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| SUNDAY, MAY 14, 2023
Depression most common is the
mood disorder in the United States.
sion, whether postpartum Depression is twice otherwise, is a risk factor as common in women or for depression in subsequent than in men, and the pregnancies,” Rottenberg said. initial onset tends If you or someone around you notices any of these to peak during the symptoms, she recommends you make an appointment reproductive years. By CORI URBAN
Special To The Republican
“So, it is not surprising that depression during and after pregnancy is one of the most common medical complications that a pregnant or postpartum woman may face,” said Dr. Elizabeth A. Rottenberg, chief of obstetrics and gynecology at Mercy Medical Center in Springfield and director of the Family Life Center. Perinatal depression is defined as any major or minor depressive episode that occurs during pregnancy or the first 12 months after delivery. Depression during pregnancy or within 12 months postpartum affects approximately 10-15 percent of mothers annually; 8-10 percent of men also experience symptoms of pregnancy- related depression, she added. Some risk factors for pregnancy-related depression are history of anxiety and/ or depression, life stress, unplanned pregnancy, lack of social support, domestic violence or poor relationship quality. Some risk factors for postpartum depression also include traumatic birth experience, neonatal intensive care unit admission and breast-feeding difficulties. Thus, “history of depres-
(PHOTO COURTESY OF ISTOCK IMAGES)
can be a conversation in the privacy of the medical office. But the doctor pointed out that the “baby blues” are normal for new parents to experience over the course of the first several weeks after delivery. This can include mood swings, crying and anxiety. “Bringing home a new baby
pears as though everyone else “has it together,” she added. “Anyone who has not spent moments crying or feeling inadequate after delivery or bringing a child home has had a different experience than most of us. This is normal!” Being that the baby blues are such a normal part of pregnancy — specifically
been a complete loss of joy or motivation to get up and face the day, despite knowing that there may be challenges to overcome.” And she emphasized that it is never normal to have thoughts of hurting yourself or others. with your OB/GYN. “But do For those suffering from not feel like it is only up to postpartum depression, medyou to recognize symptoms ication is an option. The most and seek help. We are here to common medication used to help navigate the normal vs. treat mild-to-moderate sympabnormal mood changes of toms of pregnancy-related or pregnancy and post-partum.” postpartum depression is a Her practice screens for selective serotonin reuptake postpartum depression at the inhibitor — a type of antidebeginning of pregnancy, at pressant — that, according around 28 weeks, immediateto Rottenberg, are safe and ly post-partum and again at effective for pregnant and/or six weeks post-partum using breast-feeding women. the Edinburgh screening tool. “There are other medicaThe Edinburgh screening tions that may be useful that tool is the one most frequently aren’t as common, so it is used in research and clinical important to discuss with your practice. It has been translatOB/GYN or mental health ed into more than 50 languagcare provider to establish es; it takes about five minutes which may be best suited for to complete the 10 questions you and your situation,” she that prompt “recognition of added. “Referral to mendepressive and anxiety-retal healthcare providers is lated symptoms but excludes important; medication and some constitutional questherapy together have been tions about things like sleep Above: Dr. Elizabeth Rottenberg, Chief of Obstetrics and Gyne- shown to have more benefit which are common … during cology and Director of the Family Life Center at Mercy Medical than either of the two alone.” pregnancy and post-partum,” Center, holds newborn A’layah Hollins. In more severe cases of deRottenberg said. “This tool is (PHOTO COURTESY OF MERCY MEDICAL CENTER) pression, or certainly psychoeffective at its core, but also sis, inpatient hospitalization needs to be used in clinical may be necessary to ensure is a huge lifestyle adjustment post-partum — recognizing context. In other words, if a safety, she said. “Untreated that comes with changes in true postpartum depression patient’s score is normal, but adults with pregnancy-related things like roles and responcan be difficult. Less than 20 they are tearful in the office sibilities, sleep, appetite and percent of women diagnosed or postpartum depression and/or have a flat affect that is libido. It is common to feel may have difficulty makwith postpartum depression different from baseline, these vulnerable, overwhelmed or ing sure that their newborn outwardly report symptoms. are symptoms that still need and/or other children in the ill-equipped for, arguably, “We start to worry that the to be addressed.” household are appropriateone of the hardest jobs which baby blues are becoming If based on answers/results is parenting and caring for ly clothed, fed and in safe true depression when there healthcare providers believe spaces for sleep. The biggest another human,” Rottenberg becomes an inability to care someone is experiencing risk to infants of women with said. for oneself or their baby,” abnormal mood changes or postpartum depression is that Social media can be a “dan- the doctor said. “We worry is at risk for depression, there gerous place” where it apwhen it appears that there has their mother (or father) does
not get the help that they need to ensure that they are able to safely care for themselves; one cannot care for anyone else if they are not able to care for themselves.” She advised that if something feels “off,” say something. There are tools to help detect pregnancy and postpartum-related anxiety and depression, “but this is an art as much as it is a science,” she said. “We are here to help navigate the vast spectrum of emotions involved with being pregnant and then supporting a newborn and your family at home. We can listen and provide advice/referral to non-obstetrical providers that can help with things like mental health and lactation, and we are proficient and knowledgeable about when it is important to suggest that we get involved medically. You can be a masterpiece and a work in progress at the same time.” Most depressive symptoms that are truly pregnancy and/or postpartum related improve after 6-12 months, Rottenberg emphasized that it is important to be mindful of longer-lasting symptoms that may be an indication of a more chronic anxiety and/ or depression: “This is not something to ignore or be ashamed of, and treatment can safely continue beyond the 12- month mark.”
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