In light of a recent tragedy involving a prominent New York-area physician, the Weill Cornell Medicine community came together August 15 for a discussion on postpartum depression and addressed frequently compounding issues, such as stigmatization and timely access to care.
Dr. Alison Hermann, Associate Professor of Clinical Psychiatry, Department of Psychiatry, provided a detailed overview of postpartum depression. She distinguished the condition from the relatively common “postpartum blues,” which typically affects 50-85% of new mothers in the first few weeks after childbirth. Symptoms include generally mild levels of irritability, anxiety, fluctuating moods and increased emotional reactivity. Postpartum blues are transient and do not interfere with a person’s functioning.
In contrast, postpartum depression (PPD), which affects approximately 10-20% of new mothers within the first year of childbirth, is more moderate. Symptoms may include mood changes, inability to enjoy things, excessive guilt, anxiety, and even suicidal ideation. (Men can also be affected; it’s estimated about 10% of fathers may experience PPD symptoms.) Conditions like generalized anxiety and obsessive-compulsive disorder (OCD) may also worsen or manifest for the first time in the perinatal period. Common symptoms include excessive worry, unwelcome intrusive thoughts, or excessive checking behaviors. Each of these conditions have effective treatments available, which may include psychotherapy, medication, or lifestyle changes.
One of the most severe forms of postpartum mental illness is postpartum psychosis, which affects .01% of mothers during the first three months after birth. It is considered a variant of bipolar disorder. Symptoms may include mixed or rapid cycling moods, agitation, delusions, disorganized behavior, cognitive impairment and low levels of insight. Symptoms of postpartum psychosis are a psychiatric emergency and frequently necessitate hospitalization.
While it is common for people who have a history of mood or anxiety disorders to struggle with an exacerbation or relapse of their illness in the postpartum, it’s also common for people without a history of mental health challenges to experience PPD. Though postpartum mental health conditions are common and can be concerning, Dr. Hermann emphasized the hope in early, effective intervention and treatment.
As physicians caring for patients, Dr. Hermann said, it’s not always easy to acknowledge the self as a whole person, with complex roles and needs, and to ensure each aspect of the self is honored and nurtured.
Anyone experiencing PPD is encouraged to acquire a full psychiatric evaluation. Treatment often includes a multifaceted approach with an emphasis on integrating care for spouses and other loved ones. This fall, the Weill Department of Medicine’s Well-Being Committee, in conjunction with the Department of Psychiatry, will be organizing a series of talks on physician mental health. A recording of the talk is available.
Resources
- Free, confidential, in-person and virtual counseling is available to Weill Cornell Medicine employees, their spouses, partners, and other family members through the Employee Assistance Program Consortium. Email EAPC@med.cornell.edu or call 1-212-746-5890 for more information.
- Flourish connects Weill Cornell Medicine faculty and staff with resources to support their mental wellbeing at every stage of their journey.
- Postpartum Resource Center of New York provides emotional support, educational information and healthcare and support group referrals to mothers suffering from prenatal and postpartum depression (PPD). Call the toll-free statewide help line at 1-855-631-0001.
- Postpartum Support International is dedicated to helping families suffering from postpartum depression, anxiety, and distress. Please call or text “Help” to 1-800-944-4773 (Spanish: Call 1-800-944-4773 and choose option 1 or text “Help” to 1-971-203-7773).
- The Center for Women’s Mental Health at Massachusetts General Hospital provides state-of-the-art evaluation and treatment of psychiatric disorders associated with female reproductive function including premenstrual dysphoric disorder (PMDD), pregnancy-associated mood disturbance, postpartum psychiatric illness, and peri- and post- menopausal depression. To schedule an appointment, call 1-617-724-7792.
- The LactMed® Database and Reprotox provide information on drugs and other chemicals to which breastfeeding mothers may be exposed.
24/7 Crisis Resources
- NYC Well – Free and confidential, 24/7 crisis support in 200 languages; call 1-888-NYC-Well (1-888-692-9355).
- 988 Suicide & Crisis Lifeline– Free, confidential 24/7 support for people in distress, as well as provider of prevention and crisis resources for you or your loved ones.