It is estimated that up to one in seven pregnant people will experience perinatal depression a depression that occurs during pregnancy or after childbirth. Now, a task force has put forward new recommendations to the government that they can claim to drastically lower those numbers.
The new recommendations come from the US Task Force Preventive Services (USPSTF).
For the wording of  JAMA this week, a panel reviewed earlier studies on the benefits and harms of preventive interventions for perinatal depression. The process involved examining the evidence of how effective a range of possible perinatal depression prevention methods actually are, including physical activity, education, sleep counseling for the baby, yoga, expressive writing, omega-3 fatty acids, and antidepressants. However, there was only convincing evidence that counseling for the prevention of depression is of significant benefit, especially in patients with certain risk factors, such as a history of depression.
The panel cited the combined results of 20 studies containing data for 4,107 participants investigating the potential benefits of counseling. About one third of the studies (six out of 20) examined only those individuals who were already known to be at risk for perinatal depression. Two-thirds of the studies (13 out of 20) excluded those who already met the criteria for major depression. This means that prevention methods would not do much for them, and only two-thirds of the studies (13 out of 20) considered two forms of therapy – cognitive-behavioral therapy (CBT) and interpersonal therapy.
When all the data were considered together, the panel concluded that vulnerable individuals received either of these types of counseling. Forms of counseling were 39 percent less likely to develop perinatal depression than those who did not. Finally, the recommendations state that there is "moderate" certainty that providers should refer to or refer to these services for pregnant and postpartum individuals who are at increased risk for perinatal depression counseling.
Technically, your doctor should already examine you for perinatal depression.
The 2016 USPSTF Recommendations suggested that all patients – including pregnant and postpartum – should be screened for depression. Karina Davidson, Professor of Behavioral Medicine at the Sugar School of Medicine at Hofstra University / Northwell Health, acknowledges that this is not always the case.
The hope with this new recommendation explains that SELF is that doctors will take it seriously. "It takes a village where everyone feels that this is part of the usual pre- and postnatal care," she says. "Working together, we can all work to prevent perinatal depression in women at risk."
As already mentioned, the new recommendation also means that your doctor should now have a concrete next step for you by recommending and helping you Access Therapy Interventions (This specific treatment recommendation was not part of the previous guidelines.)
Screening is particularly important for individuals with certain risk factors.
The new recommendations explicitly state that individuals who meet the following criteria should be considered at risk:
- They have a personal or family history of depression.
- You have symptoms of depression.
- They are young.
- They are single parents.
- You have a history of physical or sexual abuse.
- Her pregnancy was unplanned or unwanted.
- You experience stressful life events such as a divorce or a trauma.
- You have gestational diabetes.
- You have a pregnancy cations.
- You have no social or financial support.
If you meet these criteria, your doctor should recommend that you consider counseling to help you during pregnancy and postpartum, says Davidson. Based on what the referral says, this generally means that you recommend the CBT (which helps you identify and change problematic thinking patterns or behaviors) or interpersonal therapy (which focuses on your relationships with other people).
But yours too The doctor should check you during pregnancy and postpartum to see if you meet these criteria or not.
Experts welcome the recommendations, but with some limitations.
"It's fantastic that this is highlighted because it's such a problem. Tamar Gur, MD, a women's health and reproductive psychiatrist at Ohio State University's Wexner Medical Center, told SELF. "If we shed light on the matter, we can only hope to eradicate it." Perinatal depression can be particularly severe as it occurs at a time when people are happy and excited about a new baby, she stresses. Add this to the existing stigma of finding help for a mental health problem and it can be particularly challenging to deal with the problem.
"The recommendations are wonderful," Dr. Christine Greves, a board certified ob / gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF. "To have a good pregnancy and bond with the baby, a mother must be healthy." Pregnant and new parents often see gynecology during this time and make their providers a good starting point for mental health screenings. She says. "As part of the doctor-patient relationship, it is also important to be concerned with mental health," says Drs. Greves.
But even though this is a "big recommendation," there still has to be "worked on" (19459004). Jessica Shepherd MD, a minimally invasive gynecologist at Baylor University Medical Center, Dallas, tells SELF. For starters, the USPSTF recommendation even says that "there is no accurate screening tool to identify women at risk of perinatal depression." The counseling interviews in the panel-reviewed study ranged from four to 20 sessions, lasting between four and 70 weeks. This is highly variable and it is unlikely that a given plan will be of benefit to all. "As a clinician [that lack of a specific recommendation]it can be difficult to figure out how screening can be effective," explains Dr. Shepherd.
Even with specific guidelines, people may be faced with many therapeutic barriers due to lack of resources and lack of time, and health care, adds Dr. Shepherd added. "The way these patients can actually be treated is not really addressed," she says. Dr. Shepherd goes on to say that the recommendations fostered the conversation around perinatal depression, and that's always a good thing.
Not every doctor asks about your risk factors, so you may have to stand up for yourself.
Every provider and the healthcare system is different. Some make mental health discussions a priority while others do not care. If you feel that you have symptoms of depression or are worried that you might notice a change in your mental state after a baby, it's important to talk to your doctor, says Davidson. At a minimum, they should be able to refer you to someone who can help.
And if your doctor does not help or rejects your concerns, you may need to seek counseling on your own Time to find a new provider . "We have treatments that work," Dr. Gur. "You should not be afraid to ask for help."