Focus on Behaviorial Health is a magazine published by the Northwell Health System. This publication features health and wellness information geared toward healthcare consumers in the Long Island and New York City region.
Issue link: http://viewer.e-digitaledition.com/i/678411
Stigmas aached to postpartum depression make it dicult for many women to ask for help. During routine oce visits, physicians can make critical inroads by starting conversations about maternal mental health. D uring the early postpartum period, 70 to 80 percent of women experience sadness, fatigue, low moods or minor anxiety, according to the American Pregnancy Association. These mood changes, commonly known as the "baby blues," typically resolve without treatment. For the one woman in seven who develops postpartum depression, however, symptoms persist and may affect her ability to care for herself and her child, according to the American Psychological Association. Depending on the severity of a woman's symptoms, she may need outpatient treatment, which may include a combination of therapy and medication, or more intensive inpatient care. From outpatient services to partial hospitalization and inpatient programs, Northwell Health offers the full continuum of care for new and expecting mothers' mental health needs. Overcoming Stigmas Media stories about women who have harmed their children have negatively influenced public perception about postpartum depression, according to Tina Walch, MD, medical director of South Oaks Hospital. However, public perception isn't the only barrier. Dr. Walch noted that there is a clear link between in utero exposure to maternal illness and longer-term neurodevelopmental issues. There is also evidence that children raised by mothers who suffer from untreated postpartum depression suffer deficits. Studies haven't consistently shown long-term neurodevelopmental issues caused by in utero exposure to medications. Studies also haven't consistently shown antidepressants to be major teratogens, although some studies show noncausal associations. Yet, physicians continue to shy away from prescribing such medications. The risk of untreated illness in women with significant depression or anxiety typically outweighs the potential risks. Doctors may also feel uncomfortable initiating a conversation about mental health because they don't feel equipped to screen for and manage perinatal mood disorders. A participant in the Greater New York Hospital Association's Maternal Depression Quality Collaborative, Northwell Health initiated the Ask the Question campaign to encourage medical professionals to inquire about women's mental health during and after pregnancy. During a routine office visit, incorporating one question about how the woman is feeling or coping with the changes of motherhood can increase the likelihood of detecting symptoms of anxiety or depression for women who may need further assessment. Identifying the Appropriate Level of Care To diagnose perinatal psychiatric disorders, psychiatrists may use one of several assessments, including the Patient Health Questionnaire-2, Patient Health Questionnaire-9 or the Edinburgh Postnatal Depression Scale. These rating scales help identify women experiencing: – Depression; – Anxiety and/or inability to cope; A Statewide Resource for Perinatal Psychiatric Disorders 2 Perinatal Care