Depression Assessment: Young Mothers (Perinatal)

Overview

Having a child can be one of the most exciting and rewarding experiences in life.  It can also be stressful, especially during pregnancy and right after birth.  The many changes of pregnancy and life as a parent create stress for everyone at some point.  When these stresses pile up one after another and overwhelm the ability to cope with this stress, some women may experience depression. Thankfully, there are effective treatments available to perinatal women (women who are pregnant or in the postpartum phase) and qualified healthcare providers can help evaluate pros and cons of different options to address perinatal depression.

What is Perinatal Depression?

Perinatal depression is different from the “Baby Blues.”  The Baby Blues affect 3-75% of women and refer to more mild and shorter-lasting symptoms such as changes in mood, tearfulness, anxiety, sleep changes, and difficulties with appetite. Symptoms usually last a few days and go away on their own with out treatment.  Perinatal depression is a more serious problem that that occurs during or after pregnancy (the perinatal phase) and it is diagnosed in the same way as other forms of depression. Although people often assume that being pregnant and being a new mom are the happiest times of a woman’s life, rates of depression during and after pregnancy are relatively common.  Perinatal depression affects between 10-15% of women. This may not be surprising given that many experiences during the perinatal phase are similar to symptoms of depression—appetite changes, fatigue, and difficulty sleeping. Being depressed can make it difficult to take care of yourself and your baby, and there is some research to show that untreated depression is related to premature births, low birth weight, difficulty in bonding between mother and baby, and behavior problems in children.

What Treatment Are Effective for Perinatal Depression?

The two broad classes of effective treatment options for perinatal depression are psychotherapy and medications.

Cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) are two psychotherapies that have strong evidence for being effective in the treatment of perinatal depression. There are also medications that can safely treat perinatal depression. Although many antidepressant medications are safe to use during and after pregnancy, the benefits and risks of the medication must be considered. For example, the American College of Obstetrics and Gynecology and the American Psychiatric Association published a report on this issue and stated that decisions to prescribe medication for perinatal women must take into account how safe the medication is, how far into pregnancy a woman is, what specific depressive symptoms are most impactful, what has worked in the past, and a woman’s preferences. Therapy is a good option for women who are concerned about the impact a medication could have on their developing fetus. 

The bottom line is that perinatal depression is common and it is not a sign that someone is or will be a bad parent.  It can be very difficult to experience depression during or after pregnancy, and it is important to remember that there are safe and effective treatments available.

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