Frequently Asked Questions about depression during and after pregnancy
How common are maternal mental health disorders? Depression and Anxiety are the most common complications in pregnancy and postpartum. 1 in 7 women suffer from perinatal depression or anxiety. Only 15% of women will seek professional help.
Why don’t women get help? There is a lack of awareness, screening and easy to access treatment. There is also ongoing stigma surrounding mental health issues and a fear that the baby will be taken away. Women spend a lot of time focused on their “birth plan”, including what pajamas they will wear in the hospital and what poses the birth photographer is going to use. Rarely, is treating or protecting one’s mental health part of the birth and postpartum plan. As women we have set unrealistically high expectations for childbirth and parenting and social media posting is contributing to the overall sense that we as women, and mothers, aren’t meeting expectations if everything isn’t perfect. Developing postpartum depression or anxiety wouldn’t be looked upon favorably by our peers so we don’t talk about it or get treatment. Talking about it opens conversations and helps to identify resources for women to access in their own communities.
What happens without treatment? Postpartum depression occurs in 20% of postpartum moms and suicide is the most common cause of death in new moms. Without treatment depressed Moms are more likely to have impaired bonding with their babies. Untreated depression and anxiety during and after pregnancy can cause issues with children that are identifiable into adulthood including cognitive and developmental delays; poor self-control and aggression and an increase risk of substance abuse.
Are some women at higher risk for postpartum or maternal mental illness? Yes, studies have identified certain genetic factors that increase risk of developing postpartum depression, it tends to run in families and women with a history of PMDD are at higher risk of postpartum mood and anxiety disorders. In addition; preexisting depression, anxiety or bipolar depression, a family history of mental illness, a personal history of trauma or abuse, experiencing a stressful event in the last year, an inadequate support system, financial stress, trouble breastfeeding and mom or baby with physical health issues during and after pregnancy.
What can someone do to decrease the risk of developing postpartum depression or anxiety? In about 60 % of women, depression begins before or during pregnancy, so there is an opportunity to get into treatment before baby arrives. 40% of women don’t have symptoms until the postpartum period. The peak incidence is day 10-19 postpartum. In these women, it’s imperative that family members and health care providers are screening and talking about any concerns they have.
What treatments are available during pregnancy? Interpersonal psychotherapy is highly effective in helping to develop a support system. Medication is helpful and has been shown to be safe in pregnancy. Risks of untreated mental health disorders are associated with poor health in the mom and baby. Healthy habits like exercise, eating a healthy diet and ensuring restful sleep can help as well. We encourage patients to create a maternal wellness plan to protect their postpartum mental health and be ready to address if it occurs.
What are the risks of medication during pregnancy? We always need to balance and discuss the risks and benefits of medication treatment and risks of untreated depression. Untreated mental illness is more harmful than any prescribed medications, for mom and baby.
Are medications always required? Not always, it depends on severity of symptoms and risk factors. We don’t want to wait until symptoms are so severe that hospitalization is required, we want to treat as soon as possible to get mom feeling back to her normal self and protect the mom and baby relationship.