Recognizing Postpartum Depression and Other Perinatal Mood Disorders

A few months ago, I was contacted by the husband of a friend.  The couple had had their third child 5 months earlier and he was concerned that his wife was becoming less and less herself.  She was struggling to get out of bed and avoiding the baby and her older two children. His normally chipper, energetic wife was despondent and felt that life had no purpose.  Appropriately, he reached out to me to see whether I could confirm that this was, indeed, postpartum depression and I referred them to a psychiatrist who specialized in maternal mental health for ongoing care.

Several years ago, NPR posted a piece about Postpartum Depression.  After revisiting it, I realized that it spoke to something I’ve been thinking about quite a lot – the incredible difficulty in detecting perinatal mood and anxiety disorders for so many women who suffer from them. The NPR story focused on a couple, Paige and Bjorn Bellenbaum, and traces what occurred following the birth of a first child. What really caught my interest is that Paige was a Social Worker, a professional trained to detect symptoms of depression. This struck me as I have also heard the current Executive Director of Postpartum Support International, Wendy Davis, speak of her own struggles with Postpartum Depression after the birth of her first child. The depression she fell into was so engulfing that even as a licensed psychologist, she was unable to recognize the signs and symptoms when they appeared. She explained that the distressing thoughts coming from the depression felt too true, too real, and too unique to her experience to be depression – in a sense, the depression tricked her into thinking it was not the depression, it was her. This is why self-identification of a postpartum mood or anxiety issue is so difficult – the nature of the depression or anxiety relies on the fact that the person experiencing it perceives it to be an appropriate sadness/reaction or response to an actual threat.


In May 2018, the American College of Obstetrics and Gynecology published a recommendation that postpartum care for women become “an ongoing process, rather than a single encounter, with services and support tailored to each woman’s individual needs.” In particular, these visits should include “a full assessment of physical, social, and psychological well-being, including … mood and emotional well-being…” Like the stories of the Bellenbaum’s and Wendy Davis, this recommendation recognizes that ongoing connection with someone outside of the family who is focused on the mother and not just the infant (historically, pediatricians have been those charged with screening mothers for postpartum mood disorders) is key in navigating these very serious psychological dilemmas.  


While postpartum depression is the most frequently mentioned of all the post-labor mood issues, there are myriad other perinatal issues that can emerge in response to a new mother’s shifting hormones.  These include anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, bipolar disorder and postpartum psychosis.


If experts in recognizing postpartum mood issues struggle to notice their own disordered feelings and thinking, then it stands to reason that any postpartum thoughts, feelings or experiences that cause even seemingly small amounts of distress warrant reaching out for support from a trusted friend, Obstetrician, Pediatrician or Therapist.


If you would like to speak to someone on our team who specializes in pre-, peri- and post-natal mood issues, please email us or call us at (917) 750-1330.

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