The “I Do” Blues: Postnuptial Depression

THE “I DO” BLUES: Postnuptial Depression

By Sean Kenniff, MD

  A wedding is usually one of the most joyous days in a young couple’s life; a time to celebrate love and hope for a lifetime of happiness. But for some newlyweds the big day is soon followed by a big letdown. 

  “It should be described as the day the prince falls off his horse, and we change from girls into women,” one blogger writes. 

  “What begins the day after marriage? Misery,” replies another. 

  In many cases once the honeymoon is over, humdrum reality sets in, and that can leave unprepared couples coping with postnuptial depression-also called the ‘I Do Blues’. 

  “Building a happy, productive partnership is not easy.  The unrealistic expectations set up by our culture, media images of connubial bliss, romantic novels and song lyrics soon prove to be impossible to create, and reality then sets in,” says Dr. Tina Tessina.

  Dr. Tessina, better known as “Dr. Romance,” is a distinguished California psychotherapist and author of the book, Money Sex and Kids: Stop Fighting About the Three Things That Can Ruin Your Marriage. She says both men and women are at risk of postnuptial depression, because their expectations are often out of step with day-to-day marital life. 

  “Any situation in which the expectations are unrealistic can be considered a ‘set up’ for disappointment, which some people experience as depression,” she says. 

  In the months leading up to the wedding day the bride and groom often become the gravitational center of activity for family and friends. Some couples, especially the brides-to-be, spend so much time planning a wedding that they often fail to plan a survival strategy for the days afterwards; and when the wedding day spotlight disappears, so can a sense of purpose.  

  “People who are emotionally resilient rise to this challenge and work together to solve the problems and improve the relationship.  Those who are not resilient sink into despair and depression, and stop trying,” Dr. Tessina says. 

Signs of postnuptial depression may include

• 1. Lack of energy
• 2. Emotional withdrawal
• 3. Lack of sexual intimacy
• 4. Feelings of hopelessness, or despair
• 5. Frequent crying
• 6. Sleeplessness

  Roughly half of all U.S. marriages end in divorce, so it is normal to have some reservations about the sustainability of a new marriage, or suitability of a new spouse. It’s also difficult for some to move from the ‘me’ mindset of being single, to the ‘we’ mindset of being married. Unfortunately few people want to talk about postnuptial depression for fear it might trigger some trouble-in-paradise rumors, but experts say couples should communicate their difficulties to each other, and a professional. Antidepressant medications can help in severe cases, but most cases of postnuptial depression can be treated effectively with psychological therapy.

  “Counseling will also help you handle situations more effectively,” Dr. Tessina says, “and help you not create more drama and dysfunction in the relationship. “ 

  The best way to avoid postnuptial depression is through careful planning and maintaining perspective. First try not to put overblown significance on the wedding day. Certainly it is an important day, but it is still just another day. Before the big day it may help to delegate wedding responsibilities wherever you can, think about having a less lavish reception, try to avoid obsessions or being a perfectionist, and talk to friends and family about your stress. 

  It’s important to remember loving relationships are like flowers; they blossom quickly, need constant care and change with the seasons. Just watch out for the thorns and expect bees. 

Sean Kenniff, MD is a neurologist, radio host, and television journalist in Miami, Florida. 

Tina B. Tessina, PhD, also known as ‘Dr.Romance’, is a licensed psychotherapist in Southern California with over 30 years of experience counseling couples and individuals. She is the author of thirteen books on relationships including Money, Sex and Kids: Stop Squabbling About the Three Things That Can Ruin Your Marriage. Dr. Tessina also writes the Dr. Romance blog, and is a Relationships Expert for Redbook Love Network, Divorce360.com, and she answers relationship questions at Yahoo! Personals. She can be reached by visiting her website  http://www.tinatessina.com

Pill-Free Prescription for Depression

Dr. Sean’s Pill-Free Prescription for Depression

by Sean Kenniff, MD

    Contrary to popular belief depression comes in many forms. Seasonal Affective Disorder (SAD) is characterized by depressed mood during the winter months. Dysthymia is marked by a generalized and fairly persistent moderate level of depression. Post-partum Depression (PPD), which occurs in roughly ten percent of new moms, is often characterized by severe emotional distress following childbirth. Reactive Depression is a depressive disorder that occurs in response to a particular event. There are several other forms of depression but the most notable of all the depressive disorders is Major Depression, also called Major Depressive Disorder (MDD). MDD It is a severe and often debilitating chronic mental illness.

    A report published by the CDC’s National Center for Health Statistics in 2008 found that in any 2-week period roughly 1-in-20 people are depressed. Serious signs include feelings of overwhelming sadness, suicidal thoughts, bouts of crying for no reason, loss of interest in daily activities, feelings of hopelessness, difficulties with sleep, irritability, and loss of interest in pleasurable activities like sex.

    The cause of depression isn’t entirely understood. There are strong genetic factors that seem to predispose someone to depressive conditions. Negative life experiences can also increase the risk. There is some evidence that serotonin and norepinephrine may be playing a role, and medications that alleviate depression often seem to work by altering levels of these two brain neurotransmitters.

    Treatment with antidepressant medications is essential in many cases, but they can cause some troubling side effects. So here’s how to alleviate some of the signs and symptoms of depression without popping any pills. 

Dr. Sean’s Pill-Free Prescription for Depression

Sunlight

    Lack of sunlight in the winter months can lead to Seasonal Affective Disorder in some people. An ultraviolet sunlamp can help but natural sunlight seems to work best at alleviating the symptoms. So try to get more sunlight or head to a sunnier climate. Just why a lack of sunlight leads to depression is not clear. Some researchers suspect melatonin, a hormone produced by the pineal gland in response to dim light, may have a depressing effect on mood. Other experts have suggested vitamin-D deficiency is playing a role. Vitamin-D is made in our skin during sun exposure and some studies have found a vitamin-D deficiency can lower mood.

Fish

    Countries with the highest rate of fish consumption have the lowest rates of depression, and a diet high in fish, or fish oil supplements containing omega-3 fatty acids, can improve symptoms of depression and stabilize mood swings. A 2002 study that appeared in the Archives of General Psychiatry found taking fish oil supplements resulted in a fifty percent decrease in depressive symptoms. It appears that omega-3 fatty acids in fish help raise the level of serotonin in the brain. One study even suggested that a diet rich in omega-3 fatty acids might help improve depression in people who have not been helped by antidepressant medications.

Walnuts

    Have you ever noticed that walnuts look like the human brain? Well there may be good reason for that because walnuts also contain omega-3 fatty acids. Just ¼ cup of walnuts each day can provide you with an entire day’s worth of omega-3s. Walnuts are also a good source of magnesium and vitamin-B6 which are also important for mood stabilization and brain cell functioning.

B-Vitamins

    The brain uses B-vitamins to manufacture neurotransmitters like serotonin, norepinephrine, epinephrine and dopamine. These neurotransmitters play a critical role in mood elevation and mood stabilization. So fill your plate with healthy sources of B-complex vitamins like whole grains, eggs, bananas, and soy beans. 

Avoid Alcohol

    It’s important to mention that alcohol is well known to depress mood. But alcohol also interferes with the absorption of B-vitamins in the body which can worsen or lead to neurotransmitter imbalances. In fact it is very common for alcoholics to be severely depressed and many of them have significant deficiencies of B-complex vitamins. Alcohol abuse also increases the risk of suicide in people who have depressive symptoms.

Daily Exercise

    Just about every study ever conducted on exercise and mood has shown that regular physical activity improves mood and alleviates depressive symptoms. It’s thought that exercise increases levels of feel good chemicals, called endorphins, in the body. Plus exercise reduces stress, improves self-esteem, improves sleep, and increases energy levels. 

Cognitive-Behavioral Therapy (CBT)

    Cognitive behavioral therapy (CBT) is a specific form of talk therapy that psychologists often use to treat depression. During a CBT session the patient and therapist analyze negative behavioral patterns and dysfunctional emotions through positive insight exercises and systematic goal setting. CBT concentrates on present problems and symptom removal. Several studies have found combining CBT with antidepressant medications improves results and lessens depression relapses. Some studies have suggested CBT alone may be as effective as taking antidepressant medications.

Mindful Meditation

    There is some evidence that mindful meditation may help alleviate some of the symptoms of depression. Unlike traditional forms of meditation where thoughts are cleared, mindful meditation focuses the mind on the present. When done properly the technique allows the person to explore thoughts and actions without judgment. Some practitioners have combined mindful meditation with cognitive behavioral therapy (CBT) into a new technique called mindfulness-based cognitive therapy or MBCT. Studies have shown MBCT may also improve depression in some people. 

    It is important to reiterate that for many people with moderate or severe depression medications will be an important, if not critical element of their therapy. So make sure you discuss all of your options with a skilled mental health professional.

What is Your Health Horoscope?

What is Your Health Horoscope?

By Sean Kenniff, MD

  The secret to living a longer and healthier life may not be as simple as eating a balanced diet and getting a lot of exercise. Recent research suggests your ‘health horoscope’ may be increasing or decreasing your odds of developing diseases. First-born children in large families tend to live the longest. In fact first-born children are 2-3 times more likely to reach age 100 than later-born children. Babies born to younger mothers may also enjoy an increased lifespan according to some reports. People living in rural environments tend to live longer than those living in urban and suburban environments. Some studies have even concluded that you are more likely to die near your birthday, or in the three months following it. Stress is believed to play a role. So what does your birthday say about your health risks?

JANUARY

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

A 2004 study published in the journal Neurology found people born during January and February are at the highest risk for developing malignant and benign brain tumors. Those born in the summer months of July and August had the lowest risk.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

People born in January and December have the highest lifetime risk of developing Alzheimer’s disease, epilepsy and narcolepsy. Those born during the spring and summer months are less likely to develop these conditions.

Lower air temperature at birth has been associated with the development of increased insulin resistance and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of developing coronary artery disease earlier in life.

February

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

Lower air temperature at birth has been associated with the development of increased insulin resistance and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of developing coronary artery disease earlier in life.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

A 2004 study published in the journal Neurology found people born during January and February are at the highest risk for developing malignant and benign brain tumors. Those born in the summer months of July and August had the lowest risk.

Studies have shown people born in February and March (late winter to early spring in the northern hemisphere) are more prone to develop schizophrenia. But the difference is small, about a 10% increase compared to the lowest risk months (September and August). It’s been proposed that a lack of sunlight during these months may result in a vitamin-D deficiency. A lack of adequate vitamin-D in a newborn, or a pregnant mother might influence a child’s brain development.

March

Studies have shown people born in February until March (late winter to early spring in the northern hemisphere are more prone to develop schizophrenia. But the difference is small, about a 10% increase compared to the lowest risk months (September and August). It’s been proposed that a lack of sunlight during these months may result in a vitamin-D deficiency. A lack of adequate vitamin-D in a newborn, or a pregnant mother might influence a child’s brain development.

People born in the spring months tend to have the shortest lifespans, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

Italian researchers claim that women born in March are more likely to go through menopause earlier than women born in the fall months. On average, women in the study who were born in March went through menopause at age 48-years and 9-months, whereas women born in October went through menopause 18-months later (age 50-years and 3-months).

Children conceived in the spring and summer months, and born from January through March may be at increased risk of birth defects according to a large U.S. study. In-utero exposure to pesticide residues during the warmer months may be playing a role.

April

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

People born in the spring months tend to have the shortest lifespan, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

May

People born in the spring months tend to have the shortest lifespan, about 5-months shorter than those born during the autumn months according to a study of 15-million U.S. death certificates.

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

Babies born in May have the highest risk of developing multiple sclerosis as adults according to a 2004 study published in the British Medical Journal.

Children born in May and November are the least likely to develop Acute Lymphoblastic Leukemia (ALL).

June

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

A study published in the British Journal of Psychiatry examined data from nearly 27-thousand suicides over a 22-year period and found people born during April, May, and June are 17% more likely to commit suicide. The increased risk was higher for women (29.6%) compared to men (13.7%). It’s possible that seasonal hormone fluctuations in pregnant women may influence the developing fetal brain.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

Being born in June, April or May is associated with the shortest overall life expectancy.

Women born in the first 6-months of the year might have a higher risk of developing breast cancer according to a report published in Oncology Reports.

July

A U.S. team of researchers found children conceived during the spring and summer months are more likely to be born with birth defects including cleft lip and palate, club foot, Down Syndrome, and spina bifida. Increased exposure to pesticides may be playing a role the researchers said.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born during July and August have the lowest risk of developing benign and malignant brain tumors according to a 2004 study published in the journal Neurology.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

August

People born in August and September have the lowest lifetime risk of schizophrenia. People born during February and March have the highest risk.

People born during July and August have the lowest risk of developing benign and malignant brain tumors according to a 2004 study published in the journal Neurology.

Children born in August may be at an increased risk of developing a form of childhood leukemia called ALL. The other peak risk is in February and the increased risk may be related to peaks in infectious diseases.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born during the spring and summer months are more at risk for alcohol dependence, autism, and dyslexia, but are less likely to develop Alzheimer’s disease, epilepsy and narcolepsy.

September

People born in August and September have the lowest lifetime risk of schizophrenia. People born during February and March have the highest risk.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born from September to December may be more prone to developing panic disorder later in life.

October

People born in the autumn months of October and November are most likely to live the longest. A study of 15 million U.S. death certificates published in 1997 found on average people will live roughly five months longer if born in one of these two fall months.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born from September to December may be more prone to developing panic disorder later in life.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Women born in October are also most likely to stay fertile the longest. A study conducted by Italian researchers found women born in October experienced menopause at 50-years, 3-months. Women born in March experienced menopause the earliest at age 48-years and 9-months.

November

People born in the autumn months of October and November are most likely to live the longest. A study of 15 million U.S. death certificates published in 1997 found on average people will live roughly five months longer if born in one of these two fall months.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

Babies born in November are least likely to develop multiple sclerosis according to a 2004 report in the British Medical Journal.

People born from September to December may be more prone to developing panic disorder.

September, October, and November babies have the highest risk of developing asthma according to some studies.

Children born in May and November may be at the lowest risk of developing acute lymphoblastic leukemia.

December

Babies born in December have a lower risk of developing multiple sclerosis later in life, but November had the lowest risk.

Women born in the second half of the year have the lowest lifetime risk of developing breast cancer according to a 2000 study in Oncology Reports.

People born in December are at increased risk of developing Alzheimer’s disease, epilepsy, narcolepsy. People born during the spring and summer months had the lowest risk of these diseases.

Lower air temperature at birth has been associated with the development of increased insulin resistance, coronary artery disease and increased triglycerides as adults. So U.S. babies born during the colder winter months may be at an increased risk of having heart attacks earlier in life.

People born from September to December may be more prone to developing panic disorder later in life.