Beyond Baby Blues: Understanding Perinatal Mood and Anxiety Disorders – S2E7

[00:00:00] Jessica Stewart-Gonzalez: Welcome to The Parenting Brief. I’m your host, Jessica Stewart Gonzalez, an Arizona working mom and chief of the Office of Children’s Health at the Arizona Department of Health Services. From pregnancy to preschool, we’re here to bring you expert advice and tips to make your journey of parenthood a little easier.

[00:00:28] Thanks for tuning in to The Parenting Brief. Today we discuss a topic that has big impacts on families but is often misunderstood. Perinatal mood and anxiety disorders, including depression, obsessive compulsive behaviors, and psychosis, can occur during pregnancy or within a year after delivery. It’s a topic that’s often surrounded by stigma and fear, and it’s important for families experiencing this to know that they are not alone.

[00:00:53] Up next, we address the stigma, clear up the misconceptions, and offer support and hope for impacted families.

[00:01:05] With us today is Rachel Flater. She’s a licensed master social worker, certified in perinatal mental health, and the support coordinator for Postpartum Support International. Thank you for being here.

[00:01:15] Rachel Flater: Thanks for having me.

[00:01:17] Jessica Stewart-Gonzalez: So first, let’s just kind of start out with the basic. What is a perinatal mood disorder?

[00:01:25] Rachel Flater: That’s a great place to start. So there’s an umbrella of perinatal mood challenges that can happen, and most people have heard of postpartum depression. It can also happen during pregnancy, but it also includes anxiety disorders, panic disorders, psychosis, bipolar disorders. And really when these things become a disorder is when it starts affecting a person’s ability to function.

[00:01:56] So the severity and the way that it’s impacting their life kind of pushes it into the disorder category.

[00:02:04] Jessica Stewart-Gonzalez: What are the signs and symptoms that individuals should be looking for either in themselves or in their partner or their family member of a perinatal mood disorder?

[00:02:16] Rachel Flater: Yeah, so a lot of times people have shared with me that when they try to share with their friends or family how they’re feeling, they get met with, “Oh, that’s just pregnancy. That’s normal.” Or, you know, “That’s just baby blues. I had baby blues for three years,” which, it is important to know the difference.

[00:02:34] So in pregnancy, it’s normal to have kind of mood swings, maybe feeling teary. It’s more of a depression when it’s just this overarching gloom: irritability, agitation, even rage.

[00:02:48] Self esteem is generally unchanged in pregnancy, but with depression comes that low self esteem and guilt. Sleep is an important thing. So it’s hard to sleep when you’re pregnant, especially later on, you’re being woken a lot with bladder issues, various uncomfortable things. But with depression, there’s a difficulty falling asleep, or sustaining sleep, and then rest does not restore. So usually with pregnancy, you feel a little better after you’ve had a good night’s rest, but with depression, you just, you’re waking up and it’s all still there.

[00:03:22] And then of course, a normal amount of joy and anticipation, a normal amount of worry with pregnancy. And then with depression, you might lose any interest in the things that were once pleasurable to you, anhedonia. And then appetite changes: we want it to see increase in pregnancy, but it might be increasing, decreasing, kind of all over the place with depression.

[00:03:43] And then kind of jumping after birth, the baby blues. I want people to keep in their heads: two weeks. Baby blues last two weeks. It is hormonally driven, it’s not driven by any kind of psychiatric history or stress. It’s just, this is the hormonal changes after birth, which is a roller coaster for everybody. And it’ll look different for everybody, but again, suicidal ideation is not something that comes with a normal experience of baby blues. Again, the self esteem, feelings of guilt, rest not being able to be restorative. Similar things to look out for in pregnancy is what you’re going to look out for with baby blues. And if it continues after two weeks, it might be time to get a little bit extra support.

[00:04:34] Jessica Stewart-Gonzalez: What causes somebody to have a perinatal mood disorder?

[00:04:39] Rachel Flater: So our tagline at Postpartum Support International is you are not alone, you are not to blame, and with help you will be well. So I really want to highlight that you are not to blame.

[00:04:51] There’s no cause that we have a good handle on. It’s global, it is worldwide, people experience this. People with no psychiatric history of concern can have a postpartum mood disorder. People with psychiatric concerns, of course, that can kind of increase their risk factor for experiencing these disorders.

[00:05:14] But it can happen to anybody, and everybody should be aware of it. It’s definitely a community issue. It’s not a women’s issue. This is a community issue.

[00:05:23] Jessica Stewart-Gonzalez: How can we encourage individuals to seek the help that they need while overcoming that fear of potentially losing their kids?

[00:05:35] Rachel Flater: Yeah, that’s an incredibly scary thought, and it is valid, and it’s a concern that I hear quite often. There are safe places to go, even anonymous places to go. Postpartum Support International is a great place to start. We have a helpline that’s call or text to be able to get information. It’s a good first step to say, you know, “Hey, is what I’m experiencing normal? Where can I go for the next level of support?”

[00:06:05] It can get you to a support coordinator like me. All of Arizona is covered by Postpartum Support International support coordinators, and part of our job as support coordinators is to connect people to providers who also have that training in postpartum mental health and are safe places to talk about some of these concerns.

[00:06:27] One of the biggest concerns that people have in particular is having scary thoughts, or even images of harm coming to themself or their baby, and those are incredibly common. Even among people who are not pregnant or postpartum, we have these sort of thoughts that come into our head that might be like, “Whoa, I don’t know where that came from,” but it can really ramp up postpartum and in pregnancy, and usually centers around the baby.

[00:06:55] But these are anxious thoughts. They come from anxiety, and they come from a place of wanting to protect the baby, but they can be very scary, and very scary to talk about. But they can also be debilitating, you know, we might have moms not able to drive anywhere because they need to sit in the back seat with their baby watching their baby the whole time. So they can never go anywhere, can’t go up and down the stairs, things like that, and so we do have providers. There are providers in this state that have training on that, and know how to handle that and help get people through it without it becoming a situation that needs to involve DCS or anything like that.

[00:07:39] Jessica Stewart-Gonzalez: And then what’s next? Are there treatments? Does this last forever? How long until some of that subsides? What happens next?

[00:07:49] Rachel Flater: So the good news is that perinatal mood disorders are very treatable and there is a wide variety of support. It looks different. The intensity is different. It’s very customizable.

[00:08:03] So once you realize, “Oh, I might,” you know, “have an issue with postpartum anxiety,” it’s not an immediate, “Here’s all your medication and here’s your therapist to see once a week.” That might be the answer for some people. Other people, it might be, “I need to go to this support group,” you know, every couple of weeks. “I need to talk to my mom on the phone a couple times a month.”

[00:08:27] It can be anything. Anything that’s gonna work for you. People just need to know that they have that choice. A lot of medications are safe with pregnancy and breastfeeding that treat depression and anxiety, so that is an option. And we actually have the Arizona Perinatal access line, which is for providers who prescribe medication. They can consult with a reproductive psychiatrist and form a safe treatment plan for somebody who’s wanting to try medication, and that’s a number that patients can give to their providers so that they can work together.

[00:09:09] And then many people do just meet with a therapist, and you’re allowed to fire your therapist. If you don’t like your therapist or if you’re just not connecting right, you can try another one. I’m never irritated if a help seeker comes back to me and says, “Hey, I need some help finding somebody else. This didn’t work out,” and helping them find a good fit for that.

[00:09:38] Jessica Stewart-Gonzalez: For our listeners who tuned in today, sharing this episode can help comfort and educate those who may be struggling on their own, and may even save their life. Also, to stay informed about other important family topics like this one, all you need to do is click the follow button on this podcast player.

[00:09:54] Until next time, this is Jessica, you’ve got this.