Depression and anxiety that occurs during pregnancy or within a year after delivery are called mood and anxiety disorders in pregnancy. Depression and anxiety are amongst the most common complications during and after pregnancy. Factors that may increase the likelihood of depression and anxiety during or after pregnancy can include; history of mood disorders, anxiety, or substance abuse, family history of mental illness, inadequate support from family and friends, anxiety about the fetus, problems with previous pregnancy or birth, marital or financial problems, young age (of mother or newborn). Tiredness, problems sleeping, stronger emotional reactions, hormonal changes, and changes in body weight normally occur during and after pregnancy, but these symptoms may also be signs of depression.
It is important to remember that the overall mental health of an expectant mother is an important determinant of the health of the fetus and newborn. The goal of treatment is to maintain psychiatric stability while minimizing risks to the developing fetus.
Depression and anxiety are sometimes overlooked during pregnancy, because changes in sleep, appetite, and energy coincide with normal physical complaints of pregnancy.
However for women with histories of depression, bipolar disorder, anxiety, panic, and OCD, particularly if they have discontinued the psychiatric medications that have kept them stable before or as they became pregnant, the risk of relapse and recurrence is significant.
Symptomatic relapse makes pregnancy a challenge and seriously increases the risk for postpartum psychiatric disorders. Thus, patients with active psychiatric disorders during pregnancy require careful assessment and care.
A treatment program is developed after careful consideration of the risks and benefits for both mother and fetus of the various treatment modalities (e.g., psychotherapy, medications, and other treatments). The written consultation is carefully reviewed with the patient and (with the patient’s permission) her other care clinicians.
Postpartum psychiatric illness has been associated with ongoing risks for recurrent illness in the future and has serious negative effects on the infant and the family. Conditions of disordered mood occurring following childbirth include postpartum blues, depression, bipolar disorder, psychosis, and anxiety (including generalized anxiety, panic disorder, and OCD).
About one-half of new mothers wish to breast-feed. Women at risk for postpartum psychiatric disorders or who suffer from active postpartum disorder symptoms are comprehensively assessed and evaluated. Attention is paid to the physical as well as the psychiatric factors associated with postpartum psychiatric difficulties.
A carefully thought-out treatment plan is organized and justified by evidence-based medicine that takes into account the risks and benefits for the new mother and her baby. For breastfeeding mothers, if psychiatric medications are suggested, the choice of medication carefully takes into consideration the safest options for their breastfed babies.
For more information on mood and anxiety disorders in pregnancy and the services we offer, call the WCWCW office or schedule an appointment online today.