By Dr. Valerie M. Kading

DNP, MBA, MSN, PMHNP-BC

Group Chief Executive Officer

“It’s time to return our focus to mothers”

Many women across Arizona and the country experience the “baby blues” after giving birth. However, the American Psychological Association reports that as many as 15% to 20% of pregnant and postpartum women also endure the debilitating – and potentially life-threatening — impact of clinical depression. Known as postpartum depression (and perinatal depression in women who are pregnant), the condition is a complex mix of physical, emotional, and behavioral changes that can negatively impact not only the mother, but the baby and other members of the household as well.

Postpartum depression has been recognized for years by healthcare providers as a serious health issue. Today, though, the COVID-19 pandemic has amplified the condition in many new moms as the global health crisis continues to add new layers of stress from issues such as isolation and economic anxiety. The result: America is now facing a postpartum depression crisis, hidden inside the pandemic.

In fact, a study released last December by Brigham and Women’s Hospital in Boston suggests that pandemic-induced anxiety and depression is affecting as many as 36% of women before and soon after childbirth. About nine percent of new mothers said they felt a strong sense of grief, loss or disappointment because of the pandemic; this group was five times more likely to experience significant mental health symptoms, according to the study.

“The pandemic has increasingly brought to light the challenges these women have with maternal mental health issues,” said Dr. Valerie Kading, CEO of Sierra Tucson, a treatment facility specializing in mental and behavioral health concerns. “These women can’t have visitors in the delivery room, and they may not have support from family living out of state because of travel concerns. Mothers with older children also are juggling work from home and distance learning for their kids, on top of caring for a newborn; they may have financial or job worries. These women may be, essentially, starting their new journey of motherhood in isolation.”

What’s more, the pandemic has fueled increases in substance abuse and domestic violence — both from which perinatal and postpartum women can be at greater risk of suffering.

Women with perinatal or postpartum depression can also experience a great deal of shame, preventing them from talking about their condition or seeking help. “The media — from TV and movies to magazines and social media — frequently portray mothers as happy and joyful,” Dr. Kading explained. “Mothers of newborns who don’t display the positive emotions that we’re used to seeing in the media can be made to feel like there’s something wrong with them, and only them, increasing their feelings of isolation and amplifying depression.”

“It’s absolutely time for the focus to return to mothers, especially new moms,” Dr. Kading said. “The way a mother feels is so important to a child’s development, even while the child is still in the womb.”

 

Depression’s effects on babies, moms and families

The impact that a mother’s depression can have on family members is wide ranging. For example, perinatal mood disorder—depression that occurs during pregnancy—can cause the mother to adopt unhealthy behaviors such as use or abuse alcohol or drugs—which can result in inadequate fetal growth and neurological-language skills issues as the child matures.

Postpartum depression, which can manifest in a mother anytime from delivery up to a year after the baby is born, can have lifelong ramifications. Depressed mothers are less likely to breast feed, for example. According to the Centers for Disease Control and Prevention (CDC),  breastfeeding reduces the risk of heart disease, Type 2 diabetes, ovarian cancer, and breast cancer for the mother. Benefits of breastfeeding in newborns include a reduction in the risk of asthma, obesity, Type 2 diabetes, ear and respiratory infections, and sudden infant unexpected death syndrome (SIUDS).

Depression also can prevent mother and infant from bonding, can cause the mother to neglect older children in the household and can place strain on her marriage or other partner relationship – “increasing the chance of divorce,” Dr. Kading said. In rare cases, postpartum depression can endanger the mother’s life, as well as her family’s, if the mother harbors thoughts of suicide or harming others.

 

Help is available for mothers

“I want to let mothers know that they’re not alone,” Dr. Kading continued. “Yes, perinatal and postpartum depression are challenging, but there are trained mental health professionals available who are passionate about helping mothers in need.”

To start, Dr. Kading advises that people close to a new mom – family members, friends, even co-workers – be on the lookout for signs that she may be struggling with depressive feelings. Signs to watch for include sleep disturbances such as insomnia or sleeping excessively, appetite changes, anxiety or nervousness, excessive fatigue, extreme or frequent mood swings, feelings of low self-worth or hopelessness, thoughts of death including suicide or of harming others.

Everyone in a mom’s circle – a partner, friend or family member – can help her in some way to cope with and overcome depression. Listen to her concerns without judgment, remind her that postpartum depression is a diagnosable medical condition and that treatment is available, offer to help in specific ways such as babysitting her other children so she can engage in some self-care, refer her to treatment options such as out-patient or online therapy.

Remember that a mom’s circle includes her pediatrician, ob-gyn or other primary care provider. If you have concerns that you may be experiencing perinatal or postpartum depression, open up to your doctor, who can offer helpful suggestions and recommendations for treatment. The same advice goes for dads, too — talk to your doctor if you think your partner may have depression. In fact, postpartum depression has been diagnosed in men as well; know that your physician is there to help.

Among the resources available to Arizona residents, as well as mothers across the country, is Sierra Tucson, a nationally-recognized mental health and substance use treatment center. Sierra Tucson recently launched a new, virtual intensive outpatient program for women who are struggling with prenatal depression, postpartum depression, and perinatal mood disorders.

“Sierra Tucson has been committed to working with women for many years,” Dr. Kading said. “Postpartum depression is an under-recognized and under-diagnosed condition, and it’s a vitally important diagnosis to identify and treat. Women who suffer from postpartum depression tend to not engage fully with their baby and tend to not care for their child, which is a setup for lifelong negative consequences.”

“Our intense passion for and expertise in women’s mental health has guided the birth of our Maternal Mental Health Virtual Intensive Outpatient Program,” Dr. Kading continued. “Expanding access to the program with dedicated therapists and medical professionals, who not only understand, but who are also specially trained and certified to provide women’s mental health treatment, can impact the health of women and their families for generations.”

Sierra Tucson is offering this new program completely virtually using a secure online environment so that women participating can choose a safe and comfortable location that is best for them. All they will need is a private space and a video-enabled computer, tablet or smartphone.

The specialty program includes nine hours of care per week (three-hour sessions, three days per week) featuring curriculum built using evidence-based treatment methods such as cognitive behavioral therapy, mindfulness based therapy, and music therapy. Participants can expect to take part in group therapy sessions, which provide a supportive environment where they can discuss their feelings and challenges. All sessions are led by clinicians who are specially trained in treating postpartum depression and perinatal mood disorders.

About the Author

Dr. Valerie Kading is the CEO of Sierra Tucson, where she provides the strategic vision to ensure that the facility’s patients and their families receive the most innovative, compassionate, and leading medical and psychiatric treatment for trauma, addiction, and other mental health conditions from a world-class staff of clinicians and behavioral health professionals.

Dr. Kading brings to Sierra Tucson a special interest in women’s mental health including perinatal mood disorders, maternal well-being, and postpartum depression.

Visit www.sierratucson.com