Perinatal (pregnancy and postpartum) Depression: Frequently Asked Questions

What is antenatal depression?

Antenatal depression is a long-lasting sadness that occurs during approximately 10 percent of pregnancies, often during the first three months. Much like depression that occurs when a person is not pregnant, antenatal depression is often characterized by:

• Sadness and/or loss of interest in everyday activities
• Weight and/or appetite changes
• Changes in sleep patterns
• Fatigue/loss of energy
• Sense of worthlessness
• Crying
• Suicidal thoughts

Women with antenatal depression may have concerns over their ability to be a good mother, over the disruptions and changes to their lives and their relationships, and over the physical changes their bodies are going through. Women who have given birth before and are experiencing antenatal depression may also worry a great deal about their ability to love and/or care for additional children.

The problems don't necessarily disappear once the baby is born. Women who experience antenatal depression may be more susceptible to postpartum depression.

What is postpartum depression?

Postpartum depression is a long-lasting sadness that affects approximately 13 percent of new mothers within a year after giving birth.  It happens to all types of mothers, regardless of age, race or background. Postpartum depression's symptoms usually include:

• Sadness and/or loss of interest in everyday activities
• Weight and/or appetite changes
• Changes in sleep patterns
• Fatigue/loss of energy
• Sense of worthlessness
• Anxiety
• Crying
• Suicidal thoughts

These symptoms last longer than two weeks. In addition, women with postpartum depression may have thoughts of hurting their baby, feelings that they cannot adequately care for or protect their baby, and guilt over being unhappy during what they believe should be a happy time in their lives. Women with postpartum depression often have difficulty caring for themselves and their babies. They may even feel like no one else has felt what they feel, and no one will be able to help them.

What are the most effective treatments for perinatal depression?

Mood and anxiety disorders occurring during the perinatal period can be successfully treated with medication and/or psychotherapy. Anti-depressants and anti-anxiety medications may be used. Physicians and their patients can work to select medications that minimize harmful effects to the fetus or breastfeeding newborns (from effects through breastmilk). Psychotherapy/counseling has also been shown to effectively treat perinatal mental health issues. Research has shown that Interpersonal Therapy (IPT), in particular, is very useful with perinatal mood and anxiety disorders. Pregnancy and the postpartum period generally bring about many changes in a woman’s social network. Because IPT specifically focuses on interpersonal relationships, it is an ideal form of therapeutic treatment for pregnant and postpartum women.

What is interpersonal psychotherapy (IPT)?

Interpersonal psychotherapy (or IPT) is a type of therapy or counseling that focuses on a person's social network: their family, friends, co-workers, etc. When IPT is used for depression in pregnant women or women who have just had babies, the therapist and client work to determine how the social network has contributed to the problem, and how it can be used to solve the problem.

IPT usually lasts for 10-12 sessions. It has been found to be as effective as medication for the treatment of antenatal and postpartum depression, and may be preferable since many pregnant and breastfeeding women do not want to take drugs that may affect their baby.

How do I refer a patient to UI Women's Wellness and Counseling Service?

• UI Physicians/Providers:
  • UI physicians may refer patients via IPR consult forms sent to the UI Obstetrics and Gynecology outpatient clinics. Each patient will be contacted to schedule an initial evaluation appointment.
   
• Non-UI Physicians/Providers:
  • Providers outside the UI Hospitals and Clinics network may call 319-335-2464 to make a referral or use the UI Consult online form, which can be faxed, 319-353-6915, to our office. Each patient will then be contacted to schedule an initial evaluation appointment. 
   

What training opportunities for physicians and providers are available at UI Women's Wellness and Counseling Service?

The Women's Wellness and Counseling Service offers not only comprehensive health services, its staff of clinical researchers also study a variety of health issues including:

• Educational programs/screening for perinatal depression
• Educational programs on efficacious treatment for perinatal depression
• Training in Interpersonal Psychotherapy
• Elective rotations for medical students, residents, and fellows; Please contact Robin Kopelman, MD for more information.