Spotlight: Maternal Mental Health Month
A Q&A With the Director of Cedars-Sinai’s Reproductive Psychology Program
Most new mothers experience one or more changes in their mood before childbirth and for two weeks after the baby arrives.
Having a child is a major life event accompanied by physiological changes and the stress of caring for a completely dependent little human. That experience is commonly referred to as “the baby blues.”
But 15% to 20% of women who give birth will experience major changes in their mood and overall wellbeing that can linger for months. These new mothers can suffer from perinatal mood disorders that can include depression, anxiety, obsessive-compulsive disorder and even post-traumatic stress.
Cedars-Sinai clinical psychologist Eynav Accortt, PhD, director of the Reproductive Psychology Program, shares information on what is known about these changes in mental health faced by millions of women and the types of treatment and support that are available to help mothers recover.
Newsroom: What do we know about the scope of maternal mental health disorders?
It's a much wider range of symptoms and diagnoses than described by the term postpartum depression or “the baby blues.” Perinatal mood and anxiety disorders can be experienced during pregnancy and up to a year after birth, when symptoms often develop. When diagnosed, this can include major depressive disorder, bipolar depression, generalized anxiety, panic disorder, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder.
Newsroom: What are the risk factors for developing perinatal mood disorders?
Things that may increase the risk for developing a perinatal mood and anxiety disorder include genetic factors such as a family or personal history of mental illness. Even medical complications during pregnancy, such as preeclampsia or gestational diabetes, can elevate a woman’s risk. At Cedars-Sinai, we are investigating a possible connection between these pregnancy illnesses and inflammation. We want to know if inflammation may increase the risk of developing depression during and after pregnancy.
Parents with a newborn in a neonatal intensive care unit have twice the risk of developing postpartum depression, anxiety and PTSD. Research also points to race and ethnicity as risk factors for mental health problems associated with maternity. Black mothers are twice as likely to develop a perinatal mood or anxiety disorder than white women, primarily due to the impact of racial discrimination.
Newsroom: When should a new mother be concerned about her mental health?
If two weeks post-delivery a woman continues to experience symptoms of depression and anxiety that interfere with her ability to function or to care for herself and her baby, it’s important to get some professional help. A good first step is to speak with your obstetrician and let them know what you are going through. In addition to feeling sad or crying all the time, persistent feelings of anger, worthlessness and inadequacy, or feeling disconnected from the baby, are associated with perinatal mood and anxiety disorders. In extreme cases, intrusive, negative thoughts about self-harm, or hurting the child, can be part of mental illness associated with pregnancy, childbirth and motherhood.
Newsroom: What kind of help is available to women experiencing anxiety and depression during pregnancy and postpartum?
Therapy, including cognitive behavioral therapy. interpersonal psychotherapy or other modalities, can provide meaningful help. Antidepressants can be part of a treatment plan by providing relief and helping improve mood and regulation of emotions. In particular, Zoloft proved to be a safe and effective antidepressant to use during pregnancy and breastfeeding.
The Reproductive Psychology Program at Cedars-Sinai is dedicated to helping women experiencing mental health conditions before, during and after pregnancy. We make sure women can receive the resources, support, care and treatment they need to improve their emotional and mental wellbeing.
Mothers should not suffer in silence. The important first step is to talk to someone—a partner or other family member, a friend, a co-worker, or your physician—and let them know you are struggling. The well-baby checkups that happen frequently in the first six months of life offer a perfect opportunity for a new mother to talk to a healthcare provider about her problems.
Newsroom: As a therapist who counsels women struggling with their mental health during pregnancy or postpartum, what encouragement do you offer?
Every reproductive journey is different. Getting pregnant, having a baby, and going through the postpartum period can be stressful, life-changing experiences. It's important to give yourself grace, and to reach out to your loved ones. If you don't feel well, and you're not able to take care of yourself or your baby, there are services and providers available to help you. There is no reason to lose hope.
Read more on the Cedars-Sinai Blog: The Difference Between Postpartum Anxiety, OCD and Psychosis