Hormonal transitions don't cause depression in everyone. They destabilize mood in people who are sensitive to the shift — and that sensitivity is a clinical feature worth identifying, because it predicts what will happen at the next transition. A patient whose mood broke down premenstrually in her twenties, postpartum in her thirties, and again in perimenopause is not having three unrelated episodes.

Depression is diagnosed more often in women than in men. NIMH reports a past-year major depressive episode in 10.3% of adult women compared with 6.2% of adult men. NIMH also identifies three depressions that are specifically timed to hormone change: perinatal depression, premenstrual dysphoric disorder, and perimenopausal depression. The postpartum period is the most-studied of the three — CDC's Pregnancy Risk Assessment Monitoring System has found that roughly 1 in 8 women report symptoms of depression after giving birth.

The sorting matters as much here as anywhere in psychiatry. PMDD is not premenstrual worsening of an existing depression, and the two are managed differently. Postpartum depression is not postpartum anxiety or postpartum OCD, and none of them is bipolar disorder surfacing after delivery — which is why ACOG recommends screening for bipolar disorder before starting an antidepressant. Mood symptoms in perimenopause can also be driven by thyroid disease, iron deficiency, or sleep fragmented by night sweats, each of which has its own treatment.

Dr. Farkas brings MD/PhD neuroscience training, NIH research center experience, and board-certified psychiatric practice to that work. Her 30–60 minute evaluations are built to place symptoms on a reproductive timeline before anything is prescribed against them.

A new patient evaluation with Dr. Farkas runs 30–60 minutes. It covers your psychiatric and medical history, your reproductive history, every medication tried and how each one went, and how symptoms have lined up with cycles, pregnancies, and transitions over time.

You'll leave with a specific diagnosis explained in plain terms, a treatment plan you understand and agree with, and a follow-up already scheduled. If a PMDD diagnosis is on the table, you'll leave with a tracking method and a return date. Telehealth is available throughout South Carolina and New York. In-person appointments are available at the Hilton Head Island, SC office.