Postpartum Depression Symptoms

The Rage of Postpartum Depression

By Katherine Stone September 16, 2010

Last night I was itching for a fight. My husband wasn’t doing a SINGLE thing the way I wanted him to. In fact, I felt he wasn’t doing what I wanted him to do on purpose. So I got mad. Scary mad. I felt like he never did anything I wanted him to do, and didn’t care.This, despite the fact that he had gone on a father/son outing with our boy (and my dad) during the day to a Braves game, then went to the grocery store and then cooked dinner, which was waiting for me when I got home with our daughter.

So what. He was still a jerk, I thought. And we had one hell of a fight.

This morning I had to make that call. You know the one.

I’m sorry. It was my fault. I was crazy.

And I was. Temporarily. Most of the time I’m pretty even-tempered. I’m a nice person. I know my husband is a good guy even though he annoys me some times, just like I’m sure I annoy him. I’m not a rage-aholic by any stretch of the imagination. I don’t like yelling. At anyone.

It so happens, though,that I have my … guess what?… period. Usually, for about 2 days in the whole period process I get a short-temper. I feel more controlling. Sometimes I lose it, like last night. (Could this have been a predictive sign that I was going to get a postpartum mood disorder? I think so!)

My behavior last nightreminds me of the symptoms of anger and irritability that many moms with postpartum depression and antenatal depression get. Many of you say you have been surprised by the rage you feel with PPD. I have to admit I really wanted to punch my husband right in the face. That’s pretty surprising.

I’m glad I don’t feel like that much anymore, except on the very rare occasion, like last night. It’s scary. I don’t like it one bit. How about you?

Photo: Fotolia - © Jason Stitt

September 16, 2010 2:09 pm Filed Under: Postpartum Depression Symptoms

NPR on Screening for Postpartum Depression

By Katherine Stone March 13, 2010

Thanks to Kim Schworm Acosta for giving me the heads up on this interview on WBUR (NPR in Boston) with Dr. Jeanne Watson Driscoll about postpartum depression and the issue of legislating PPD screening. Listen in by following the link below and clicking on the listen button underneath the title! It's 15 minutes long and Dr. Driscoll is awesome!

Lawmakers Weigh Mandatory Depression Screening for New Moms [in Massachusetts; the federal legislation is does not mandate screening]

March 13, 2010 12:04 pm Filed Under: Postpartum Depression Symptoms

Single Screening Tool Accurately Tests for Several Mood & Anxiety Disorders

By Katherine Stone March 12, 2010

A company called M-3 Information has developed a free, online checklist that research shows can accurately indicate whether a patient may have depression, anxiety, PTSD or bipolar disorder. The study will be published in the March/April 2010 issue of the Annals of Family Medicine. The developers of theM-3state that the 27-question screening tool is private, easy to use, and does not require any personal information to be shared. Users can continue to monitor their progress by retaking the test at regular intervals. The study found:

"The M-3 is a valid, efficient and feasible tool for screening common psychiatric illnesses in primary care. Its diagnostic accuracy equals that of presently used single-disorder screens but with the additional benefit of being combined into a one-page tool. The M-3 potentially can reduce missed psychiatric diagnoses and facilitate proper treatment of identified cases."

I just tested it out and it only took 1 minute to take. Easy peasy lemon squeezy.

I don't believe they've tested the M-3 specifically for perinatal mood and anxiety disorders. It would be interesting to hear results on that specifically.

March 12, 2010 12:34 pm Filed Under: Postpartum Depression Symptoms

NIMH Offers Healthcare Pros Downloadable Pocket Card for Suicide Assessment

By Katherine Stone February 20, 2010

Healthcare providers can follow this link to download the Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) pocket card. It provides protocols for conducting a comprehensive suicide assessment, eliminating suicide risk, identifying protective factors, and developing treatment plans and interventions responsive to the risk level of patients.

February 20, 2010 9:49 am Filed Under: Postpartum Depression Symptoms

Boston Globe Endorses Postpartum Depression Screening Legislation in Massachusetts

By Katherine Stone February 1, 2010

The editorial board at the Boston Globe has come out in favor of legislation that would require postpartum depression screening in Massachusetts.

"Early detection could stave off far more serious problems for mothers and their babies, whose well-being is deeply linked to the first few months of care. And universal screening would ensure that no woman falls through the cracks. The sooner new mothers can be diagnosed, the sooner they will recover."

Exactly.

February 1, 2010 9:25 am Filed Under: Postpartum Depression Symptoms

ACOG Strongly Encourages Prenatal & Postpartum Depression Screening

By Katherine Stone January 22, 2010

Yesterday I drafted an open letter to Dr. Gerald F. Joseph, president of the American College of Obstetricians and Gynecologists, to ask him what he planned to do to support his stated platform of postpartum depression. Here’s just a bit of it.

I know obstetricians aren’t psychiatric professionals. I knowyou already have enough responsbilities, what with delivering babies. I know you already have tough jobs, what with all the liabilities you have. I know you already don’t have enough time with your patients.

It’s just that many women never get to a psychiatrist. The only healthcare providersthey seeare you –the OB –and their pediatrician. You may be the only chance they ever get to be identified, treated and recover effectively from a perinatal mood or anxiety disorder like postpartum depression.

A lot of OBs out there are doing amazing work, but there are still too many who either don’t help or make things worse. I hate to say it but I hear from more than a few women with postpartum depression who tell me they didn’t receive good treatment from their OB/GYNs. Some have been made to feel like damaged goods, like their OBs couldn’t get away from them fast enough. Some have been made to feel like nothing was wrong, or were simply ignored. Just today, I received the following in an email from a reader:

“My OB/GYNs were, honestly, terrible. They were phenomenal when I was pregnant, and with delivering my baby, but with the postpartum stuff they treated me like a piranha and did a bad job of diagnosing what was going on (which, I believe, has made my recovery longer and allowed the disease to get more intense than it had to).”

The overall gist of my “open letter”post was that I felt I hadn’t seen much coming down the pike yet from Dr. Joseph and ACOG on postpartum depression, and I was beginning to get a little curious. But then guess what happened??

This.

Yes, that’s right. ACOG is now encouraging OB/GYN’s to screen patients for depression both during pregnancy and after.

“Screening for depression during pregnancy and afterward benefits women, infants, and families, according to a new Committee Opinion issued today by The American College of Obstetricians and Gynecologists (the College) and published in the February issue of Obstetrics & Gynecology. Because pregnancy and the postpartum period are pivotal times to identify women suffering from depression, the College encourages ob-gyns to strongly consider screening for it.” (my emphasis)

This is a good start from ACOG. As reported on MedPage Today (which did the best story on this), however, they left a lot of wiggle room.

“What screening tools to use, who should do the screening, and how often were also left up to the physician’s discretion in the ACOG committee’s opinion, published in the February Obstetrics & Gynecology.”

In the MedPage Today story, Dr. Joseph explained:

“Unfortunately, although I personally and many, many of our fellows feel that screening in the pregnant patient during and certainly after is extremely important,” he told MedPage Today, “there’s not a big girth of information that would allow us to publish evidence-based guidelines that say it absolutely should be done.”

I wonder how OB/GYNs will react to that. Will they say, “If they can’t even tell us for sure when and how to do it then why should we screen for postpartum depression?” Will they assume the pediatrician is going to do it? Or will they say “I was thinking of doing this anyway so I’m going to take the initiative and start now.” I also wonder what kind of additional data ACOG is looking for to make the postpartum depression screening guidelines a little more helpful, and if they plan to undertake getting that kind of information for use in the future.

I’m not disagreeing that more data may be needed. I just wonder when we’re gonna get it.

January 22, 2010 12:52 pm Filed Under: Postpartum Depression Symptoms

Study Finds Internet Effective Way to Administer PPD Screens

By Katherine Stone March 11, 2009

The March 2009 issue of Maternal Child Health Journal offers a study from researchers at George Washington University and Johns Hopkins that examined using the Internet to screen for postpartum depression symtpoms. The Postpartum Depression Screening Scale (PDSS) and the Edinburgh Postnatal Depression Scale were used and then compared with the results of screens administered in person.

The study found thatahigher proportion of Hispanic and Asian women participated on the Internet compared to the in-person study. (Interesting!) It also found that the PDSS had excellent "internal consistencies and construct validity", which I think means it was very effective no matter how it was administered. The Internet sample also reported more risk for major postpartum depression (PPD) compared to the community sample (23% vs. 12%). They concluded that the Internet is a viable and feasible tool to screen for PPD.

I just love this place! I'll be adding this study to the speech I give on how women with perinatal mood and anxiety disorders use the Internet. If you're interested in havingme speak at your event, let me know! (Plug. Plug. Plug.)

March 11, 2009 1:16 pm Filed Under: Postpartum Depression Symptoms

Screening in Hawaii; Misguided Opposition to the MOTHERS Act

By Katherine Stone August 1, 2008

Here are some links to women writing about PPD in the blogosphere:

Diane in Hawaii writing about the organizations that conduct PPD screenings in the Aloha state

Tiffani writing about the MOTHERS Act and the misguided opposition to it

August 1, 2008 1:03 am Filed Under: Postpartum Depression Symptoms

PPD Screening Program in MI Receives Grant

By Katherine Stone April 1, 2008

The American Psychiatric Foundation (APF) has named five universities as the recipients of Helping Hands Grants, and one of the winning programs focuses on postpartum depression.

Michigan State University College of Human Medicine Upper Peninsula Campus in Marquette, Michigan, is being awarded the grant for the "Upper Peninsula Maternal Emotional Support Program" to implement a network of postpartum depression (PPD) risk assessment screening opportunities, professional educational curriculums and integrated community outreach efforts for all new mothers in the Upper Peninsula. This program will establish a consistent risk assessment screening progam for PPD at Marquette General Hospital, educate health professionals in the use of PPD screening tools and provide outreach and community resources to at-risk mothers to reach 2,300 patients, physicians and staff.

Each of the five recipients receives a $5,000 grant for a community mental health service project initiated and managed by medical students under the supervision of medical faculty. The Helping Hands Grant Program raises awareness of mental illness and the importance of early recognition and builds an interest amongst medical students in psychiatry and working in underserved communities. The American Psychiatric Foundation is the philanthropic and educational arm of the American Psychiatric Association. The mission of the foundation is to advance understanding that mental illnesses are real and can be effectively treated. For more information, please visit the foundation’s Web site at http://www.psychfoundation.org/ . The awards are made possible through an unrestricted educational grant from Otsuka America Pharmaceutical, Inc.

Go State! (I’m an MSU alumna.)

April 1, 2008 9:55 am Filed Under: Postpartum Depression Symptoms

Why Universal Screening for PPD is Necessary

By Katherine Stone March 3, 2008

I found an excellent article on Health Commentary calling for universal screening for PPD written by Amy Gagliardi, a writer and research based at Yale University. Check out the whole piece, but here is a highlight:

Wilen and Mounts in their article, Women with Depression – “You Can’t Tell by Looking” suggest that when screening for depression in the health care setting is based on clinical observation alone, 50% of women suffering from depression are missed. In a study of 888 pediatricians, Olson et al conclude that even during the postpartum period when pediatricians have frequent contact with mothers and babies, pediatricians rarely identify maternal depression through a routine inquiry about symptoms or through family history. In fact, the most common identification method reported was the physician’s overall impression or the impression in combination with 1 or 2 questions about the mother’s symptoms. Only 4% of the physicians in this study reported using formal diagnostic criteria to identify maternal depression while none reported using a validated screening tool to identify maternal depression.

Universal screening is a necessary prerequisite towards the identification and treatment of maternal depression and this is not a responsibility specific to any one discipline. Whether we are discussing perinatal depression, which is depression during pregnancy and the postpartum period, or depression at any time throughout the life course, systematic and universal screening is the most effective way to identify depression. Of interest is a study which utilized a 2 question screen of mothers during well child visits. One group of mothers received the screen on paper while the other group was screened by means of a scripted interview. Although both methods were proven to require very little time, the paper screen was verified to be a more effective model.

March 3, 2008 10:02 am Filed Under: Postpartum Depression Symptoms