More Clinicians Need to Address Postpartum Depression and other Postpartum or Perinatal Mood and Anxiety Disorders

“It’s okay to tell me that you’re not okay.”

Postpartum depression (PPD) and postpartum or perinatal mood and anxiety disorders (PMADs) are the most common medical concerns for women after childbirth. Yet few medical and mental health professionals really know how prevalent and serious PPD and PMADs are.

There is a great need for better screening to identify women struggling with postpartum disorders. Likewise, more therapists and mental health providers need to know about treatment approaches that are effective in stabilizing and managing symptoms. Those who work with pregnant women and new mothers, as well as children, are in a good position to help.

A Surprising Number of Women Screen Positive for PPD

In the largest study to date, Northwestern Medicine researchers found that one in seven new mothers (14% of the 10,000 interviewed by telephone) screened positive for depression between 4 and 6 weeks after giving birth. Among those who received follow-up for the first year after giving birth, 22% had experienced depression.

The most common follow-up diagnosis among the 14% who screened positive was major depressive disorder. Almost two-thirds of these women were found to have additional conditions including anxiety and bipolar disorders.

Occurrence of Other PMADs Also Needs Greater Awareness

Women who experience obsessive thoughts and anxiety are often very confused by their symptoms, because they come unexpectedly, and are widely misunderstood. The obsessive-compulsive thoughts and crippling anxiety of these disorders receive even less attention than PPD. Some brief information on these disorders:

• Postpartum Obsessive Compulsive Disorder (PPOCD) is diagnosed for 3-5% of postpartum women. Brain imaging studies show that the active area is the part that controls maternal instinct, or protective behavior. PPOCD appears to come from intrusive protective (maternal) thoughts.
• Celebrity Brooke Shields struggled with a postpartum mood disorder and is helping raise awareness in her book Down Came the Rain.
• 50% of women with bipolar disorder are first diagnosed during postpartum care.
• 60% of bipolar women present initially as depressed during postpartum care.
• 85% of bipolar women who stop taking medication during pregnancy will experience a relapse of symptoms before the end of pregnancy,

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