Depression and Hormones
Depression and Hormones
In my previous article, we took a close look at the link between menopause and mental health and how, until now, HRT and hormone balance have not been considered as a relevant course of treatment for patients presenting with mental health conditions.
In this article, we look at one of the most common mental health conditions – depressive disorders (depression).
What is Depression?
According to the ICD 10 Classification of mental and Behavioural Disorders which is used by psychiatrists to diagnose depressive disorders, a depressive episode is described as low mood which has been present consistently for at least two weeks. It may be mild, moderate, or severe in severity and if severe, can be life-threatening because it can lead to people feel suicidal.
Depression is one of the most common mental health disorders in the UK and it is estimated that up to 30% of the population have - or have suffered from in the past - some form of depression. What is also striking is that women are more than twice as likely to have depression compared with men.
Depression is very concerning for the medical profession as it can be associated with other mental and physical health conditions such as alcohol and drug abuse, obesity, high blood pressure, strokes, heart disease, infertility and even cancer.
The Role of Hormones in Depression
During my years of treating patients as a psychiatrist, I have become interested in the role of hormones in mental health conditions, and this is one of the key reasons why I decided to form The Hormone Clinic.
By monitoring my patients' mental health over a period, I began to recognise that patterns were emerging between their moods and emotional states and hormone fluctuations with their levels of progesterone, oestrogen, testosterone and DHEA.
What are the Symptoms of Depression?
There are many common symptoms that you might experience with depression. These include low mood, poor self-esteem, low self-confidence, reduced motivation, energy, and concentration. Sleep and appetite may also be affected, and it may be associated with suicidal thoughts.
Reaching a diagnosis of Depression
Typically, when I see a patient who is presenting symptoms of depression, I will start with a thorough history and mental state examination in the 45-minute Initial consultation. As well as a patient's medical and mental health history, I will be looking for specific changes in mood over time.
With my female patients, I track changes in mood throughout patients’ monthly menstrual cycle as well as consider whether they are perimenopausal, menopausal or post-menopausal.
With men, I consider their age as men's testosterone levels begin to fall from the age of 30 and are noticeable from the age of 40 where weight gain, reduced muscle mass and hair loss is often evident. The age group 45 to 49 is associated with the highest suicide risk and low testosterone may contribute to this.
Treatment of Depression
As I have mentioned previously, treatment for a depressive disorder includes antidepressants and therapy such as cognitive behavioural therapy (CBT) and until recently, HRT and hormone balance have not been considered as a relevant course of treatment.
At The Hormone Clinic, treatment for depression will always start with balancing hormones and alongside a thorough mental state examination, blood testing will take place to measure the levels of progesterone, oestrogen, testosterone and DHEA and if required, a course of bioidentical hormones (BHRT) will be prescribed to help restore hormone balance.
Alongside BHRT, other aspects of hormone and lifestyle will be discussed including exercise and diet where foods that are high in fat and protein and low in carbohydrates will be recommended.
At this stage, I will also consider if antidepressants are required and if a course of Cognitive Behavioural Therapy (CBT) is indicated.
Aftercare and Depression
Following a review consultation where bioidentical hormones (BHRT) will be prescribed, a second review consultation will take place after 6 weeks. At this stage, I will monitor the patient's progress and adjust the doses of hormones if required. Typically, I would expect to see a significant improvement after 3 months.
Book an Appointment
If you are concerned about your mental health and think you might be experiencing depression, The Hormone Clinic is here to help. Start by booking a free 15-min discovery call with our medical secretary and we can start you on the road to restoring your health and quality of life.