New Jersey is the only state required by law to screen prenatal and postpartum women
In the past decade, we’ve embraced the importance of screening, diagnosing and treating postpartum depression. But a new study found that the depression may actually start during the pregnancy. This finding suggests that if we can diagnose and begin treating depression sooner, the new mother will face less severe postpartum symptoms and recover more successfully.
Depression in women during childbearing years is quite common and prenatal depression can affect close to one in four women. If my patient is using antidepressants or other psychotropic drugs before pregnancy, we discuss how these drugs might affect a potential pregnancy. Some women have been routinely using this type of medication for so long, they don’t recall what condition it originally was prescribed to treat.
But if a pregnancy is in the woman’s future, I advise her to talk with her mental health or primary care physician about weaning off certain medications or making medication changes where appropriate. Mental health issues should be treated like any other chronic disease and addressed well before the onset of pregnancy.
Mother’s Depression can Affect the Baby
A large Swedish clinical study that included more than 360,000 newborns found that a depressed mother increases the risk of preterm birth, often due to a lack of self-care during the pregnancy. In addition to premature birth health risks, babies of depressed women may also experience emotional and developmental issues such as chronic sleeping problems, difficulty reaching a calm state, social skills impairment and problems in school.
How do I know if I have prenatal or postpartum depression?
Pregnant women and new mothers are faced with a barrage of hormones, worries and new responsibilities. As a result, their own mental and physical health needs can often be ignored. But depression affects the mother, child, and family dynamic. Signs of depression can include any of the following symptoms:
- Feeling restless, moody, sad and hopeless most of the time
- Crying regularly and feeling overwhelmed
- Having no energy or motivation
- Eating and sleeping too little or too much
- Having trouble focusing, making decisions, remembering things
- Feeling worthless and guilty
- Loss of interest or pleasure from activities you used to enjoy
- Withdrawal from friends and family
- Experiencing chronic headaches, body aches or undiagnosed stomach problems
Who can test me for pregnancy-related depression?
Start by discussing the subject with your OB/GYN or any health care provider you see regularly. Many doctors rely on the Edinburgh Postnatal Depression Scale, comprised of a simple 10-question survey. If your results suggest a possible depression condition, your doctor will guide you in terms of connecting with a mental health professional who specializes in prenatal and postpartum depression diagnosis and treatment. Treatment plans generally include ongoing talk therapy and possibly medication that is safe for use during pregnancy.
Identifying and addressing maternal depression early on is critical to ensuring a positive long-term relationship between mother and baby. Most importantly, it is a treatable condition. If your doctor doesn’t screen you for depression before, during, and after you give birth, be sure to ask for it. New Jersey is currently the only state in the U.S. that requires OB/GYN caregivers to discuss postpartum depression with their pregnant patients; screen new mothers before they leave the hospital; and rescreen during the baby’s first few checkups. This screening is also covered by the Affordable Care Act.