For women with endometriosis the last thing they think they will ever have to deal with is depression. But it is a very real possibility, not only because of the disease and the painful symptoms it causes but also because of some of the treatments used to control it.
In the psychiatric world depression is defined as:
1. Severe despondency and dejection, accompanied by feelings of hopelessness and inadequacy.
2. A condition of mental disturbance, typically with lack of energy and difficulty in maintaining concentration or interest in life.
Coping with endometriosis can cause both physiological and psychological depressive symptoms. Learning to recognize them quickly is an important first step to getting the proper medical help.
In a general sense women going through depression have a sense of hopelessness. There can be a variety of things that will trigger depressive episodes that cause a loss of interest in daily activities and a sense of worthlessness; death of a family member or close friend, break up of a marriage, or even an illness. In the case of endometriosis it is a little easier to pinpoint likely causes of depression in women who suffer from it.
The first thing to look at is the emotional toll endometriosis can have on women. In many cases it can be an up-and-down roller coaster of emotions depending on:
• Many women experience the worst symptoms just before and during their period. This can cause extreme fatigue from dealing with the pain.
• Treatments that don't work at relieving the pain and discomfort caused by endometrial lesions in the abdomen.
• Hormone controlling drugs that cause hormonal imbalances causing mood swings and irritability.
• The inability to participate in activities with family and friends. In some cases a lack of support for what they are going through from family, friends, and coworkers will also contribute to feelings of depression.
• Uncomfortable or painful sex adversely affecting relationships
• The inability to get pregnant.
• The cost of getting their endometriosis treated, particularly if they do not have insurance.
Probably the two biggest factors that contribute to depression in women with endometriosis are finding a treatment that works for them and the treatment method itself. Endometriosis is a disease that responds to the amount of estrogen a woman produces each month. This is all ties to her monthly menstrual cycle. The goal of most treatment regimens is to suppress or limit the amount of estrogen a woman produces. To do this hormone suppressing drugs are used.
The most common hormone controlling drugs used are birth control pills, for mild cases, Gestrinone, Danazol, Depo Lupron, Synarel, and GnRH agonists. The problem with using these types of drugs is that they force an early menopause on the woman taking them. This happens because these drugs cause the body to slow down the production of many of a woman's hormones. This causes a hormone deficiency which can cause depression.
The other factor in this is finding a treatment that actually works for each individual woman. The reaction to these various hormone controlling treatments can vary from woman to woman. Each woman also reacts differently to the endometriosis itself. It can take quite a bit of time and energy just finding the proper treatment regimen. During this time it can begin to feel like there is no treatment out there that will help them.
Endometriosis can be a frustrating disease to deal with for any woman. It is estimated that about 5.5 million women suffer from this disease in the United States and Canada alone. For any woman getting treatment for their endometriosis it is important to work with your doctor and health care providers as your treatment regimen progresses. Only you can tell them what is working and what isn't so any medications can be adjusted as needed or other treatment options can be considered.