What are the symptoms of peripartum mood disorder?
There are several varied symptoms associated with peripartum mood disorders, which may include some or all of the following:
- Emotional instability such as unexplained crying and mood swings
- Feeling alone
- Excessive anxiety or worry
- Unexplained increased energy
- Lack of enjoyment in the activities that were once enjoyable
- Thoughts of hurting yourself or the baby
- Lack of bonding with your baby
- Fear of being left alone with the baby
- Hearing voices or sounds that others can not
- Feelings of guilt or worthlessness
How is peripartum mood disorder diagnosed?
A definitive diagnosis of peripartum mood disorder requires evaluation and diagnosis from a licensed healthcare provider. It is required that at least five of the above symptoms listed be present for at least two weeks. These symptoms must also be a change from previous behaviors. Because many of the symptoms of peripartum mood disorder may mimic other major depressive disorders, a screening test should always be performed.
What are screening tests for peripartum mood disorders?
- Edinburgh Postnatal Depression Scale
- Patient Health Questionnaire-9
- Postpartum Depression Screening Scale
Most physicians use a two-step screening process to diagnose peripartum mood disorder. If any of the questions are positive, a more comprehensive screening and evaluation can be done regarding peripartum mood disorder. It is also recommended that at least one perinatal and four postnatal screenings be performed.
How can peripartum mood disorders be prevented?
Evidence has shown that home health visits, peer support, and psychotherapy are good prevention methods. This is especially true for first-time mothers, adolescent mothers, or those who have had traumatic deliveries. Selective serotonin reuptake inhibitors (SSRIs) also show some benefit in the prevention of peripartum depression for mothers with a previous peripartum depression diagnosis.
What are treatments for peripartum mood disorders?
- Psychotherapy– this is usually the first line of treatment for mild to moderate cases. Most research is on the effectiveness of cognitive-behavioral therapy.
- Pharmacological– SSRIs are the gold standard for the treatment of moderate to severe peripartum mood disorders.
- Exercise– increased physical activity has shown a decrease in peripartum mood disorders due to the release of endorphins that positively affects the mood.
- Electroconvulsive therapy– this is usually used for severe cases if medications are not helpful or tolerated. It is safe for pregnant women.
What if treatment does not work for me?
For anyone who has thoughts of harming themselves or their baby, inpatient therapy is usually the best course of action. Also, if any of the other standard treatment modalities are not effective in improving your symptoms, inpatient treatment would be the next option.
Peripartum wellness is of the utmost importance as this disorder can impact the mother, baby, and entire family. If you would like to learn more about peripartum mood disorders, any of our healthcare professionals at the Speciality Clinic of Austin would be able to review your concerns in detail.
Hartford HealthCare Institute of Living. (n.d.). Peripartum Mood Disorders Program. https://instituteofliving.org/programs-services/peripartum-mood-disorders
Hübner-Liebermann, B., Hausner, H., & Wittmann, M. (2012). Recognizing and treating peripartum depression. Deutsches Arzteblatt international, 109(24), 419–424. https://doi.org/10.3238/arztebl.2012.0419
illerer, K.M., Neumann, I.D., Slattery, D. A. (2012). From Stress to Postpartum Mood and Anxiety Disorders: How Chronic Peripartum Stress Can Impair Maternal Adaptations. Neuroendocrinology; 95:22-38. doi: 10.1159/000330445
Langan, R.C. and Goodbred, A.J. (2016). Identification and Management of Peripartum Depression. Am Fam Physician. 93(10):852-858.