HEALTHY FAMILY
Mental Health Care
for New Moms
Treating postpartum mood
or anxiety disorders
BY COURTNEY MCGEE
Signs of Postpartum
Depression • Changes in appetite, sleep
or energy not related to
having a newborn
• Not being able to sleep when
there is the opportunity
• Indecisiveness, being easily
overwhelmed, difficulty
concentrating or finding yourself
ruminating • Tearfulness, guilt, hopelessness
or a sense of helplessness
Signs of Postpartum Anxiety
• Restlessness • Shortness of breath and/or
racing heart
• Stomach trouble
• Poor appetite
• Difficulty with sleep
• Excessive worry going to the
worst-case scenario quickly (i.e.

her spouse is late from work so
she assumes he was in a car
accident and died)
• Excessive checking of
the baby
• Some of the depressive
symptoms above
Online Resources
www.postpartum.net www.2020mom.org
www.dmvpmhresourceguide.com/ maryland/transition-to-motherhood
that once brought her happiness, and even
towards her baby. She may feel empty.

Is it something that the mom will
effectively recognize in herself?
In my practice, I request that the woman bring
in her partner, or a trusted support person if
she is single, to review signs and symptoms
of PMADs versus “baby blues.” I also give
explicit instructions on what to do if they
think there is a problem. If it takes a village to
raise a child, it takes a community to support
a new mom. Often, the mom is so focused on
the baby that she neglects her own needs. She
may also be confused by what her new normal
How common are perinatal
is as her role shifts to mom. It’s hard to see a
and postpartum depression?
Nationally, 15 percent - 20 percent of storm if you’re standing in the eye of it.

women will experience a PMAD. In over
half of these women it will start during How well do all providers
pregnancy. In Maryland, latest data indicate screen for signs of trouble?
14 percent of women experience postpar- This is improving. In a 2009 study, less
tum depression and 20 percent experience than 44 percent of obstetricians reported
postpartum anxiety.

screening new moms for PMADs. Today, all
major groups representing obstetricians,
pediatricians and physicians in general rec-
Who is most at risk for
ommend screening. The American College of
wrestling with these
Obstetricians and Gynecologists, American
mental health conditions?
Women who have had a past episode of Academy of Pediatrics and The American
depression, whether during pregnancy or Medical Association all have screening guide-
not; women with lower educational levels; lines, and Medicaid offers financial incentives
minorities; women who have had medical to pediatricians who screen mothers. It’s
complications in pregnancy or delivery, or significantly more prevalent now. The big
whose babies have had issues; and women obstacle is timing and followup. For example,
with overall less social or financial support screening in the hospital after delivery and at
the 6-week postpartum appointment is great;
are more at risk for a PMAD.

however, PMADs can develop in the first year,
so ongoing assessment is necessary.

What sort of signs or symptoms
should people be aware of?
Mental health issues can be insidious. What does treatment
Often the woman is well into it before generally involve?
anyone, including herself, really can see a A combination of cognitive behavioral ther-
problem. Depression may present as sad- apy and medication coupled with practical
ness, but many times it presents itself as advice and support work amazingly well.

a lack of pleasure. The woman will not say Many antidepressants are considered safe
she is feeling down, but she is not feeling during breast feeding as well. I find that my
any interest or joy either. The woman feels patients are usually feeling much better after
“meh” towards everything, even things six to eight sessions of therapy.

48 Washington FAMILY FEBRUARY 2020
MOFLES / ISTOCK / GETTY IMAGES PLUS
B ecoming a mother can be the
most magical of times in a wom-
an’s life. It can also be among the
most trying of times, especially for moms
who struggle with mental health matters
as they adapt to their new roles. Help is
available, but also critical.

Here, Sharon Fisher, a psychiatric men-
tal health nurse practitioner, answers some
questions about perinatal or postpartum
mood or anxiety disorder (PMAD). Fisher
is the owner of Nurtured Well, a women’s
mental health clinic in Maryland.