Perinatal Mood Disorders


A brief primer

If you are a “perinatal” woman, this means you are pregnant or somewhere in the first 12 months of having delivered a baby.  If you live in the Chicagoland area, you have probably been screened at some point during your pregnancy or after for “depression”.  This is becoming the standard of care nationally as well, but hasn’t reached all areas of the country quite yet.  Increased awareness has many benefits, and one is early detection and treatment of mental health issues that can, if left untreated, have the potential to negatively impact the lives of women and their families.  However, as with most things in life, women have a continuum of experiences while they are pregnant and becoming mothers from feeling excitement and joy to feeling stressed and overwhelmed to feeling intense sadness or anxiety that impairs their ability to go about their day to day lives.

With all the talk about postpartum depression, it can be difficult to sort out and may be hard for women to know when they need to reach out for help.  It is important for women to understand that their mental health is an important part of a healthy pregnancy, and that adjusting to being a parent in the postpartum period can be a challenge where mental health can be compromised without proper support and access to parenting information.  It is also important for women to know that there are a subset of women that are very sensitive to hormonal changes in their bodies, and in the postpartum period may experience mood disturbances (from minor to severe).  Research on this period of a woman’s life supports that it is a huge life change and adjustment and coupled with the hormonal flux is a vulnerable time for developing mental health problems.  Many perinatal women I see for psychotherapy say things like, “I should be happy”, or “What’s wrong with me that I feel so {insert emotion}?”  The truth is, becoming a mother brings up the full range of emotions and interestingly, can trigger underlying vulnerabilities.  Be gentle with yourself, and treat yourself as lovingly as you would your infant.

In terms of treatment, there are lots of questions about psychotropic medications (antidepressants, in particular) and their safety during pregnancy and breastfeeding.  The good news is that psychotherapy has been shown to be just as effective for mild to moderate depression and anxiety as medication.  If you are worried about exposing your baby to medications in utero or via breast milk, then psychotherapy is an equally viable mode of treatment.  For some women, medication may be necessary to decrease their symptoms, and it is important to speak to a psychiatrist about weighing the risks and benefits of taking medication.  I’ve worked with many women over the years that were treated successfully with medications during pregnancy and postpartum while breastfeeding with minimal to no impact on their infants.  The bottom line is that what is best for you as a mother and supports your functioning will ultimately be best for your baby! 

If you have questions or concerns about treatment and would like to discuss these further, please do not hesitate to contact me at nlively@family-institute.org.

There are also several good sources of information on postpartum depression online, including the Links section of this site.

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