies have shown that interpersonal therapy and cognitive/behavioral therapy can be very effective for the treatment of mild to moderate depression. Psychotherapy may be particularly useful for women patients during pregnancy and during times when they are trying to conceive to avoid possible effects on the developing fetus that may result from the use of some medications.
There is no clear evidence of gender differences in the effectiveness of antidepressant medications; although, women experience more adverse side effects than do men. Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Paxil, and Luvox have fewer side effects and have been found to be particularly useful and effective in women patients. Some doctors suggest increasing doses of antidepressant drugs premenstrually, as the menstrual cycle may alter drug-absorption rates.
Is it safe to take antidepressants during pregnancy?
Because of the potential risk to the developing fetus or newborn, the costs and benefits of the use of antidepressants must be weighed carefully for women who are pregnant, breast-feeding, or trying to conceive. Most large-scale studies have not shown any significant increase in birth defects in children of women using tricyclic antidepressants (Anafranil, Elavil, Pamelor) or SSRIs during pregnancy; but be certain to consult with your own physician because not all studies have had similar results. However, MAOIs (Nardil, Parnate) may adversely affect the developing fetus and lead to complications during delivery. Lithium (commonly prescribed for bipolar disorder) has been linked to an increased incidence of birth defects; however, many healthy babies have been born to mothers using this medication.
Doctors should choose the lowest effective dose of medication and select drugs with the least sedative and anticholinergic (rapid heartbeat, high blood pressure, slow digestion, dry mouth, constipation, and urinary retention) potency because of possible adverse effects on the newborn. In patients with severe depression, doctors must weigh the risks and benefits in both the mother and the infant of medication as compared to not administering drug therapy.
Symptoms of Depression
A persistent sad, anxious or "empty" mood
Sleeping too little or too much
Reduced appetite and weight loss, or increased appetite and weight loss
Loss of interest or pleasure in activities once enjoyed
Restlessness or irritability
Persistent physical symptoms that don't respond to treatment (such as headaches, chronic pain, or constipation and other digestive disorders)
Difficulty concentrating, remembering or making decisions
Fatigue or loss of energy
Feeling guilty, hopeless or worthless
Thoughts of death or suicide
Those who are experiencing five or more of these symptoms for longer than two weeks or whose symptoms interfere with their daily routine should see their doctor or a qualified mental health professional. A physical examination to rule out other illnesses may be recommended.
(Source: Learning to Recognize Clinical Depression, National Mental Health Association, January 2001)
Anxiety Disorders and Women
This article has been adapted from "Anxiety Disorders," National Institute of Mental Health, NIH Publication No. 00-3879, 2000. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. These disorders fill people's lives with overwhelming anxiety and fear. Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless and can grow progressively worse if not treated.
Anxiety disorders that are prevalent in our society are
1) Panic disorders
2) Obsessive- compulsive disorder
3) Post-traumatic stress disorder
4) Social phobia (or social anxiety disorder)
5) Specific phobias
6) Generalized anxiety disorder
The common theme of all of these anxiety disorders is excessive, irrational fear and dread.
People with panic disorder have feelings of terror that can occur suddenly and repeatedly without warning. Because these attacks cannot be predicted, people with panic disorder may worry excessively when and where the next one will strike. Panic attacks can even occur during sleep. Common symptoms experienced are heart palpitations, sweating, weakness, numbness in a person's hands, dizziness and nausea. A person can also experience chest pain or smothering sensations, a sense of unreality or fear of impending doom or loss of control. An attack generally peaks within 10 minutes, but some symptoms may last much longer.
Panic disorder affects about 2.4 million adult Americans1, and is twice as common in women as in men.2 It most often begins during late adolescence or early adulthood. Panic disorder is often accompanied by other serious conditions such as depression, drug abuse or alcoholism, and might lead to a pattern of avoidance of places or situations where panic attacks have occurred. Basically, those affected avoid any situations in which they would feel helpless if a panic attack were to occur.
Panic disorder is one of the most treatable of the anxiety disorders.
Obsessive-compulsive disorder, or OCD, involves anxious thoughts or rituals a person feels he or she can't control. The disturbing thoughts or images are called obsessions, and the rituals that are performed to try to prevent or get rid of them are called compulsions. There is no pleasure in carrying out the rituals, and only temporary relief is obtained once the rituals are completed.
Examples of OCD may be checking the stove several times before leaving the house or excessive hand washing. For people with OCD, such an activity might consume an hour a day or more and interfere with daily life. People with OCD may avoid situations in which they might have to confront their obsessions, or they may try to unsuccessfully use alcohol or drugs to calm themselves.
OCD affects about 3.3 million adult Americans.3 It strikes men and women in approximately equal numbers and usually appears in childhood, early adolescence or early adulthood.4 If OCD grows severe enough, it can prevent someone from holding down a job or from carrying out normal responsibilities at home.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a debilitating condition that can develop following a terrifying event. People who suffer from PTSD usually have persistent frightening thoughts and memories of the ordeal and feel emotionally numb. Violent attacks such as mugging, rape or torture; being kidnaped or held captive; child abuse; serious accidents such as car or train wrecks; and natural disasters such as floods or earthquakes can cause PTSD. PTSD could occur after a person witnesses an event, such as the massive death and destruction that followed the terrorist attacks in New York and Washington, D.C. on September 11, 2001.
Those who suffer from PTSD repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. PTSD affects about 5.2 million American adults.5 Women are more likely than men to develop the disorder. PTSD is diagnosed only if the symptoms last more than a month. In those who do develop the disorder, symptoms usually begin within three months of the trauma. In some cases, the condition may be chronic, and might not show up until years after the traumatic event.
Social Phobia (Social Anxiety Disorder)
Social phobia, also called social anxiety disorder, involves overwhelming anxiety and excessive self-consciousness in everyday social situations. Intense fears may interfere with work or school and other ordinary activities. People with social phobia recognize that their fear is unreasonable but they are unable to overcome it.
Social phobia can be limited to one type of situation such as fear of speaking, eating, drinking or writing in front of others. Many people with this illness have a hard time making and keeping friends.
Social phobia affects about 5.3 million American adults.6 Women and men are equally likely to develop social phobia.7 The disorder usually begins in childhood or early adolescence.
A specific phobia is an intense fear of something that poses little or no actual danger. Some of the common specific phobias are fear of heights, closed-in places, tunnels, highway driving etc. Such phobias are not just extreme fear, they are irrational fear of a particular thing. When adults with phobias realize that these fears are irrational, they often find that facing (or even thinking about facing) the feared object or situation can trigger or bring on a panic attack or severe anxiety.
Specific phobias affect an estimated 6.3 million American adults8 and are twice as common in women as in men.9 Specific phobias usually first appear during childhood or adolescence and tend to persist into adulthood.
Specific phobias are highly treatable with carefully targeted psychotherapy.
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It is chronic and fills one's day with exaggerated worry and tension, even though there is little or nothing to provoke it. Sometimes, the source of worry is hard to pinpoint. People with GAD cannot seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle tension, muscle aches, twitching, irritability, sweating and hot flashes. They also may feel nauseated or have to go to the bathroom frequently. People with GAD don't characteristically avoid certain situations as a result of their disorder.
GAD affects about 4 million American adults10 and about twice as many women as men.11 The disorder comes on gradually, but the risk is the highest between childhood and middle age.
Treatment of Anxiety Disorders
In general, anxiety disorders respond to two types of treatment: medication and specific types of psychotherapy sometimes called "talk therapy." The choice of one or the other, or both, depends on patient and physician preference and also on the particular anxiety disorder. Anxiety disorders are not all treated the same and it is important to determine the specific problem before embarking on a method of treatment.
Payment for Anxiety Disorders
The cost for treating anxiety disorders may be partially or fully covered for those with health insurance or those who belong to a health maintenance organization (HMO). There are also public mental health centers that charge people according to a sliding scale. Those on public assistance may be able to receive care through their state Medicaid plan.
For more information on mental health, contact
National Institute of Mental Health (NIMH)
Office of Communications and Public Liaison
6001 Executive Blvd., Room 8184
Bethesda, MD 20892-9663
Toll-free information services
General Inquires 301-443-4513
Web site: www.nimh.nih.gov
National Mental Health Association
1021 Prince St.
Alexandria, VA 22314-2971
American Psychiatric Association
1400 K St., NW
Washington, DC 20005
American Psychological Association
750 First St., NE
Washington, DC 20002-4242
Second State Sponsored Latina Women's Health Symposium Held
The second Latina Women's Health Symposium presented in Spanish was sponsored by IDPH at Triton College in River Grove, Illinois, on July 29, 2002. The one-day conference, titled "Un Día para la Mujer Latina: Mejorar la Salud a Través de las Etapas de la Vida" ("A Day for the Latina Woman: Improving Health throughout all Stages of Life"), was conducted in collaboration with state, county and local Hispanic community organizations. Approximately 250 women from neighborhoods in the area attended the free conference.
Many Latina women are unaware that health disparities exist between ethnic groups and that diseases such as diabetes affect a greater proportion of Latina women than the white population. The aim of the conference was to educate Latina women about health issues that are of particular concern to them through workshops, food and exercise demonstrations, and educational exhibits. Workshop topics included self esteem and personal growth, nutrition, hormonal changes throughout life, menopause, osteoporosis, exercise and health care rights. Especially popular were Dr. Rosita Marcano's interactive personality assessment called psychogeometry, which describes various personality types through geometric shapes, along with her message to value oneself as a woman by caring for one's own mental, physical and emotional needs. Lisa Simeone's overview of the Patient's Bill of Rights in a question and answer format also highlighted many important things the women did not previously know, including the right to have a language interpreter when they go to health care establishments. One conference participant summed it up in her conference evaluation by saying,
"Congratulations for the program and for having invited us. We hope you can have more in the future. At my age of 66 years, I have learned so much in this day. I will let others know how valuable this program is and how much I learned today."
Lisa Simeone, Region V manager of the U.S. Department of Health and Human Services Office for Civil Rights, discusses access to care issues and the Patient's Bill of Rights.
Fitness instructor Yolanda Vázquez brings participants to their feet as they learn how to use Latin rhythms to get an aerobic workout.
In addition to the Illinois Department of Public Health's Office of Women's Health and Center for Minority Affairs, major sponsors included Nuevos Horizontes/Triton Community Center, Illinois Health Education Consortium/AHEC and Eli Lilly and Company. The planning committee chaired by the Illinois Department of Public Health, included the Chicago Department of Public Health, Chicago Hispanic Health Coalition, Cook County Department of Public Health, Gottlieb Memorial Hospital, Illinois Department of Human Service's Bureau of Hispanic/Latino Affairs, Illinois Health Education Consortium/AHEC, Nuevos Horizontes/Triton Community Center, ProCare Centers/Centro de Salud Familiar, Resurrection-Westlake Hospital and Suburban Cook County TB Clinics. Other contributors included A Grand Florist, Amerigroup, Child and Family Connections, Loyola University Medical Center, Mary Kay Cosmetics, National Cancer Institute's Cancer Information Service, National Osteoporosis Foundation and Squire's Florist.
Cardiovascular Health Awareness Mini Grants
In fiscal year 2002, the Illinois Department of Public Health, Office of Women's Health, awarded more than $53,000 in mini-grants to 17 local heath departments throughout Illinois. Grant awards ranged between $1,000 and $4,000. Eligibility was limited to certified public health departments in Illinois who were not currently receiving funding from the Office of Women's Health. The seminars were designed to provide women of the community with the information and resources needed to identify, address and combat cardiovascular disease and related health issues. They addressed heart disease, obesity/overweight, nutrition, physical activity, body image/self esteem and stress management.
Fiscal Year 2002 Mini-Grant Recipients
|Coles County Health Department||Marshall County Health Department|
|Egyptian Public and Mental Health Department||McLean County Health Department|
|Fayette County Health Department||Ogle County Health Department|
|Greene County Health Department||Perry County Health Department|
|Hancock County Health Department||Putnam County Health Department|
|Jefferson County Health Department||Sangamon County Health Department|
|Kankakee County Health Department||Vermillion County Health Department|
|Kendall County Health Department||Will County Health Department|
|Macon County Health Department|
Vermillion County Health Department and a coalition of Vermillion County organizations presented their women's summit on May 14, 2002. Cathy Rigby, Olympic Gymnast and stage performer, was the keynote speaker. More than 300 women attended the summit, participating in a variety of sessions and health screenings.
Middle School Students Educated to Improve Lifestyle
The Illinois Department of Public Health, Office of Women's Health, sponsored the Boston-based, Emmy Award-winning FoodPlay Productions to perform "This Is Your Life" to more than 3000 fifth- to eighth-grade students in Chicago's southwest suburban communities during the week of April 15-19, 2002. Founded and directed by Barbara Storper, M.S., R.D., the humorous, but poignant performance of "This Is Your Life" combines live theater with essential health messages to enable teens to better assess the messages they receive from the media, peers and family so that they will make healthy lifestyle choices. As part of the program, participating schools also received a follow-up resource kit that meets the national standards for achieving health literacy. Included in the resource kit were a 200-page teacher's activity guidebook; a primer of frequently asked questions and answers; handout packets for students, parents and teachers; health brochures; a teacher's evaluation; and a press packet. For more information about how to bring FoodPlay Productions to schools in your area, contact 1-800-FOODPLAY.
Mike Dorval of FoodPlay Productions tells the true story of Tanya (shown above on the poster, not real name), a 14-year-old who has anorexia and who now has osteoporosis from her lack of proper nutrition. Mike also describes how the media gives youth impossible body image ideals to live up to by showing how the life-size Barbie (seated in chair) could not stand on her under-sized feet, nor realistically have these chest, waist and hip proportions if she were a real person.
Mike Dorval and Wendy Kinal of FoodPlay Productions compare lunches to show how an average fast food lunch inverts the quantities of the food guide pyramid, while a healthy lunch gives us what we need for energy, beauty and a healthy body.
Office of Women's Health Grant Program Highlights
In July, Governor George H. Ryan announced $1,873,100 in grants to local health departments, and other organizations to address the special problems that women face at every stage of life. A total of 75 Women's Health Initiative grants were awarded.
The Office of Women's Health (OWH) partnered with the University of Illinois at Chicago's Center for Research on Women and Gender to evaluate fiscal year 2000 grant programs and to identify those that were effective and can be replicated by other agencies. Eight model programs were identified by the center and were implemented in fiscal year 2002 to address cardiovascular disease, eating disorders, menopause, osteoporosis and women's health coalition building. The fiscal year 2003 grants will continue to implement these model programs and document impact on the health of women in the state of Illinois.
Fiscal Year 2003 Model Program Grants and Project Contacts
Cardiovascular Disease-Heart Smart for Teens
Cook County Department of Public Health
Elaine Ricketts, M.P.H., C.H.E.S.
Frankfort Community School District 168
Karla J. Lee
Girl Scouts-Fox Valley Council
Healthy Families Chicago
Henderson County Health Department
Jane Addams Hull House Association
Mercy Hospital and Medical Center
Pike County Health Department
Nancy Halpin, R.N.
St. Clair County Health Department
Phone 618-233-7703 ext 4415
Tazewell County Health Department
Will County Health Department
Cardiovascular Disease-Heart Smart for Women
Bond County Health Department
Maxine Barth, R.N., M.S.N
Bureau County Health Department
Champaign-Urbana Public Health District
Crawford County Health Department
Jenna Murray, R.N.
Decatur Memorial Hospital
East Side Health District
Effingham County Health Department
Crystal Schutzbach, R.N.
Ford-Iroquois Public Health Department
Cathy McEwen, R.N.
Illinois Valley Community College
Gloria J. Bouxsein, R.N., M.S.N.
Jersey County Health Department
Lynn Welling, R.N., B.S.
Lewis and Clark Community College
Livingston County Health Department
Linda P. Rhodes, B.S.
Loretto Hospital of Chicago
Marshall County Health Department
Wanda Aberle, R.N., M.S.
Mather Life Ways
Elizabeth J. Sassen, R.N., B.S.N.
McLean County Health Department
Menyard County Health Department
Norwegian American Hospital
Peoria City County Health Department
Kate Van Beek M.S.
Rend Lake College
Phone 618-437-5321 ext 225
Roseland Community Hospital
Ta Shaunda Shumpert
Rush-Copley Medical Center
Sinai Community Institute
Springfield Dept. of Public Health
Shirla M. Short, R.N.
Phone 217-789-2182, ext. 118
University of Illinois at Chicago
Aida L. Giachello, Ph.D.
University of Illinois-Tazewell Unit
Carol M. Erickson
Washington County Health Department
Erica Blumenstock, R.N., B.S.N.
Whiteside County Health Department
Phone 815-626-2230 ext 309
Woodford County Health Department
Laurie Schierer M.S.
Phone 309-467-2371 ext 4213
YMCA of Elgin
Advocate Trinity Hospital
Michael A. Coppola
Mercer County Hospital
Jennifer Hamerlinch, R.N.
Family Service Center
Loretta C. Smith, R.N., M.S.
Mental Health Association in Illinois
Beth Maschinot, Ph.D.
Osteoporosis-Building Better Bones
Advocate Illinois Masonic Medical (Hispanocare)
Edgar Country Public Health Department
Brenda Regan, R.N.
Greene County Health Department
Susan Thornton, R.N.
Henry County Health Department
Jasper County Health Department
Kane County Health Department
Knox County Health Department
Logan County Health Department
Debra Cook, R.N., B.S.N.
Barbara Masters, R.N., B.S.N.
Mercer County Health Department
Lynne Schweppe, R.N.
Montgomery County Health Department
Dolores Wheelhouse, R.N.
OSF St. Francis Medical Center
Virginia S. Daggett, R.N.
St. Mary's Hospital
Vicki Vaughn, R.N., B.S.N.
Stephenson County Health Department
Sharon Lang, R.N.
Osteoporosis Provider Education
Loyola University of Chicago
Pauline M. Camacho, M.D.
Southern Illinois University School of Medicine
Richard W. Pamenter, Ph.D.
Osteoporosis Worksite Education
Macoupin County Health Department
McHenry County Board of Heallth
Karen Ciesielczyk, R.N., B.S.
Menopause Access Community Health Network
Asian Human Services Inc.
Fayette County Health Department
Hancock County Health Department
Howard Brown Health Center
Illinois State University
Linda G. Learned
Lake County Health Department
Marion County Health Department
Sangamon County Health Department
St. Mary's Medical Center
David C. Adcock
The Women's Health-Line is a resource provided by the Illinois Department of Public Health to refer women to agencies and services in Illinois. The Health-Line is confidential and free of charge and operates from 8 a.m.-5 p.m. weekdays. Just call 1-888-522-1282.
The OWH promoted its Health-Line in the Carbondale, Rockford and Springfield areas during the first six months of 2002. Ads were placed in local newspapers and shoppers, and the sides of buses served as moving billboards promoting the Health-Line. Several local agencies used ad slicks to promote the Health-Line in their communities as well. Over the next two years, the campaign will target other urban areas.
Camera-ready ad slicks are available for programs and newsletters that wish to advertise the Health-Line. Just call the Health-Line number above.
Powerful Bones Educational Kit for the Classroom Available
In conjunction with the Powerful Bones, Powerful Girls Campaign sponsored by the U.S. Centers for Disease Control, U.S. Department of Health and Human Services' Office on Women's Health and the National Osteoporosis Foundation, the Illinois Department of Public Health, Office of Women's Health, developed and distributed the Powerful Bones Osteoporosis Education Kit for use in middle school and junior high school classrooms. The kit includes fun, interactive lesson plans and a Power Point presentation. For more information or to obtain copies, contact the Women's Health-Line at 1-888-522-1282.
Screen For Life: The National Colorectal Cancer Action Campaign-New Materials
Download new patient materials that explain the facts about colorectal cancer screening. New materials include "Basic Facts on Screening" and "Screening Saves Lives." Screening guidelines and additional campaign materials are also available on this page: www.cdc.gov/cancer/colorctl/resource.htm.
The 2001 Women's Health Report Card
The second Making the Grade on Women's Health: A National State-by-State Report Card, a comprehensive assessment of women's health status and health policies at the state and national levels, was recently released. The 2001 Report Card explores 33 health status indicators and 32 health policy indicators and grades and ranks the 50 states and the District of Columbia. The benchmarks for assessing women's health are based mainly on the goals set by the U.S. Department of Health and Human Services' Healthy People initiative.
The Report Card is available both online at the National Women's Law Center at www.nwlc.org as a PDF file and for purchase.
Healthy Woman newsletter is published quarterly by the ILLINOIS DEPARTMENT OF PUBLIC HEALTH. Story ideas, suggestions and comments are welcome and should be forwarded to Lisa Keeler, editor, Illinois Department of Public Health, Office of Women's Health, 535 W. Jefferson St., Springfield, IL 62761; or call 217-524-6088.
George H. Ryan, Governor
John R. Lumpkin, M.D., M.P.H., Director
Illinois Department of Public Health
Sharon Green, Deputy Director
Office of Women's Health
Generally, articles in this newsletter may be reproduced in part or in whole by an individual or organization without permission, although credit should be given to the Illinois Department of Public Health. Articles reprinted in this newsletter may require permission from the original publisher.
The information provided in this newsletter is a public service. It is not intended to be a substitute for medical care or consultation with your health care provider and does not represent an endorsement by the Office of Women's Health. To be included on the mailing list, call 1-888-522-1282.
Questions? Need Information? Materials? Referrals? Call the Women's Health-Line. 1-888-522-1282
If the address label on this newsletter is incorrect, please send it back to us with corrections. If you know others who would like to be added to our mailing list, please let us know. Just call the helpline.
Correction to Winter 2001 Newsletter
Please note that, in the article titled "Office of Women's Health Reaches out to Latina Women," the partner agency listed as Illinois Department of Public Health-Office of Hispanic/Latino Affairs was mislabeled and should have read, Illinois Department of Human Services-Bureau of Hispanic/Latino Affairs. Please accept our apologies for this error.
Mark Your Calendar
October 23-24, 2002
Donald E. Stephens Convention Center
Topics to be Addressed
For registration information, contact Brenda Blasko at 217-524-6088 or toll-free at 888-547-0466. For exhibitor information, contact Emily Duft at 312-814-7098.