Dr. Erica Richards and the Important Differences in Women’s Mental Health

Dr. Erica Richards, Chair and Medical Director of the Department of Psychiatry at Sibley Memorial Hospital joins us to discuss the nuances of women’s mental health. We discuss underrepresented groups, stigmas, and everyday challenges that often prevent people from seeking help. Dr. Richards also explains how the pandemic has taught us new ways to treat depression and anxiety. Join us for this eye-opening conversation. 


More on Dr. Erica Richards:
Website: hopkinsmedicine.org/profiles/details/erica-richards

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Quotes:
People can have anxiety and not have depression. People can have depression and not have anxiety. But there really is an overlap of symptoms.
Dr. Erica Richards

In most instances, it's the therapy and the medications combined that not only get people better but keep them well moving forward.
Dr. Erica Richards

Women are around 2 to 3 times more likely to experience a major depressive episode or a mood disorder compared to men. 
Dr. Erica Richards

Show Notes:

Dr. Erica Richards: I am the Chair of Psychiatry at Sibley Memorial Hospital in Washington, DC. So we are a Johns Hopkins Community Hospital.

Dr. Erica Richards: I'm always excited to spread the word and open discussions about mental health in terms of women. 

Dr. Erica Richards: What we know about women is that they're around two to 2 to 3 times more likely to experience a major depressive episode or a mood disorder compared to men. 

Dr. Erica Richards: I spent a lot of my time learning about women's mood disorders, meaning everywhere from what we call premenstrual dysphoric disorder or premenstrual mood symptoms all the way through pregnancy, menopause and beyond.

Dr. Erica Richards: Depression can seem like anxiety. Anxiety can manifest as mood disorders or depression.

Dr. Erica Richards: They're both thought to be related to an imbalance of serotonin in the brain.

Dr. Erica Richards: The word or the thought that they're antidepressants. But we actually use these medications as an anti-anxiety medications as well, again, because we think of them as this continuum.

Dr. Erica Richards: There's also caution with the benzodiazepine class of medications because of the potential for dependence. 

Dr. Erica Richards: What we try to do is to really get the source of the anxiety.

Dr. Erica Richards: I don't think medications are always the answer.

Dr. Erica Richards: We want to really prevent, that breakthrough anxiety from happening. And that's the medication piece.

Dr. Erica Richards: The therapy piece and really talking about why this is happening is also extremely important.

Dr. Erica Richards: There is a role evolving for the genetic testing to let us know which medications may work.

Dr. Erica Richards: We use anti-psychotic medications a lot of times to treat not only schizophrenia, sometimes for bipolar disorder, depending on how a patient presents, but that class of medications, sometimes in terms of long-term effects, can change our metabolism.

Dr. Erica Richards: We really advocate for treatment and monitoring for potential side effects or long-term effects.

Dr. Erica Richards: Therapy alone is worth a try. But what we see a lot of times is that if people are so ill that they actually are not able to process that therapy.

Dr. Erica Richards: People from underrepresented minority populations. So patients of color, of course, will experience equal, if not higher rates of mood disorders, for example. But all things being equal, they are less likely to seek care.

Dr. Erica Richards: More recent studies are showing that people are ready to talk about it, but they want to talk about it in an environment that they consider to be culturally appropriate.

Dr. Erica Richards: Underrepresented minorities are also underrepresented in the mental health world.

Dr. Erica Richards: We need more representation, but we also need kind of more understanding that people's experiences just aren't going to be the same regardless of what they look like.

Dr. Erica Richards: The other really good thing that came out of this, in my opinion, is we're able to reach more people by providing virtual care.

Dr. Erica Richards: For a population that I treat, which is postpartum depression, that made all difference.

Dr. Erica Richards: At Johns Hopkins and our community clinics, we found that no-show rates actually went down.

Dr. Erica Richards: You are not alone. Let's acknowledge this. Let's talk about it. Let's be open and honest, because you are not alone. A lot of people are experiencing this, and it was across all ages.

Dr. Erica Richards: The loneliness really took a toll on a lot of people.

Dr. Erica Richards: There's a whole line of study that goes on with the role of inflammation and depression.

Dr. Erica Richards: There's a few new or what we call novel therapeutics or new treatments that have been FDA-approved. 

Dr. Erica Richards: Between the ketamine, the brexanolone, the new studies that are going on with psilocybin, there is progress in the field. It's not going to be the same mainstream treatments that might get you better.

Dr. Erica Richards: When we ask, as mental health professionals, about suicide we actually normalize that conversation also. And we really want to encourage people to seek help if that's how they're feeling.

Dr. Erica Richards: If you're feeling that desperate, we want you to come into the emergency room.

Dr. Erica Richards: We treat this on a regular basis. We have ways to keep people safe until they're feeling better.



Keywords:
TriciaReillyKoch, DoroBushKoch, HealthGig, Longevity, Wellness, PhysicalHealth, MentalHealth, Health, HealthCare, Depression, Anxiety, WomensHealth, Therapy