Maternally Yours took on an extremely important topic this
week: postpartum depression. Following the loss of Sarah Harnish and her
17-month-old daughter, Josephine Boice, this show was dedicated to their
memory. Though this topic is heavily stigmatized and rarely discussed, this
tragic event has prompted many in the area to come forward and discuss postpartum
depression as well as other mental illnesses prevalent in the childbearing
years.
Postpartum depression is defined as the onset of depression
within 4 weeks after delivery. The bravery of seven mothers in the Sarasota
community was celebrated, as they came forward to discuss their experiences
with PPD over anonymous phone interviews. Common threads of these experiences
included sleep deprivation, isolation, breastfeeding/hormone triggers, mental
health triggers, not knowing who to turn to, lack of support, fear of losing
one’s baby to the authorities, suicidal ideation and attempts, and suicide
prevention due to not knowing what care the baby would receive. Overall,
seeking treatment, engaging in exercise, being in sunlight, providing partners
with a list of triggers, and talking about it were consistently cited as
helpful means of dealing with PPD.
Sarah Workman Checcone, founder and executive director of
the Postpartum Society of Florida, and Monica L. Cherry, licensed mental health
counselor, are two Sarasota community experts in postpartum mental health that
came in to discuss the topic of PPD. They provided expert information on
diagnosis of PPD, symptoms of PPD, risk factors surrounding PPD, and methods of
receiving help. Additionally, Sarah Checcone was brave enough to discuss her
own experiences with PPD.
In the Diagnostic and Statistical Manual (DSM IV), the
manual that states criteria for diagnosing mental health disorders, there is no
specific set aside area for postpartum depression. Instead, it is considered an
onset of a regular clinical depression, bipolar, or psychosis (which could
include schizophrenia) occurring within the time 4 weeks following birth.
Post-partum blues, depression, and psychosis are all separate things: 50-80% of
women experience postpartum blues, which is normal but transient. If these
feeling persist for over 4 weeks, this gets into clinical area of postpartum
depression. Additionally, it could be postpartum bipolar or psychotic episode. Psychosis
is similar to schizophrenia- much more rare, 1 in 500.
Risk factors for PPD are personal psychiatric history (i.e.,
mood disorder diagnosis), stressful life events, lack of social support, and a
lack of family support. There are no demographic variables that have been
identified as making someone more likely to experience PPD.
Monica Cherry did notice, however, age-related trends in her
private practice experience. Women 18-29 years of age tends to be the most
frequent as far as treatment; she thinks because they tend to be screened more
regularly by Healthy Start.
Another common theme of PPD that Checcone mentioned was women
displaced from their families. Giving birth six months ago and then moving from
somewhere else requires finding a new support system, which can often add to
feelings of isolation characteristic of PPD. Additionally, high-need babies can
be a trigger for PPD with the added responsibilities of care.
One of the courses being offered by Checcone at the
Postpartum Society of Florida now is a workshop where women and couples can
take a personality inventory to figure out what helps them keep calm, what
stresses them, and what triggers extreme stress in order to identify
problematic areas.
To learn more about Sarah Checcone’s organization The Postpartum Society of Florida, you can
refer to her website at www.postpartumflorida.com.
IF YOU THINK YOU MAY
BE SUFFERING FROM POSTPARTUM DEPRESSION, ADJUSTMENT OR MOOD DISORDER, ANXIETY
OR PSYCHOSIS, PLEASE GET HELP:
In addition to Sarah and Monica’s organizations, here are
some helpful resources:
Hotlines:
1 (800) 773-6667 (1-800-PPD-MOMS) - PPD hotline to talk to a
mom who has had PPD)
1 (800) 784-2433 (1-800-SUICIDE) – English speaking suicide
hotline
1 (800) 784-2342 (1-800-SUICIDA) – Spanish speaking suicide
hotline
1 (800) 273-8255 (1-800-273-TALK)
1 (877) 968-8454 (1-877-YOUTHLINE) - this is counseling for
teens by teens)
1 (866) 488-7386 (the Trevor Project, for LGBTQ youth)
http://crisischat.org
HEALTHY START of
SARASOTA:
- Universal screening at the first prenatal care
appointment does take place via the Healthy Start Risk Screen.
- If someone is an active client in Healthy Start,
they are monitored for signs of depression.
- After the baby is born, referrals to Healthy
Start can be made when depression* is identified by health care providers.
(*Active, serious mental illness should be referred directly to a mental health
treatment center. We have funding only
for outpatient anxiety and depression, not for in-depth mental health treatment
and we cannot pay for medical prescriptions.
That said, if someone would call us we would work with them to get the
help they needed.)
- Up to three years after a baby’s birth, a woman
having symptoms of depression can call Healthy Start for help.
- In all of the cases above, a Healthy Start Care
Coordinator will talk to her about the concerns she has and the level of
support she has from her family. They
will discuss available options for assistance based on the degree of difficulty
she is having, and will arrange for counseling and follow-up with the goal of
averting a crisis.
- Instead of the Coalition website, quickest and
direct help can be obtained by calling the Healthy Start Program at (941) 861-2905.
ADDITIONAL LOCAL SUPPORT AND MENTAL/BEHAVIORAL HEALTH CARE:
SUSAN FEINGOLD’S BOOK
AND BLOG:
Happy Endings, New Beginnings: Navigating Postpartum
Disorders
THE EDINBURGH SCALE:
NATIONAL WEBSITES:
