Depression is a big problem in women during and after pregnancy, but it's also a concern throughout the reproductive years.
Now, new research reports that nearly 5 percent of women between the ages of 20 and 44 have struggled with major depression.
And another 4 percent of women in that age group have experienced minor depression.
But neither group is getting adequate care for the condition. Less than one third of women with major depression were being treated with antidepressants. For those with minor depression, only 20 percent had been given an antidepressant.
"Depression impacts women of childbearing years who aren't pregnant," said study senior author Dr. Alexander Butwick. He's an associate professor of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine in California.
"By improving awareness of depression in the reproductive years, we may be able to better optimize care before a woman gets pregnant. We can get appropriate counseling and treatment in place before pregnancy, which may help mitigate depression during pregnancy," Butwick said.
Nearly 13 percent of women experience major depression during pregnancy, according to the researchers. Depression during pregnancy has been linked to several serious outcomes, including the mother's self-harm or suicide, diminished growth in the baby, early delivery and inadequate mother-child bonding.
More than half of women who have depression during pregnancy also had depression before pregnancy, the researchers noted. So getting a treatment plan in place beforehand would be ideal.
But about half of U.S. pregnancies are unplanned. That's why the study authors wanted to see how many women are dealing with depression during their reproductive years.
"Depression, if uncontrolled, may have an impact on a woman and her pregnancy outcome. If you're aware of a problem beforehand, you have the luxury of time to plan," Butwick said.
The study included data from a nationally representative survey of health and nutritional status in the United States. The data is continuously collected in two-year cycles. For this study, the researchers looked at 2007 to 2014.
The survey included nine questions to determine depression, ranging from "Do you feel tired or have little energy?" to "Do you have thoughts that you would be better off dead or of hurting yourself in some way?"
Major depression required participants to have five or more depressive symptoms more than half the days in the past two weeks, while minor depression involved fewer than five, according to the study.
The data only has pregnancy status for women aged 20 to 44, so that's the age group targeted by researchers. They excluded women who were pregnant and those who had given birth in the past 12 months.
The study ended up with 3,705 women of reproductive age. Of these, 5 percent suffered from major depression.
Factors associated with major depression included having high blood pressure, smoking and having government insurance. The one factor with a statistically significant link to minor depression was having a high school education or less.
Butwick said these associations shouldn't be considered as risk factors for depression. More study is needed, he added.
Dr. Chris Karampahtsis is a psychiatrist at NYU Winthrop Hospital in Mineola, N.Y., who helps oversee a maternity mental health program. He reviewed the study's findings.
"The big challenge has been that there hasn't been much research in nonpregnant women of childbearing years. This is a particular subset of women that requires focus," he said.
"Depression is very treatable, but it has to be identified. This study found a large group of women that are being undertreated or not treated at all for depression. It shows we definitely have to become better at screening for depression," Karampahtsis noted.
He said the big public health concern is that about a quarter of adults with minor depressive symptoms go on to have major depression. "Intervening early can have a significant impact," he said.
The study was published March 12 in the journal Obstetrics and Gynecology.
Learn more about depression in women from the U.S. National Institute of Mental Health.
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