Vivian McAllister Dearden, CNM

Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.

Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.

We don't yet know what causes depression, but it's thought that it is a combination of genetic, biological, environmental, and social influences. Because of this, the most effective treatments for depression combine medication with psychotherapy. Therapy, especially cognitive-behavioral therapy, can be extremely helpful in resolving the negative thoughts and feelings that come with depression. It gives patients new tools that they can use themselves to cope when their depression is making them feel down.

Some of the common medications used to treat depression include antidepressants such as SSRI's (Prozac, Paxil, Zoloft) or atypical antidepressants (Cymbalta, Wellbutrin). It's important to remember that these medications have different effects on everybody, and no one medication works right for everyone. Patients may have to try a couple before finding the one that works just right for them. If the first medication they try doesn't work, they should talk to their doctor about trying something else. In extreme cases where medication is not enough, electro-convulsive therapy and hospitalization may be the answer to keeping a severely depressed person safe.

Depression is a difficult illness to deal with, but it is more common than believed and there are many people who can help. With the right treatment, individuals with depression can get back to fully enjoying life again.

Despite the name, not everyone with polycystic ovarian syndrome develops cysts on their ovaries. It is also possible to have ovarian cysts without having PCOS. The symptoms of polycystic ovarian syndrome are actually related to insulin resistance, a condition where the insulin made by the body is not effectively recognized by the cells. This causes the pancreas to release higher levels of insulin in order to keep blood sugar levels stable, and the excess insulin interferes with hormone production in the pituitary and ovaries, causing the PCOS symptoms.

The symptoms of PCOS include:

• Weight gain
• Acne
• Facial or body hair
• Thinning head hair
• Missing or irregular periods
• Infertility

PCOS is a syndrome, which means that if patients have PCOS, they might not have each and every symptom. Even a few of them might be enough to have physicians check for polycystic ovarian syndrome. A doctor might perform an exam and order blood tests to measure hormone levels.

Treatment for PCOS may include:

• Insulin sensitizers, which help the body use insulin more effectively, lowering hormone levels. The most commonly used insulin sensitizer is metformin.
• Weight loss. Being overweight does not cause PCOS, and PCOS can make losing weight difficult. Still, weight loss can improve symptoms for many women.
• Birth control pills to regulate menstruation and sometimes reduce symptoms such as acne.
• Fertility medications, especially medications to stimulate ovulation such as clomiphene.
• Anti-androgen medications, which work to treat symptoms such as acne and facial hair.
• Low-carb diets, which work similarly to insulin sensitizers to lower hormone levels and help reduce weight.
• Ovarian drilling or resectioning, surgical procedures sometimes performed if infertility is a persistent problem. These procedures open up the wall of the ovary to temporarily make ovulation more likely.

Polycystic ovarian syndrome is one of the most common endocrine disorders affecting women. Left untreated, it can increase the risk of diabetes, heart disease, and certain cancers. Fortunately there are many good treatment options available.