In a New York Times interview, Dr. Sanjay Gupta, the chairman of the psychiatry department at Olean General Hospital in Olean, N.Y,, and clinical associate professor of psychiatry at the University of Buffalo, discusses severeal pertinent questions that we’ve talked about here on Beyond Blue: weight gain with meds, postpartum depression, depression in menopause and more. Here are a few excerpts. To read the entire interview, “Women, Weight Gain and Antidepressants,” click here.

Q. Conventional wisdom is that antidepressants also may lead to weight gain. True?
A. Researchers aren’t exactly sure why psychiatric medications cause weight gain. In some cases, it may simply be a consequence of successful treatment. As patients recover from their illness, they may also recover their appetite, which can be beneficial if they were previously underweight. In other cases, however, researchers suspect that psychiatric medications — especially S.S.R.I.’s and tricyclic compounds — may stimulate abnormal appetite by blocking histamine and serotonin receptors in the brain.
Sometimes, the weight gain is minimal — only a few pounds over six months to a year. However, all too often, the increase is medically significant, with many patients reporting at least a 7 percent increase in body weight. Such rapid weight gain may increase the risk of high blood pressure, lipid disorders, diabetes, heart disease, arthritis and some types of cancer.

Q. Is postpartum depression being undertreated?
A. Major depression affects twice as many women as men, regardless of race or economic background. There are many possible causes, including hormonal, genetic and reproductive factors.

Women who have postpartum depression are demonstrating a predisposition to being bipolar. This crippling mood disorder has been historically underdiagnosed and undertreated, leaving many mothers at risk, which can lead not only to suicide but possibly to long-term emotional or behavioral problems for the child.
After being diagnosed, a woman should begin with short-term psychotherapy sessions and focus on specific problems like loneliness or grief. At home, common-sense measures like getting help with household chores and regularly scheduled babysitting can give a mother a chance to catch up on lost sleep and regain control of her life. Unfortunately, reasonable suggestions like these are often forgotten during these stressful periods.
Q. Is there a relationship between menopause and depression?
A. Yes, but we still don’t know why. Some experts think it may have to do with either a personal or family history of depression. For many women, however, the depression is related to a perceived change of roles. Oftentimes, there is a tendency for many women at midlife to look back on their life and review what has or hasn’t been achieved. Then, of course, there are changes in estrogen that may also be associated.

Some women think depression is a natural part of aging, which is incorrect. The key is not to let depression go undiagnosed for so long, because it causes more dysfunction, and possibly physical complications, including a loss of bone mineral density and increased risk of heart attack.
Q. Is depression at all preventable?
A. Seasonal affective disorder, S.A.D., certainly is. This is a distinct type of depression that starts when the clocks are turned back in midautumn and lasts straight through to the midspring, when days finally get longer and light intensity increases again. Common S.A.D. symptoms include irritability, fatigue, headache, disinterest in sex, a tendency to oversleep and overeat, and feeling down in the dumps for no apparent reason. Experts at the National Institute of Mental Health believe that as many as 10 to 25 million Americans — 80 percent are women — are affected.
The cause is still unknown. Some experts believe the short days and long nights affect the body’s biological clock, or circadian rhythm. One theory is that lack of bright light affects melatonin production. This is the special hormone that influences sleep patterns, as well as emotional and physical well-being. Reduced sunlight hours during the cold-weather months is also thought to disturb the secretion of cortisol, the stress hormone that plays a major role in how we react to a variety of daily stressors.

Since lack of sunlight is thought to be a major cause of S.A.D., a good prevention strategy is phototherapy. This consists of daily exposure for 30 minutes to a special lamp that is 10 to 20 times brighter than ordinary light. Many people say they start to feel better within five days of using phototherapy first thing in the morning.
Depression is an illness that has a genetic component, and it can recur often, even without obvious stressors. While we can’t alter our genetic predisposition, positive steps can be taken to minimize or prevent further depression episodes. In addition to knowing early warning signs, making positive changes in your environment can certainly help. These can include improving your self-awareness, resolving emotional conflicts, exercising regularly and avoiding alcohol. And just be sure to get plenty of rest.