Premenstrual Dysphoric Disorders
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).
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Dr. Accortt in the News
February 2023: Glamour Magazine: Postpartum Anxiety Is More Common Than You Think—Here’s What You Need to Know
December 2022: Cedars-Sinai Newsroom: Immune System Irregularities Found in Women With Postpartum Mood & Anxiety Disorders
October 2022: Verywell Family, Researchers Find Possible Predictor of Postpartum Depression
June 2022: ABC News, Postpartum Depression Screening, Changes to Nurse Training.
August 2021: AirTalk KPCC Radio, The History of C-Sections, The Significance We Put on "Birth Stories" And How It Impacts Mental health
(fast forward to 13 minute mark)
July 2021: AirTalk KPCC Radio, Why Women Have Long Kept Early Parts of Pregnancy a Secret and the Arguments For Moving Away From the 12-week rule
(fast forward to 28 minute mark)
July 2021: Los Angeles Times, Postpartum depression on the rise, especially for women of color, during COVID-19 pandemic
October 2020: The Candidly, PMDD Affects Millions Of Women. So Why Aren’t We Talking About It?
October 2020: Cedars-Sinai Discoveries Magazine, A Real-Life Stress Test
September 2020: Cedars-Sinai Blog, Infertility and Mental Health
July 2020: Cedars-Sinai Newsroom, Reproductive Psychology Program Focuses on Mother and Family Wellness
May 2020: Hawaii News Now, Sunrise, How to Prevent Anxiety & Depression Before and After Giving Birth
April 2020: The Bump, How to Spot Postpartum Depression in Your Partner or Friend
12/3/19: Quartz, Ten questions about mothers’ mental health could promote resilient pregnancies
5/10/19: CGTN America, US comedian uses her act to turn the spotlight on postpartum depression
5/1/19: KTLA News, How One Comedian’s Battle With Postpartum Depression Turned Laughs Into Legislation
3/20/19: KFI News Radio, FDA Approves First Drug for PPD, Brexanolone (Zulresso)
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.