Not-so-fun Facts:
Approximately 15% of pregnant persons experience "perinatal" (sometime during or after pregnancy) depression, making perinatal depression the "most common complication of childbirth." Perinatal depression is not the "baby blues" which is a common experience postpartum and usually starts and resolves within the first 2 weeks postpartum.
It is estimated that up to 80% of women with perinatal depression are never diagnosed or treated.
It is estimated that the prevalence of having an anxiety-related disorder in pregnancy is approximately 20%.
If someone already has a mood or anxiety-related condition, their risk of worsening or return of symptoms during pregnancy and post-partum is elevated.
So, Dr. Facer, what do you make out of the data?
I want the world to know perinatal mood and anxiety-related conditions are common and undertreated. This pains me. I hear of many individuals who, for whatever reason, suffer unnecessarily. This may be due to beliefs of "oh this is just what happens in pregnancy, you'll get through it," stigma surrounding obtaining mental health treatment, or perhaps well-intended, but often misguided, fears from individuals, family members, and even doctors about medications for mental health during pregnancy. I want to shed light on these conditions and encourage individuals to seek treatment.
So what do perinatal depression and anxiety look like?
Perinatal depression may consist of symptoms such as low mood, difficulty finding enjoyment in things (including baby, partner, hobbies, etc), low motivation and energy, poor concentration, feelings of guilt, low self-worth, and sometimes suicidal thoughts. Sleep and appetite may also be affected, however, it's tough to distinguish between these as mental health symptoms or expected changes in pregnancy and the postpartum period. Anxiety may co-mingle with depression, or stand alone. It can manifest as significant worry - often about the health of the baby - with thoughts that are difficult to control or reassure, rumination, feeling on edge, muscle tension, irritability, or sometimes panic attacks. These symptoms make functioning difficult and can impact partner and baby relationships.
What can I do if I, or someone I know, is suffering from a perinatal mood and/or anxiety condition?
Get help! You do not have to do this alone. Many experts out there are willing to assist you in the process. When in doubt, please reach out. We are trained to help assess your situation and collaborate with you on what to do, or not do, about it.
Treatment modalities include:
Psychotherapy: opening up about your experience and learning skills to address difficulties can be extremely impactful. Navigating relationships and establishing a support system are also key features of a therapeutic approach in the perinatal period.
Medications: there are many medication options for mental health that are safe and effective for use during pregnancy and breastfeeding. I would feel comfortable with my closest friends and family taking them. An expert can help you navigate which options would best fit your specific situation.
Lifestyle: This includes specific recommendations regarding sleep, nutrition, physical activity, supplements, etc. which can have a big impact, and minimal side effects!
Combination treatment is my favorite and research shows it tends to be better than any one treatment alone. Collaboration is key - being able to talk with an expert about options and tailoring treatment to your situation is the beauty behind the "art" of mental health treatment.
You can find an expert using Postpartum Support International's (PSI) provider directory! PSI also has free resources available for individuals seeking treatment in the perinatal period.
If you are located in Idaho, I would love to be considered as the expert to help you navigate this process. You can see my clinic details on my website.
If you are not located in Idaho, you can use my Therapize Yourself course to help navigate the thoughts, emotions, and behaviors associated with depression and anxiety.
Kaden Facer, MD is an Idaho psychiatrist specializing in perinatal and paternal mental health, which includes postpartum depression and anxiety.
Reference: Hutner, Lucy A.; Catapano, Lisa A.; Nagle-Yang, Sarah M.; Williams, Katherine E.; and Osborne, Lauren M., "Textbook of Women's Reproductive Mental Health" (2021).