A Mother's nighmare: Perinatal Mood and Anxiety disorder

Recently, I  joined the efforts of a fellow parishioner in supporting women suffering with postpartum mood disorders.   I suffered depression with my first two births, but had no idea how severe it can be, especially left untreated.  This April, I attended a 2-day training by an organization called, "Postpartum Support International".  I learned more than I ever could have imagined about this devastating hormonal disorder.  How critical this condition effects women, babies and the entire family!

Having a child is an exciting event in a woman’s life for most.  But it also bring a great deal of stress and anxiety as her hormones fluctuate during her pregnancy and postpartum period, considered the fourth trimester. Though this is a normal occurrence in the biological system, a new mother may not have the ability to identify such swings.  Coupled with having to handle a crying or colicky newborn at the same time is overwhelming at best.  Nearly 35% of reported new mothers suffer from postpartum mood disorder, of one kind or another.  If left untreated, this condition can often move into a psychosis, which is the most dangerous condition for the mother and the infant.  The problem is many of these mothers do not know or want to call for help.

Perinatal Mood and Anxiety Disorders, (PMAD) is one of the most under-diagnosed condition in today's medicine.  Over 400,000 infants are born to mothers with depression.  Many practitioners do not recognize, or are equipped, to help these mothers beyond the postpartum period.  This lack of information leaves these mothers and families at risk of a more serious problem, a psychosis.   Identifying and preparing women for this period is the mother’s lifeline.  Many women have no idea how their emotions will change within a day or a few hours post delivery. During this time of confusion, she feels overwhelmed and lacks confidence.  She may feel that she is not a good mother and become detached from her newborn.

Screening is a must in order to make sure the correct therapy and/or medications are in place for the mom-to-be.  We are learning that mood enhancing drugs such as Zoloft are not toxic for the baby during pregnancy and does not penetrate breast milk, as once thought.   We are learning more and more that mothers can be medicated safely during pregnancy and postpartum periods and beyond while breastfeeding.  Along with this, they are finding out that changing medications in the middle of any of these stages of childbirth can detrimentally effect the mother's depressed condition.

Who is at risk of perinatal mood and anxiety disorder?  History is one place to look, both family and personal with a diagnosis of depression, anxiety, OCD, eating disorders, or bipolar disorders.  Did she have significant mood changes during puberty, PMS, or hormonal Birth control?  Pre-pregnancy diabetes, thyroid imbalance and other endocrine disorders also heighten the risk of PMAD.  There are many other life situations that can be a precursor, as well.

Is there support for the mother during this time?  Women need help through this initial period of parenthood; does she have it within the family?  If not, this will have a detrimental impact the mother, infant, and entire family.  With support, which could include a postpartum doula, the mother’s ability to care for her newborn will greatly improve.  A postpartum doula is trained to help the mother in caring and nursing her baby during the "fourth trimester."

Finally, the pharmaceutical and obstetrican worlds need to get together more for the women in these situations.   Also, women need to know that they can and should call, not wait months enduring their condition until the postpartum period is over.  They need to let their practitioner know what's going on now.   Treatment at the onset of PMAD is crucial for the mother, but also the baby, and the entire family.   As I look over my notes from this training, I am overwhelmed myself as to how much to touch on and leave off in this article.  We are a prolife community and all phases of life have trials and triumphs, childbearing is one that needs it's own special attention.  The Postpartum phase of life is a special time with special needs for each individual mother and family.  It is my prayer that more physicians, therapists, and family members become aware of this critical time, for helpless infant and the family as a whole.