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Baby blues & beyond: New ways to help new moms with depression

From talk therapy to yoga, U-M team offers care and a chance to help others through research

Postpartum depression affects many women in the first months after a baby is born.

Postpartum depression affects many women in the first months after a baby is born.

They’re supposed to be the happiest times of your life, right? But being pregnant or a new mom can have a dark side – temporary or lasting depression.

How quickly you get help, and what kind of help you get, for symptoms like moodiness, insomnia and loss of appetite can make a big difference for you and your baby.

Maria Muzik, M.D., M.S., who leads a University of Michigan clinic focused on mental health during pregnancy and the first year of a child’s life, offers more information on this important issue. May is the awareness month for these issues.

Q: How many women actually experience true depression during pregnancy or soon after giving birth?

A: Depression can be confusing for women when it occurs during pregnancy or in your first year of motherhood, since having a baby is commonly expected to be a very happy occasion. Yet almost 1 in 10 pregnant women will experience true major depression – and many more will experience less severe forms.

Women are especially vulnerable to depression in the period immediately following childbirth.  By some estimates, about 80 percent of women who have just given birth experience “baby blues” or “postpartum blues” for a few days or weeks, characterized by extreme sensitivity, moodiness and sleep problems. In most cases, this problem resolves itself within one to two weeks of giving birth without requiring treatment.

But some new moms experience something more lasting – mood symptoms or anxiety that continue and cause a great deal of distress. The problem often begins within a few days of giving birth, and continues and grows worse for weeks or months.

This is called postpartum depression or postpartum anxiety. Postpartum depression affects nearly 20 percent of families who have infants, and many more cases go unreported or undiagnosed; and untreated.  Over 2,500 women and their families are affected by postpartum depression each year in Michigan alone.

Q: Do most of these women get help?

A: Unfortunately, no. It is easy to attribute symptoms of depression to the pregnancy itself, which is why depression is sometimes misdiagnosed or ignored in pregnant women, causing them to suffer needlessly. Similarly, not enough women get help for lasting postpartum mood and anxiety issues.

Q: Doesn’t it just pass with time? Why should a woman seek treatment?

A: Left untreated, severe depression can have long-term consequences for both mother and baby. Lack of proper nutrition, adequate rest, or prenatal care because a pregnant woman is depressed may contribute to premature births and low birth-weight infants. And studies have also shown that postpartum depression is more likely to occur if depression during pregnancy goes untreated.

If a woman starts experiencing depression or anxiety after giving birth, it can affect her ability to bond with and care for her infant, as well as her relationships with her partner and others.

We started our Women and Infants Mental Health Clinic at the U-M Department of Psychiatry and Depression Center to offer care and support to women experiencing any of these issues. We’re also working on a number of studies to test new options for treatment.

Q: What does the clinic offer?

A: We’re a multidisciplinary team of psychiatrists, psychologists, clinical social workers, nurses and more. That allows us to provide a range of clinical services to women experiencing depression, anxiety or related disorders.

We provide both consultation and continuing care for women and their children – including for trauma-related difficulties around the time of childbearing, infertility, or following the loss of a pregnancy or infant. We encourage the involvement of fathers, partners, and other key supports whenever possible.

Our faculty and staff are steeped in the field’s latest knowledge and do research to evaluate, improve, and refine the care we provide. We’re especially interested in the parent-child relationship and effective ways to intervene and provide support during the critical period around childbirth, including enhancing parenting and bonding.

Q: What about antidepressants during pregnancy or breastfeeding?

A: We believe the first option for any women experiencing these issues should be “talk therapy” – approaches such as cognitive behavioral therapy and interpersonal psychotherapy, that involve repeated sessions with a trained therapist. Complementing that, we advise women to use exercise, yoga, and other approaches – and to take part in support groups of women like them, moderated by women who have been through what they’ve been through.

Medications such as antidepressants  or other medicines (for example, sleeping aids and medicines for anxiety relief) are our third line of treatment – necessary in some women, but not the first strategy we turn to. For some women, whose illness is severe, these medicines are important supplements to the other strategies to potentiate effects and support a speedy recovery. Our doctors are well versed in the state of the art knowledge on medication safety and only prescribe medicines where we have adequate data on their safety record, and only after extensive discussion with the patient and, if wished for, her family.

Q: Not everyone lives near a clinic like yours. What should someone do if she suspects she’s having depression symptoms during or after pregnancy – or if a loved one is concerned about a pregnant woman or new mom’s moods?

A: If you or someone you know may be struggling with postpartum depression or anxiety, it’s vital you contact a health-care professional as soon as possible. The obstetrician, family doctor or nurse midwife caring for the woman should be able to connect you with information, resources, and details about local support groups.

The most important thing is not to stand still and hope it will pass. Pregnancy and the first months of motherhood are vital, but relatively brief, times. Every day that passes without help can make a real difference in the long-term health of the mother and child. Don’t wait.

Take the next step:

  • Read about postpartum depression from the U-M Depression Center’s Depression Toolkit
  • Find out how depression can affect women during pregnancy on the Women and Depression website
  • Learn more about U-M’s Women and Infants Mental Health Clinic
  • Read the official declaration from Governor Rick Snyder making May Postpartum Depression Awareness Month
  • Get information about postpartum depression support services available nationwide on postpartum.net
  • Call the U-M Mental Health Research Line at (734) 232-0255, to find out if you’re eligible to take part in research studies – research teams need both people with mental health conditions and those without.
  • If you are having a mental health emergency and you are in Michigan or northern Ohio, call (734) 936-5900 to reach the U-M Health System’s Psychiatric Emergency Department. If you are elsewhere, call 911.
  • Support programs for pregnant women and new mothers at U-M by giving to the Women and Infants Mental Health Program

Rachel Upjohn Building

The U-M Department of Psychiatry & Depression Center offer a wide range of mental health care & perform research to improve care everywhere. From innovative clinics to novel outreach efforts, U-M psychiatrists, psychologists, social workers, neuroscientists & others use their expertise to aid patients of all ages. Both the center & department are based at the Rachel Upjohn Building on U-M’s East Medical Campus, with inpatient units & psychiatric emergency care in U-M hospitals & basic research at the Molecular & Behavioral Neuroscience Institute.

 

new_logos_180x1806For more than 160 years, the University of Michigan Health System has been a national leader in advanced patient care, innovative research to improve human health and comprehensive education of physicians and medical scientists. The three U-M hospitals have been recognized numerous times for excellence in patient care, including a #1 ranking in Michigan and national rankings in many specialty areas by U.S. News & World Report.

 

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