Postpartum Depression and Related Disorders: Clinical Strategies to Identify and Treat Mothers Who Are Suffering in Silence – Hilary Waller

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It’s not a topic that comes up at play groups or over coffee. Instead, 1 in 7 new mothers prefer to suffer quietly, engulfed in shame and secrecy, afraid to dispel the ever-present myths about motherhood – “everything is perfect”, “I love being a mother”, and “this is the happiest time of my life”.

She doesn’t share the dark thoughts, intense anxiety, scary intrusive thoughts, checking excessively on the baby, feelings of inadequacy, grief over her former independence, thoughts of harming herself or the baby, and even delusions and hallucinations.

Perinatal Mood and Anxiety Disorders (PMADS), are real, pervasive, and life-threatening.

Are you missing the signs with the women you treat?

Watch this compelling recording and gain tools to intervene during a critical period that does not offer the luxury of time.

Postpartum women are exceptionally vulnerable, as are their infants who are fully dependent on them. And given that suicide is the 2nd leading cause of maternal death, this recording is a must-watch for any professional working with pregnant or postpartum women.

1. Recognize how and why mood disorders in the perinatal period are unique, nuanced and high-risk.
2. Differentiate between “normal” perinatal experiences and clinically relevant symptoms.
3. Design effective, efficient, and appropriate interventions utilizing screening tools, interview questions, and The PPSC’s Voice of Depression Response Model.
4. Explain ways the family system is impacted by PMADs and how to address intergenerational issues between grandmother, mother and child.
5. Articulate why therapist vulnerability and urgent care need render supervision and collegial collaboration especially important in this field of work.
6. Discuss impact of special circumstances (breastfeeding, NICU, perinatal loss, adoption, depression in the partner) on therapeutic process and treatment planning.

The Clinical Profile of PMADs: (Perinatal Mood and Anxiety Disorders):

• What causes postpartum mental health disorders?
• The “perinatal masquerade” and illusion of perfection in motherhood
• Why “perinatal” is a multi-decade stage in life
• What makes mood disorders during this period unique
• Breaking through guilt, shame and silence
• Limitations of the research and potential risks

PMAD Screening and Assessment

• Are you asking the right questions?
• Red flags: What to look/listen for each time you see her
• Evidence-based assessment tools
• Differential diagnosis: The PMAD spectrum
  • Depression, Anxiety, OCD, PTSD, psychosis
• The Postpartum Stress Center PMAD Response Model
• How to respond if she discloses thoughts of harm to herself or the baby
• Where and how to refer to a specialist/higher level of care

Clinical Interventions for Mothers Who are Symptomatic, Exhausted, and Preoccupied

• How treatment differs for this population
• Create a safe “holding environment”
• Help her break through guilt, shame and silence
• Navigating scary intrusive thoughts
• Practical interventions for busy new moms
• The perinatal family: Identify and engage necessary supports in treatment
• Tools for healing the perinatal intimate partnership
• Psychotropic medications: Safe for pregnant or nursing mothers?
• Collaborative care with other providers
• Videos: Beyond the Fear & Voices of Recovery
• Exercises: Token assessment and case examples

The Nuanced Experience of the Perinatal Clinician

• Managing countertransference
• Ethical decision making: Breaking the rules and self-disclosure
• Collaboration and collegial support

Special Considerations

• Feeding issues: Breastfeeding and/or bottle
• Infertility/Assisted reproductive technologies
• Trauma
• NICU
• Perinatal grief and loss
• When PMADs are left untreated or present later in motherhood
• Multicultural factors