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Expert Transcript

Kathleen Mahoney, RN, APN, Perinatal Clinical Nurse Specialist, Robert Wood Johnson University Hospital

Speaker: What is perinatal mood disorder?

Kathleen: Perinatal mood disorder is something that between 10 and 20% of women develop. It can range from anxiety, slight depression to major, full-blown depression that follows the birth of the baby up until the baby is approximately 1 year of age.

Speaker: What causes PMDs?

Kathleen: Weíre really not sure what causes them. We are fairly certain it has something to do with the delivery process, whether itís stressors or hormones weíre really not sure. We just know that the situation is real. Itís is something women suffer from and something that we can help them with.

Speaker: When should a doctor be consulted?

Kathleen: Whenever a woman has a question as to whether or not sheís coping well or if she thinks something is wrong she should always contact her physician. We would never tell a woman not to contact a doctor so if her family or herself feels that something is going on, she should contact a physician.

Speaker: What are the symptoms of PMDs?

Kathleen: Extreme anxiety, even obsessive compulsive disorder, panic can be some of the symptoms. In addition, flashbacks to the delivery, obsessive thoughts, all can be symptoms of PMDs.

Speaker: What is postpartum depression?

Kathleen: Postpartum depression is true clinical depression. About one in eight of women can suffer from postpartum depression. It is treatable. It is something that can be diagnosed by a physician and that the woman need not suffer with.

Speaker: How long will PPD last? And will it go away on its own?

Kathleen: Postpartum depression can last up to a year after the birth of a baby. Itís fully treatable and women can get medication for it, they can get therapy for it. It is not likely to go away on its own completely, much better served if the woman gets help for it.

Speaker: Is PPD biological, physiological or hormonal?

Kathleen: It may be a little bit of everything. It may have that hormonal piece. The drop in hormones that are present during pregnancy ,the sudden drop in them with the delivery of the baby may have an impact. It may be biological, brought on by extreme fatigue or from triggers in the womanís brain so it all may be just a large compilation of everything that causes these symptoms.

Speaker: How can family help?

Kathleen: Family can help by being a support to the woman. We know that women who have a good support structure who have people to depend on to help her with care of the baby, care of herself, care of her activities of daily living generally do a little bit better and maybe even get over the initial baby blues from the delivery with that kind of support and help. So families can definitely help with the support. In addition, families can help by recognizing that the woman is depressed, that the woman is not coping well with her activities of daily living or that sheís having problems with the baby. If they recognize them even if the woman doesnít they can get her the help that she needs.

Speaker: What can a woman with PPD or PMD do to cope?

Kathleen: Thereís lots of things they can do to cope. They can try to take frequent rest periods, little harder said than done when you have a brand, new baby but getting plenty of sleep really does help. Eating a good, healthy, nutritious diet so that their overall health and wellness is maintained is also important. Taking medications that the physician prescribed again can help them to overcome the depression that accompanies some of these postpartum mood disorders. Talking to people, making sure that there is someone there that she can depend on, someone there that she can hash things out with, somebody there to lean on when the going gets tough is really important.

Speaker: What help is available in New Jersey for PPD and other PMDs?

Kathleen: In New Jersey, we have a 1-800 number that they can call 1-800-328-3838. This will hook them to a warm line and all they have to do is say, Iím having trouble coping postpartum or Iím having trouble after the birth of my baby and they will be hooked right into someone who is a mental health expert and this is available in either English or Spanish. In addition, there is a Web site,, and this is something that gives them resources, lets them know where mental health professionals are in their area and gives them some facts around postpartum depression, postpartum mood disorders that may be helpful for them to read about and to learn about, but the bottom line is they have to know there is nothing to be ashamed of.

Speaker: What can a woman with PPD or another PMD do to cope?

Kathleen: The first thing she can do is not be afraid to ask for help so she can call her physician and make an appointment, get the treatments she needs. But thereís daily things she can do too, making sure she gets plenty of rest, help with the baby if she needs it, takes those naps when the baby is napping making sure she doesnít get overtired. She can get a support group. These are available in many communities and she can call local hospitals and find out where these support groups are occurring. She needs to make sure she eats a healthy diet, keeping herself as healthy as possible in order to make sure that stress doesnít get her down and that the mood disorders and the postpartum depression canít feed off of that lack of energy and fatigue and poor nutrition.

Speaker: What help is available in New Jersey for PPD and other PMDs ?

Kathleen: In New Jersey, we have a 1-800 number that families or moms can call if they think they need the help. The number is 1-800-328-3838. This immediately goes to someone who is trained to answer the phone and all the woman or the family member has to say is we have an issue with someone who has just had a baby or I think I have postpartum depression or something is wrong with my postpartum experience, and they will be linked immediately into a mental health professional who can triage them and ask them questions on the phone. This is available in English and Spanish. In addition, thereís a Web site. If the family or the woman wants more information or isnít sure, it is and this gives them information about postpartum depression, information about postpartum mood disorders, where there are support groups, where there are people who are trained to assist them with this issue, and what the professionals are learning about postpartum depression. That, of course, is free of charge.

Kathleen: In addition, thereís a Web site, Thatís where they can go and learn about what professionals are learning about postpartum depression, if they have questions about it maybe finding out what are the symptoms. The families can go there. This Web site also has English and Spanish information on it.

Speaker: In New Jersey, we are required to screen women before they leave the hospital, postpartum women. And we screen them using a very simple self-assessment tool but as a result of that screening, hospitals are forced and nurses and social workers teach patients about the symptoms of postpartum depression. And it doesnít matter where you give birth, everyone is required to do this. And our institution we had a family who carried a mom into the emergency room. They were told at the hospital that they gave birth that these were the symptoms of postpartum depression and that they should be aware of them and that this women had suddenly become very, very depressed and the dad understood what he was supposed to do. He didnít wait, he just brought her to the emergency room immediately and got her the help that she needed. So families are listening to this education and theyíre acting on it and I do believe that the structures and processes we have in place in New Jersey saved that mom because the dad listened to what he was supposed to do and got her the help she needed.

Speaker: What are some risk factors?

Kathleen: Some of the risk factors for postpartum depression, anyone can get postpartum depression. It doesnít matter what your race, your ethnicity, whether you make a lot of money or make no money at all, work or donít work. It doesnít matter, everyone is at risk for postpartum depression. But some people are more at risk. People who have a pre-existing depression, even if it was treated, are more at risk for postpartum depression. People who had postpartum depression with a previous birth even if they didnít have it with their second might get it again with a third baby. So each woman has to be treated separately with each pregnancy so that we can properly screen them and get them the help that they need.

Speaker: The story with the emergency room, where was that?

Kathleen: He brought her in here but she didnít deliver here. So the point is that everybodyís screening and everybody is getting the same message so everybody can get the help that they need.

Kathleen: It Ďs required by law in New Jersey that we screen all postpartum women for postpartum depression before they go home. Every hospital has to do this. Itís at that time, the nurses or social workers, whoever is doing the screening, takes the opportunity to educate the mother and the family about the symptoms of postpartum depression even if they donít screen at being at risk for the disorder. We did have a patient who came into the emergency room here at Robert Wood Johnson University Hospital who did not deliver her baby here here but who had gotten the education and screening at the hospital where she did deliver. Her family understood the risks, they understood the symptoms and they immediately brought her to the hospital when they recognized that she was needing some serious help. I believe that by getting her here that we did save that mom and save that mother/baby relationship because of the education that that family received. So the regulation and the legislation on screening and education in New Jersey is working.

Perinatal mood disorders are treatable. But first you have to ask for help.

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Last Modified: Thursday, 12-Jul-12 11:44:40