Perinatal and Postpartum Depression: Identifying and Treating These Disorders

Anxiety, depression, stress. These represent everyday real-life struggles for women at child-bearing age and beyond. As a society, everyone expects happiness when bringing a newborn into the world, but the reality for many women is far from that. That is why it is so important to talk about maternal mental health during the perinatal and postpartum period.

Education about the state of mind during this time can be empowering. It gives women the opportunity to acknowledge it, seek for treatment and hope for a better tomorrow, says Rachael Rohaidy, M.D. psychiatrist with Baptist Health.

(Watch now: Hear from Rachael Rohaidy, M.D. psychiatrist with Baptist Health. Video by Alcyene Almeida Rodrigues.)

More than 3.5 million women give birth each year in the United States.  “When we look at our friends and family who become pregnant, it is supposed to be a happy time,” says Dr. Rohaidy. “But in reality for a lot of women, it becomes a very stressful time in their lives. Even trying to become pregnant.”

One in 9 new mothers has postpartum depression. This rate is very high and that is why Dr. Rohaidy emphasizes the importance of an open discussion about maternal mental health. “Postpartum depression is much more common that we think it is and know,” she says. “It is not something that every new mom wants to admit to. It is a tabu … We don’t talk about it. When don’t even recognize it in ourselves sometimes.”

There is a period that starts right after childbirth that is called “the baby blues.” When you are expecting, levels of female hormones, such as estrogen and progesterone, are very high. After delivery, hormone levels drop back to normal and this may cause symptoms, such as “a little weepiness, crying, slight irritability, lack of sleep,” says Dr. Rohaidy. That period should last for about two weeks only. “After that, if anything lingers or get worse — crying spells, irritability, anger, moodiness, sadness — some moms experience not wanting to interact with the baby as much. That time frame is very important to look at and to reach out for help,” she says.

Because it is supposed to be a happy time, it is hard for many women grappling with postpartum depression to admit they need help. According to Dr. Rohaidy, it is important to know the different levels of the disorder to seek the right treatment.

Dr. Rohaidy explains there are different modalities of treatment — and it is not just about medication. “Talk therapy, group therapy, which includes cognitive behaviors therapy, nutrition, staying hydrated, making sure there is some kind of exercise routine, sleep hygiene,” she adds. Anything that can be done holistically is also going to be additive to any treatment that needs to be given pharmacologically.

When we look at the possibility of medication, the specialist explains it involves anti-depressants. And depending on the severity of the symptoms, and whether or not there is also a mix of psychosis or mania, we are also talking about anti-psychotics as treatment, she says. But postpartum psychosis is rare. It happens in up to 4 new mothers out of every 1,000 births. 

“Not every single medication is for every single person or situation, so treatment can vary from mom to mom,” explains Dr. Rohaidy.

“The result of medication is life-changing,” she assures, while reiterating the importance of seeking the right treatment. “Anything that the mom feels, the child feels as well when they are in utero.” If the disorder goes untreated, it can impact growth of the fetus, cause pre-term labor and equate to poor outcomes after delivery, she adds.

 A Personal Note from the Doctor

“When I was diagnosed with postpartum depression, it wasn’t me who even noticed or realized that these things were going on,” said Dr. Rohaidy. “It was my baby’s pediatrician who brought it up. A lot of times we wonder about being labeled, not heard. Perhaps sometimes we don’t even realize it.”

She adds: “I talk to a lot of family members. It is important for them to realize – not just the patients – they can be your (the patient’s) best advocate. Husbands, wives, partners, friends, siblings. If you are noticing the crying, the non-responding, a change in personality, it’s really important to bring that to light and to get treatment as soon as possible.” 

The Importance of Support Groups

Support groups are important because they give you the sense that you are not isolated, that you are not alone, explains Dr. Rohaidy. “Having that connection with other moms that are going through similar things can really be empowering. I do feel support groups are the way to go. A lot of us don’t want to talk about it with others, because if we ignore it, it will go away.”

Baptist Health is fully prepared to help you navigate through this important time in your life, she says. Should you need any information to prepare for your baby’s arrival, Maternity services has an experienced team of certified childbirth educators, who can lead you to informative classes on labor and delivery, newborn care and more.

One of Baptist Health’s initiatives, The Barbara C. Gutin Pre and Postpartum Program at Boca Raton Regional Hospital offers a variety of free Mommy Matters support groups

The support groups help you:

• Learn mindfulness and self-care techniques while navigating motherhood
• Find support for you and your family in the transition into parenthood
• Understand the physiological impact of pregnancy on postpartum depression
• Acquire tools to achieve a balanced, harmonious relationship with your partner

The Mommy Matters lecture series for new and expectant mothers is available ​on zoom. Topics include prenatal and postpartum nutrition, postpartum depression, pregnancy, and pelvic health, heart health for new moms, and more.

Please visit here if you or someone you know needs more information.