{"id":6154,"date":"2020-05-14T13:00:11","date_gmt":"2020-05-14T12:00:11","guid":{"rendered":"https:\/\/euromedic.rs\/pregledi\/psihijatrija-psihologija-anksioznost-copy-copy\/"},"modified":"2020-10-07T10:47:16","modified_gmt":"2020-10-07T09:47:16","slug":"psihijatrija-psihologija-depresija-kod-menopauza","status":"publish","type":"post","link":"https:\/\/euromedic.rs\/pregledi\/specijalisticki-pregledi\/psihijatrija\/psihijatrija-psihologija-depresija-kod-menopauza\/","title":{"rendered":"Psihijatrija\/psihologija – Depresija kod menopauza"},"content":{"rendered":"

Depresija je \u010dest pratilac perimenopauze. \u017dene u kasnoj perimenopauzi imaju \u010dak \u010detrnaest puta ve\u0107i rizik za razvoj depresije.<\/span><\/p>\n

Perimenopauza je razdoblje od nekoliko godina koje prethodi kona\u010dnom prestanku menstruacije. To je razdoblje velikih promena za \u017eenu, kako u endokrinom i reproduktivnom sistemu, tako i u socijalnoj i psiholo\u0161koj dimenziji.<\/span><\/p>\n

Depresija u perimenopauzi delimi\u010dno je uslovljena promenom socijalnog okru\u017eenja, socijalne uloge \u017eene i porodi\u010dne dinamike \u0161to otvara brojna pitanja na temu identiteta \u017eene u ovom osetljivom periodu<\/span><\/p>\n

Drugo obja\u0161njenje depresivnih smetnji u perimenopauzi je biolo\u0161ke prirode i uklju\u010duje promene nivoa hormona estrogena, progesterona i androgena. \u017denski polni hormon estrogen ima za\u0161titnu ulogu u o\u010duvanju kostiju, krvnih sudova, ali i u o\u010duvanju psiholo\u0161ke ravnote\u017ee. Sni\u017een nivo estrogena u centralnom nervnom sistemu izaziva promene raspolo\u017eenja: tugu, \u017ealost, bezna\u0111e. Osim promena nivoa hormona, sni\u017eena je i aktivnost serotoninskog sistema neurotransmisije.<\/span><\/p>\n

Ve\u0107a verovatno\u0107a da se pojavi depresija u menopauzi postoji kod \u017eena koje su ve\u0107 ranije imale depresivne krize, kod \u017eena koje se bave stresnim poslom, kod \u017eena koje mnogo pu\u0161e i kod \u017eena koje su ra\u0111ale posle 40-te godine \u017eivota. Jatrogena menopauza (izazvana npr. hirur\u0161kim odstranjenjem jajnika) tako\u0111e pove\u0107ava rizik od depresije.<\/span><\/p>\n

Simptomi:<\/strong><\/p>\n

Najmanje dve nedelje ve\u0107i deo dana \u017eena ima depresivne smetnje, a \u010desto i simptome anksioznosti. Glavni simptomi su: poti\u0161tenost, neraspolo\u017eenje, strepnja, napetost, gubitak interesovanja za ina\u010de omiljene aktivnosti, nesanica, umor, ote\u017eana koncentracija, ose\u0107aj krivice, ose\u0107aj manje vrednosti, ranjivost, pla\u010dljivost.<\/span><\/p>\n

Le\u010denje:<\/strong><\/p>\n

Tretman depresije zavisi od intenziteta simptoma i posledi\u010dne disfunkcionalnosti.<\/span><\/p>\n

Bla\u017ee depresivni simptomi u perimenopauzi povla\u010de se po uklju\u010denju samo supstitucione hormonske terapije ili uz psihoterapijski suport.<\/span><\/p>\n

Ne uzimaju sve pacijentkinje hormonsku terapiju. Podeljena su mi\u0161ljenja o koristi naspram rizicima supstitucione hormonske terapije. U svakom slu\u010daju potrebno je mi\u0161ljenje ginekologa, a po\u017eeljno je i mi\u0161ljenje interniste.<\/span><\/p>\n

Ako depresivne smetnje ometaju \u017eenu u svakodnevnom \u017eivotu i vode osiroma\u0161enju njenih kontakata, nemogu\u0107nosti obavljanja li\u010dnih i dru\u0161tvenih aktivnosti, a naro\u010dito ako je visok stepen subjektivne patnje pra\u0107en ose\u0107anjem krivice i ose\u0107anjem manje vrednosti, terapiju antidepresivima ne treba odlagati bez obzira na to da li \u017eena uzima hormonsku terapiju ili ne.<\/span><\/p>\n

U slu\u010daju razvoja velike depresivne epizode i suicidalnih misli (tzv. involutivna\u00a0<\/span>melanholija) psihijatrijska terapija je apsolutno indikovana i hitna.<\/span><\/p>\n

Naj\u010de\u0161\u0107e se koriste antidepresivi koji poja\u010davaju serotoninsku aktivnost u mozgu (SSRI).<\/span><\/p>\n

Efikasnost primene SSRI lekova ve\u0107a je ako se koriste uz hormonsku terapiju. Ako postoje kontraindikacije za hormonsku terapiju ili je pacijentkinja odbija, koriste se u le\u010denju dualni antidepresivi (inhibitori ponovnog preuzimanja serotonina i\u00a0<\/span>noradrenalina). Postoje pokazatelji da su ovi antidepresivi jednako efikasni kao i kombinacija SSRI lekova i estrogena.<\/span><\/p>\n

U svakom slu\u010daju indikovana je i psihoterapijska podr\u0161ka jer ova depresija nije samo biolo\u0161kog porekla. Ti\u010de se problema \u201enovog\u201c identiteta \u017eene u njenom \u201enovom\u201c dobu.<\/span><\/p>\n

Zaklju\u010dak:<\/strong><\/p>\n

U na\u0161oj sredini mnoge \u017eene radije ne tra\u017ee stru\u010dnu pomo\u0107. Delom je to zbog straha od psihijatrijske stigmatizacije, ali delom i zbog pogre\u0161nog uverenja da su tuga, strepnja i ose\u0107aj besmisla \u201eobavezni program starenja\u201c. Na\u017ealost, i neki zdravstveni profesionalci uveravaju \u017eene da je \u201esve to normalno i prolazno\u201d i da je le\u010denje nepotrebno. Zbog toga i dalje veliki broj slu\u010dajeva depresije u perimanopauzi (i menopauzi) ostaje neprepoznat i nele\u010den.<\/span><\/p>\n

Zahvaljuju\u0107i produ\u017eenju \u017eivotnog veka, \u017eena \u010dak tre\u0107inu \u017eivota pro\u017eivi u menopauzi. To je vi\u0161e nego dovoljan razlog da zajedni\u0107ki radimo na unapre\u0111enju zdravlja i kvaliteta \u017eivota.<\/span><\/p>\n

Euromedik ima tim za menopauzu: ginekolog, endokrinolog, neurolog, fizijatar, a deo tima, ukoliko \u017eelite, mogu biti psiholog i psihijatar.<\/a><\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Depresija je \u010dest pratilac perimenopauze. \u017dene u kasnoj perimenopauzi imaju \u010dak \u010detrnaest puta ve\u0107i rizik…<\/p>\n","protected":false},"author":1,"featured_media":6156,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[489],"tags":[350,108,332,330],"class_list":["post-6154","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-psihijatrija","tag-depresija","tag-menopauza","tag-psihijatrija","tag-psihologija"],"yoast_head":"\nPsihijatrija\/psihologija - Depresija kod menopauza - Le\u010denje<\/title>\n<meta name=\"description\" content=\"Depresija je \u010dest pratilac perimenopauze. \u017dene u kasnoj perimenopauzi imaju \u010dak \u010detrnaest puta ve\u0107i rizik za razvoj depresije. 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