Women's Mental Health

Question 1

What is Women’s mental health?

Answer 1

Mental Health issues specific to women

Reproductive health
- Pregnancy/postnatal
- Menstrual related disorders
-Menopause
- Infertility

Question 2

Why Women’s Mental Health?

Answer 2

• Distinct area
• Unique problems
• Integrated approach
• Children
• Family
• Socio-economic factors

Question 3

Perinatal disorders

Answer 3

• Pregnancy and postpartum
• Mood disorders
• Anxiety Disorders
• Psychosis

Question 4

Normal Mood changes in pregnancy

Answer 4

• Labile mood common, normal
• A certain degree of heightened anxiety – normal
• Post delivery – baby blues 3 -5 days
• resolves spontaneously

Question 5

What is abnormal?

Answer 5

• Persistent changes in mood
• Incapacitating anxiety
• Inability to function
• Numbing, inability to feel
• Suicidal, homicidal thoughts

Question 6

How common are perinatal mood disorders?

Answer 6

Perinatal mood disorders are common, affecting 1 in 10 women.

Question 7

What is the usual mood associated with perinatal mood disorders?

Answer 7

The usual mood associated with perinatal mood disorders is depressed mood.

Question 8

When do perinatal mood disorders often start?

Answer 8

Perinatal mood disorders often start during pregnancy, with 21% of pregnant women affected.

Question 9

Do perinatal mood disorders continue after pregnancy?

Answer 9

Yes, they often carry on into the postpartum period.

Question 10

What are the consequences of perinatal mood disorders for the mother and child?

Answer 10

For the child: Poorer growth and development.

Attachment?: There may be issues with emotional attachment

Question 11

Is perinatal anxiety common?

Answer 11

Perinatal anxiety may be more common than depression.

Question 12

When does perinatal anxiety often start?

Answer 12

Perinatal anxiety often starts during pregnancy.

Question 13

What is the biggest risk factor for perinatal depression?

Answer 13

Perinatal anxiety is the biggest risk factor for depression.

Question 14

What concerns are common in women with perinatal anxiety?

Answer 14

Women with perinatal anxiety often have concerns around the baby.

Question 15

What condition is associated with postpartum anxiety?

Answer 15

Postpartum Obsessive-Compulsive Disorder (OCD) is associated with postpartum anxiety.

Question 16

How common is postpartum psychosis?

Answer 16

Postpartum psychosis is rare, affecting less than 1% of women.

Question 17

What type of psychosis is most often seen in postpartum psychosis?

Answer 17

Postpartum psychosis most often manifests as affective psychosis.

Question 18

How serious is postpartum psychosis for the mother and baby?

Answer 18

It is very serious; the mother is at high risk to herself and the baby.

Question 19

What are common symptoms of postpartum psychosis?

Answer 19

Common symptoms include labile mood, restlessness, and agitation.

Question 20

What delusions are associated with postpartum psychosis?

Answer 20

Delusions around the child are common, and the mother may be homicidal toward the child.

Question 21

What is the importance of recognizing postpartum psychosis?

Answer 21

It is crucial to recognize and treat postpartum psychosis promptly.

Question 22

Who is at risk of postpartum psychosis

Answer 22

• Previous Psych Illness
• History of Illness in current pregnancy/past pregnancy
• Unwanted child
• Poor social support
• Substance use

Question 23

How to treat postpartum psychosis

Answer 23

• Recognise cases
• Screen women
• Assess risk to mum and baby
• Refer
• Psychiatrist
• Clinic – advice on baby, feeding
• Support groups
• Mobilise social support
• Destigmatise

Question 24

Medication for postpartum psychosis

Answer 24

• Generally SSRI’s and TCA’s safe in pregnancy and breastfeeding
• Antipsychotics – reasonably safe
• Mood stabilisers – teratogenic risk
• ECT – option
• Ideally prescribe in conjunction with psychiatrist

Question 25

Breastfeeding

Answer 25

- MOST WOMEN ON MEDS CAN BREASTFEED!!!!! - Risk of child dying from diarrhoea, respiratory disease, malnutrition higher than medication side effects - Case by case basis

Question 26

What is infanticide?

Answer 26

Infanticide is when a mother kills her child.

Question 27

What are the categories of infanticide?

Answer 27

- Neonaticide * young women * Unwanted pregnancy * Denial of pregnancy - Abuse - Socioeconomic reasons - Mentally ill

Question 28

What is a common characteristic of mothers who commit infanticide due to mental illness?

Answer 28

- Almost always psychotic - Delusion around children - May be part of suicide attempt

Question 29

How should threats of infanticide by a mentally ill mother be treated?

Answer 29

Such threats should be taken very seriously.

Question 30

What should be assessed in women at risk of infanticide?

Answer 30

It is important to ask about: - Mental illness - Poor social support - Unwanted pregnancy

Question 31

What is Premenstrual Dysphoric Disorder (PMDD)?

Answer 31

PMDD is characterized by serious and severe mood changes linked to the luteal phase of the menstrual cycle.

Question 32

When do the symptoms of PMDD resolve?

Answer 32

The symptoms resolve with the onset of menses.

Question 33

What is important to remember about PMDD?

Answer 33

It is important to be aware that PMDD exists and can significantly impact a woman's mental health.

Question 34

What are the treatment options for PMDD?

Answer 34

Treatment options include: - Hormonal therapy - Intermittent use of SSRIs (Selective Serotonin Reuptake Inhibitors)

Question 35

How is menopause categorized?

Answer 35

Menopause is a normal event in a woman’s life.

Question 36

What mood-related symptoms can occur during menopause?

Answer 36

Women may experience mood swings and mood lability.

Question 37

Are memory problems associated with menopause?

Answer 37

Yes, memory problems can occur during menopause.

Question 38

What factors contribute to symptoms during menopause?

Answer 38

Both hormonal and psychological factors contribute to menopausal symptoms.

Question 39

How does menopause affect the risk of depression?

Answer 39

Menopause is a time of increased risk of depression.

Question 40

What treatment options are available for mood symptoms during menopause?

Answer 40

SSRIs (Selective Serotonin Reuptake Inhibitors) can be used to manage mood symptoms.

Question 41

What is a common physical symptom of menopause?

Answer 41

Hot flushes (or hot flashes) are a common symptom.

Question 42

How is infertility considered in terms of stress?

Answer 42

Infertility is a severe stressor.

Question 43

What is another stressor related to infertility?

Answer 43

The process of fertility treatment itself is also a significant stressor.

Question 44

What impact does infertility have on self-image

Answer 44

Infertility can cause problems with self-image.

Question 45

How can infertility affect marital relationships?

Answer 45

Infertility can lead to marital conflict.

Question 46

What type of loss might be experienced due to infertility?

Answer 46

Infertility can involve a sense of loss, including loss of potential children and disrupted life plans.

Question 47

What mental health issues are associated with infertility?

Answer 47

Anxiety and mood disorders are commonly associated with infertility.

Question 48

What are some psychodynamic issues related to infertility?

Answer 48

Psychodynamic issues related to infertility may include unresolved psychological conflicts and distress.

Question 49

How can medication be involved in infertility?

Answer 49

Medication may be used to address both the physiological aspects of infertility and the associated mental health issues.