Transcript File - Lana Isaacson, LCSW, CAC III,Certificate in

Emotional Wellness in Pregnancy
and Motherhood
by Lana Isaacson, LCSW, CAC III of Pathways Counseling, LLC 720.432.5262
Overview
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Reflect on your own experience
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Brief personal / professional history
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Differentiate b/w prenatal mood disorders, baby
blues, forms of PPD, & psychosis
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Risk factors
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Self-help coping skills
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Treatment
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Empowering new mothers & self-love
From “What to Expect When You're Expecting”
The Dudes Credo:
“Don't talk about what we walk about & we don't judge”
Participant Reflection Form
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What was one emotional challenge you experienced during
pregnancy or as a new mom?
What was one coping skill or community resource that you used
during pregnancy or as a new mom that contributed to your emotional
well-being?
What is one belief or “mantra” that helped you get through a difficult
time in motherhood?
Ignorance is Not Bliss
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Healthcare knowledge can save lives!
Knowledge can help expecting moms improve their
emotional well-being, create a wellness plan (for
pregnancy & after baby arrives), & seek help if needed
So, why aren't more professionals sharing emotional
wellness information with women???
What Family Health Educators/New Parent Leaders CAN
Do to Support Women in Seeking Help
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Include (matter of fact) information about
perinatal mood disorders in your class...
because the women who are suffering won't
bring this up
Great opportunity to present information to
mom and spouse because it's usually
spouses who encourage moms to seek help
Include a perinatal mood disorder resource
list in your class handouts
Approach expecting moms who seems to be
struggling & ask them, “How are you
doing?” Let them know, with your verbal &
nonverbal language, that you care, are
willing to listen, & can handle this topic.
Distinguishing between “normal”
pregnancy/postpartum challenges
and a perinatal mood disorder
Differential Assessment
Questions:
1. Are you having more bad days than
good ones? (feeling out of control,
depressed and/or having anxious
thoughts most of the day)
2. Are you struggling to take care of
your own basic needs and the needs
of your baby?
From “What to Expect When You're Expecting”
Baby Blues- not PPD
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Prevalence: up to 80% of mothers!
Onset: Peak on postpartum day 5; usually resolves by day
10; can last up to 3 weeks
Symptoms include:
Mood swings
Tearfulness
Irritability
Loss of appetite/joy
Low energy
Anxiety
Insomnia
The 5 Different Presentations of
PPD
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Depression/Anxiety
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Panic Disorder
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Obsessive-Compulsive Disorder
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Post-Traumatic Stress Disorder (PTSD)
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Psychosis
Postpartum Depression/Anxiety
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Prevalence: up to 1 in 5 new moms
Onset: any time during the 1st year of motherhood (PSI states, “50% of
postpartum depressive episodes begin prior to delivery”)
Symptoms include:
lack of positive feelings toward or discomfort around baby
excessive anxiety (including thoughts of baby being harmed)
irritability
sad mood
inability to experience joy (“anhedonia”)
too much or too little sleep &/or appetite
physical symptoms without apparent physical cause
loss of concentration
suicidal thoughts
inability to take care of basic needs of self and/or baby
Who's got the “Blues”
and/or Postpartum Depression?
Risks of Untreated Depression & Anxiety
To mother: Recurrence/lasting depression
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“Depression often persists for months to years after childbirth, with lingering
physical and psychological functioning following recovery” (England, Ballard
& George, 1994, MedEdPPD)
“The most significant factor in the duration of PPD is delay in receiving
treatment” (England et al.)
To child:
Prenatal
Postpartum
Premature birth
Low birth weight
Blood vessel constriction
Higher cortisol levles
Poor weight gain
Sleep problems
Social, motor, & cognitive skill delays
Behavioral problems
Poor attachment
Postpartum Psychosis
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Medical emergency! Hospitalization & medication
recommended
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5% suicide and 4% infanticide rate
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Prevalence: Affects 1 to 2 women per thousand
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Onset: usually 2 to 3 days postpartum
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Symptoms include:
A BREAK IN REALITY
mother may initially present as confused/delirious
visual or auditory hallucinations
paranoia
delusional thoughts
What Causes PPD?
Vulnerability
Triggering Events
Genetic Background
Huge Hormonal Shifts
Early/Childhood Experiences
Sleep Deprivation/Exhaustion
Stressful Life Events
Inadequate Support
Mismatch of expectations
Risk Factors of PPD
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Personal or family history of mental illness or
substance abuse
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Past depression- 25-40% risk of PPD
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Prior PPD- 50-80% risk recurrence
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Prior perinatal loss
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Past abuse or neglect in mother's history
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Mother's loss of her own mother
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Social isolation/poor support system
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Thyroid dysfunction
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Sensitivity to hormonal changes (ex. PMS, mood
changes while taking birth control pill or fertility medication)
Additional Risk Factors for PPD
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50% of all PPD start during pregnancy
50-75% relapse after discontinuing medication
when pregnant
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Childcare stress
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Multiple births
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Teenage mothers
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Profound change in lifestyle
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Unrealistic expectations!
This Isn't What I Expected...
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Labor and Delivery- varies from birth plan
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Nursing difficulties
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Colicky or hard to care for baby
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Relationship changes with spouse
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Changes to self-image
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Superwomen: wife/mother/professional
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Disappointment over the common myth that
pregnancy and the postpartum period are the most
exhilarating times of life for all mothers!
Treatment of PPD
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Rule out medical causes (ex. Thyroid issues)
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Self-help coping skills
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PPD support group (Two most powerful words are “Me too”)
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Psychiatric evaluation and medication
- Yes! There are safe meds for pregnancy &
breastfeeding
- Medication has been found to be the most effective
tool in treating PPD
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Individual counseling
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Childcare & other help with your home
Self-Help Coping Skills
S = sleep (4-5 hrs straight)
E = exercise
L = laughter
F = food (healthy)
CARE for MOMS
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See handouts for more coping
skills
Empowering New Mothers &
Cultivating Self-Love
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Use humor, choose a positive
outlook, & see the bigger picture
Let go of any shame/guilt
Be open to the life lessons your
baby will teach you! (especially
when things go awry)
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No competitive parenting
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There is no “right” way to parent
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Create a supportive sista'hood!
Emotional Wellness Skills Taught in Treatment
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Recognize the difference between a feeling or thought, ex.
fear or baby being hurt vs. action (hurting the baby) or
inaction (unable to care for baby b/c paralyzed with fear)
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Self-help coping skills in anxiety and depression relief
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Problem-solving skills & structuring day with baby
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Develop more accurate and positive perspectives (of life
with baby & of oneself); improve self-esteem
Create a better balance between mom and baby's needs
Improve communication skills (asking for help, setting
limits, authentically expressing feelings)
More Emotional Wellness Tips
“Only when we learn that taking care of ourselves is as necessary
as taking care of our families...do we achieve our full potential
as mothers” - Kleiman & Raskin
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Develop a positive “mantra” to help you through tough times,
ex. This too shall pass”, “I'm doing the best I can”, “Let it go”
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Identify your strengths as a mother & personal interests/gifts
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Let go of control & trust in the hidden gifts that life brings
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When facing a painful situation, choose your reaction~
1. change it
2. change your perspective 3. accept it
4. don't change & stay unhappy
Lana's Top 5 Emotional Wellness Tips
1. Sleep when baby sleeps
2. Let go of perfectionism,
prioritize, & set realistic
expectations of yourself
3. Develop friendships with other
moms & babies (as well as
experienced moms)
4. Do things you love to do even if
baby comes along
5. Focus on & celebrate what you
accomplished today