Women are 2-3 times more likely to suffer with depression and anxiety in their lifetime than men. But rates are the SAME before puberty and after menopause! Reproductive mood and anxiety disorders have been my research and clinical interest since my first year in graduate school. I started out by investigating risk for premenstrual dysphoric disorder (PMDD).
PMDD is a chronic condition that significantly affects well-being during the reproductive years. The pattern of symptoms of PMDD is linked to the menstrual cycle, with the onset of symptoms in the late luteal phase (2-3 days before a period begins) and the symptom offset shortly after the beginning of menses. At least five of 11 symptoms are necessary for diagnosis, with at least one of the symptoms being related to mood. Symptoms include depressed mood, anxiety/tension, affective lability (ups and downs), anger/irritability, decreased interest in activities, difficulty concentrating, fatigue, appetite changes, sleep difficulties, feeling out of control and physical symptoms. I found the most common emotional symptom reported was irritability.
PMDD is associated with significant personal and economic costs, increased work absenteeism, reduced work productivity, and reduced quality of life. Sex differences in depression rates suggest that women might be at increased risk for psychiatric illnesses as a result of naturally changing hormonal levels during their reproductive cycle. In addition to high rates of pregnancy, postpartum, and perimenopausal depression, up to 85% of menstruating women exhibit one or more menstrual cycle related symptom, 20–40% report Premenstrual Syndrome (PMS), and 2–9% report PMDD.
My current research focuses on inflammation driving the mood & anxiety symptoms that arise during naturally changing hormonal levels in pregnancy and postpartum. My early research focused on other biological risk factors, for example, I measured the electrical activity in college women's brains. This EEG research has been published and showed that women with PMDD have similar brain frontal brain activity as those with major depression - even if they are in the follicular phase of their cycle (ie. not having mood or anxiety symptoms)! I also published a diagnostic tool for PMDD researchers to use, since none existed in 2002-2005. Links to all of this research can be found in ResearchGate.
If you have trouble accessing any articles, please let me know. I can send you a full PDF (for educational purposes only).
Dr. Accortt in the News
3/20/19: KFI News Radio, FDA Approves First Drug for PPD, Brexanolone (Zulresso) - Correction: Rix states that Dr. Accortt "treats thousands of women at CS" - Thousands of women delivery babies at CS every year. Dr. Accortt does not treat them.
Winter 2019: Cedars-Sinai Discoveries Magazine, Stop The Stigma
9/11/18: USC Center for Health Journalism, Cedars-Sinai PPD Screening Program May be Model for State
Summer 2018: Cedars-Sinai Catalyst Magazine, The Helping Hand of Los Angeles Funds Postpartum Depression Screening Program, scroll down to page 40 of magazine
5/18/18: TODAY.com, Alyssa Milano on Postpartum Anxiety
5/3/18: Cedars-Sinai Maternal Mental Health Research
10/19/17: Cedars-Sinai Postpartum Depression Screening Program
3/24/17: MomCo. App for Social Support
Dr. Accortt is a California licensed clinical psychologist. When she isn't seeing patients in private practice she conducts research in the OBGYN department at Cedars-Sinai. She will update this page with important maternal mental health news and research.