Maternally Yours: Episode 103 (Epilogue): Postpartum Depression

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.

To learn more about Monica Cherry, LHMC, you can visit her website at www.monicalcherry.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.