Depression bei Frauen

Zusammenfassung

Frauen leiden häufig im Zusammenhang mit reproduktiven Ereignissen, also vor der Menstruation, während und nach der Schwangerschaft und in den Wechseljahren an affektiven Erkrankungen. Dieses liegt an den komplexen Zusammenhängen zwischen weiblichen Geschlechtshormonen und Neurotransmittern, aber natürlich auch an den Einflüssen belastender oder sich verändernder Lebensumstände. Affektive Symptome können in diesen Zusammenhängen erstmals manifest werden, und in Symptomausprägung oder Schwere variieren. Wochenbetterkrankungen betreffen fast 20% aller Frauen und bergen das Risiko der Schädigung des Kindes durch Vernachlässigung, durch komorbide Zwangssymptome und im extremen Fall durch Infantizid. Die Ursachen der Wochenbettdepression, die sich meist sechs Wochen nach der Geburt manifestiert, sind nicht geklärt. Die Therapie umfasst psychopharmakologische und psychotherapeutische Interventionen, erstere in Abhängigkeit davon, ob die Patientin stillen kann oder möchte. Die Perimenopause ist im Leben einer Frau die Zeit mit dem höchsten Depressionsund Angsterkrankungsrisiko. Hier sind die Zusammenhänge zwischen hormonellen Veränderungen und der psychischen Symptomatik gut belegt. Behandlungsstrategien beinhalten demnach sowohl hormonelle als auch psychopharmakologische, in manchen Fällen auch psychotherapeutische Interventionen.

Summary

Reproductive events including the postpartum and perimenopause are a major risk factor for the development of depression and anxiety in women. This is due to the complex relations between female hormones and neurotransmitters as well as to life events after birth and in midlife. Affective disorders can both become manifest for the first time in the woman’s life or show an aggravation in frequency and severity during these times. Postpartum depression affects up to 20% of women and occurs about 6 weeks after delivery. It is highly associated with harming the baby either because of neglect, comorbid obsessive-compulsive symptoms or in the worst case because of infanticide. The etiology of postpartum depression is not entirely clear – hormonal changes alone do not account for it. Treatment comprises psychopharmacological and psychological interventions, the former depending on whether the woman can or wants to nurse. Perimenopausal depression on the other hand is clearly associated with changes in hormonal levels, it affects about 20% of women and comprises both physical and psychological symptoms of menopause, which interfere with each other. Treatment comprises hormonal, psychopharmacological and in some cases psychotherapeutic interventions.

Schlüsselwörter

Wochenbetterkrankung - Hormone - perimenopausale Depression

Keywords

Postpartum depression - hormones - perimenopausal depression

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