Baby Blues: Identifying and Treating Postpartum Depression

For weeks after the birth of her son 32 years ago, Kay Kaldor cried constantly. When she mentioned the uncontrollable sadness to her doctor, “he told me to have a glass of wine,” she recalled.

Fast-forward three decades: Patients suffering from postpartum depression (PPD), as Ms. Kaldor most certainly was, find help through counseling, support groups and, sometimes, medication. And thanks to a PPD screening program at Baptist Hospital, women at risk for this debilitating condition are often identified — and referred for help — before symptoms worsen.

“Postpartum depression is not new, but our awareness has increased tremendously,” said obstetrician/gynecologist Jason James, M.D., who leads the Baptist Hospital Family Birth Place task force that conducts screenings and research. “We now know that through vigilant screening, we have the potential to help many families and avert tragedies like suicide or, in rare cases, the death of a baby at the hands of the mother.”

Mood swings, often linked to fluctuating hormones, can be exacerbated by the overwhelming life changes that occur after giving birth. These “baby blues” are common and usually diminish within six weeks. About 15 percent of new mothers, however, find themselves in a deeper, longer-lasting depression, according to the National Institutes of Health.

Nurses at the Family Birth Place have screened more than 7,000 new moms in the hospital since beginning the program in mid-2010. Nearly 300 of the women fell into the high-risk category, based on the Edinburgh Postnatal Depression Scale, a short questionnaire. About two weeks after new moms go home, they are called and screened
again.

“In general, PPD can hit any new mother,” said nurse practitioner Mari Seidu, R.N., program co-coordinator.

“But our survey did find that those over age 40, as well as Asians, had slightly higher odds.”

“We also know that women with a history of depression, those who are having problems breast-feeding, women without family support, newer immigrants and women who have relationship problems with spouses may be more prone to PPD,” said Lisa Robinson-Trainor, R.N., program co-coordinator.

One such new mother gave birth at Baptist Hospital in December 2011. Unlike Ms. Kaldor, who cried easily and often but was able to function, this South Florida woman, who asked that her name be withheld, had symptoms that were more serious. “I was emotional while I was pregnant, but after the baby I became a lioness with my cub,” said
the 32-year-old woman, who refused to let anyone touch her baby.

“I was convinced she was going to get sick. The tipping point came when she was about 2 months old and someone with a cold sore kissed her. My pediatrician tried to reassure me, but I was frantic. I began to blame myself and think that I was an unfit mother because I couldn’t protect her. Eventually, I didn’t want to hold my baby.”

Fortunately, she called the Family Birth Place staff.

“Without the survey and the information, I wouldn’t have known there was help available,” she said. The new mother improved after counseling and talking to other women going through similar circumstances.

“It’s important that patients realize this is a medical issue and that they need help,” said Silvia Bermudez, Ph.D., a psychologist and member of the PPD screening task force.

“Children do better when the mother is emotionally well and stable.”

Rene Paez, M.D., South Miami Hospital’s chief of obstetrics/gynecology, said doctors should make their patients aware of the symptoms of PPD, and that message is reinforced through patient education provided by nurses and social workers at the hospital’s Center for Women & Infants.

Dr. James believes that every hospital should screen for PPD, and all of Baptist Health’s maternity services are making moves in that direction.

“We have an obligation to our patients,” he said. “There’s no question we can help many families by raising awareness and identifying those at risk.”

Symptoms of PPD include:

•  Inability to sleep or eat
•  Feelings of anger, sadness or guilt
•  Uncontrollable crying
•  Worries that you might harm the baby
•  Isolating yourself from others
•  Thoughts of death or suicide

Get Help:
If you think you have PPD:
•  Talk to your physician or a mental health professional.
•  Visit PostPartum.net. For information about Postpartum Support International’s support groups in English and Spanish, call Judi Carreno at 305-740-8998, Ext. 147.
•  Learn more about PPD at MarchofDimes.com.

Tags: depression, pediatrics