Depression Answers

Postpartum Depression Causes

Q.One of the more popular theories of biologically caused depression has been hypoglycemia, which is low blood sugar. In his book Fighting Depression, published in 1976, Harvey M. Ross, M.D., said "In my experience as an orthomolecular psychiatrist, I find that many patients who complain of depression have hypo- glycemia (low blood sugar). ...Because depression is so common in those with hypoglycemia, any person who is depressed without a clear cut obvious cause for that depression should be suspected of having low blood sugar" (Larchmont Books, p. 76 & 93). But in their book Do You Have A Depressive Illness?, published in 1988, psychiatrists Donald Klein, M.D., and Paul Wender, M.D., list hypoglycemia in a section titled "Illnesses That Don't Cause Depression" (Plume, p. 61). The idea of hypoglycemia as a cause of depression was also rejected in the front page article of the November 1979 Harvard Medical School Health Letter, titled "Hypo- glycemia - Fact or Fiction?".

A.Another theory of a physical disease causing psychological unhappiness or "depression" is hypothyroidism. In her book Can Psychotherapists Hurt You? psychologist Judi Striano, Ph.D., includes a chapter titled "Is It Depression - Or An Underactive Thyroid?" (Professional Press, 1988). Similarly, three psychiatry professors in 1988 asserted "Frank hypo- thyroidism has long been known to cause depression" (Alan I. Green, M.D., et al., The New Harvard Guide to Psychiatry, Harvard Univ. Press, 1988, p. 135). The theory here is that the thyroid gland, which is located in the neck, normally secretes hormones which reach the brain through the bloodstream necessary for a feeling of psychological well being and that if the thyroid produces too little of these hormones, the affected person can start feeling unhappy even if no problems result from the endocrine (gland) problem other than the unhappiness. The American Medical Association Encyclopedia of Medicine lists many symptoms of hypothyroidism: "muscle weakness, cramps, a slow heart rate, dry and flaky skin, hair loss ... there may be weight gain" (Random House, 1989, p. 563). The Encyclopedia does not list unhappiness or "depression" as one of the consequences of hypothyroidism. But suppose you began to experience "muscle weakness, cramps...dry and flaky skin, hair loss ... weight gain"? How would this make you feel emotionally? - depressed, probably. Just as hypo- thyroidism (hypo = low) is a thyroid gland that produces too little, hyperthyroidism is a thyroid glad that produces too much. Therefore, if hypothyroidism causes depression, then it seems logical to assume hyperthyroidism has the opposite effect, that is, that it makes a person happy. But this is not what happens. As psychiatrist Mark S. Gold, M.D., points out in his book The Good News About Depression: "Depression occurs in hyperthyroid- ism, too" (p. 150). What are the consequences of hyperthy- roidism?: Dr. Gold lists abundant sweating, fatigue, soft moist skin, heart palpitations, frequent bowel movements, muscular weakness, and protruding eyeballs. So both hypo- and hyper- thyroidism cause physical problems in the body. And both cause "depression". This is only logical. It is hard to feel anything but bad emotionally when your body doesn't feel well or work properly. It has never been proved hypothyroidism affects mood other than through its effect on the victim's experience of feeling physically unhealthy. Some people think chemical imbalance related to hormonal changes must be a possible cause of "depression" because of the supposed biological causes of women's moods at different times of their menstrual cycles. I don't find that argument con- vincing, because I've known so many women whose mood and state of mind was consistently unaffected by her menstrual cycle. Psychology professor David G. Myers, Ph.D., labels premenstrual syndrome (PMS) a myth in his book The Pursuit of Happiness (William Morrow & Co., 1992, pp. 84-85). Of course, some women experience physical discomfort due to menstruation. Feeling lousy physically is enough to put anybody in a bad mood. Some people believe women experience undesirable mood changes for biological reasons because of menopause. However, a study by psychologists at University of Pittsburgh reported in 1990 found that "Menopause usually doesn't trigger stress or depression in healthy women, and it even improves mental health for some". According to Rena Wing, one of the psychologists who did the study, "Everyone expects menopause to be a stressful event, but we didn't find any support for this myth" ("Menopausal stress may be a myth", USA Today, July 16, 1990, p. 1D). It is also widely believed that women go through a period of depression for biological reasons after giving birth to a child. It's called postpartum depression. In his book The Making of a Psychiatrist, Dr. David Viscott quotes Dr. George Maslow, a physician doing an obstetrical residency, making the following remark: "Come on, Viscott, do you really believe in postpartum depression? I've seen maybe two in the last three years. I think it's a lot of shit you guys [you psychiatrists] imagined to drum up business" (Pocket Books, 1972, p. 88). A woman who had given birth to eight (8) children, which in my opinion qualifies her as an expert on the subject of postpartum depression, told me what she called "postpartum blues" are real, but she attributed postpartum blues to psychological rather than physiological causes. "I don't know about the physiological causes", she said, but "so much of it is psychological." She said "You feel awful about your looks", because in our society a woman is "supposed" to be thin, and for at least a short time after giving birth a woman just isn't.

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