Prevention of Perinatal Mood and Anxiety Disorders

During the last few years, many articles have been written on the etiology of postpartum depression (PPD) and other perinatal mood and anxiety disorders (PMADs). Biochemical and psychosocial causes have been noted in much of the research. Interestingly, a paucity of information remains regarding how to lower the incidence of, decrease the severity of, and possibly prevent these illnesses. That is where my focus lies. Why not attempt to circumvent the suffering in the first place?

For almost 3 decades, stemming from my own personal experiences with suicidal depression following the births of my children, my message has been one of hope. Not only are PPD and related illnesses completely treatable with proper help, their incidence rates can be minimized, and in some cases they can even be prevented so that the nightmare never begins. In Postpartum Depression For Dummies, I outlined many preventive steps for women who know they are at high risk for a bout of illness following a delivery.

Although chemical and life factors place women at high risk for PPD and other PMADs, no one is immune. Even women with no previous personal or family mental health issue can be hit hard. Therefore, regardless of risk factors, every new mother should arrange certain pieces of a wellness strategy, ideally before the baby comes. These basic steps can help to ward off emotional and psychological problems after delivery. The first 7 steps are for all mothers, and the last 2 are for those who are already suffering or know they are at high risk.

1. Have realistic expectations of motherhood—throw out the myths and fantasies.
2. Discuss wishes and concerns with your partner—communicate expectations and make an agreeable plan together.
3. Pay attention to nutrition (including supplements) to feed the body and brain, such as the right proteins, complex carbohydrates, omega-3 fatty acid, vitamin D, folate, etc.
4. Plan for nighttime sleep to protect brain chemistry—even a breastfeeding mom can get a few hours of uninterrupted nighttime sleep with a good plan.
5. Exercise or use special breathing to oxygenate the brain.
6. Find emotional support, ie, people to lean on and be “real” with.
7. Find logistical support, ie, people to give you regular breaks to nurture yourself and “recharge your batteries.”
8. Seek psychotherapy with a professional who specializes in perinatal disorders (if you are at high risk).
9. Take medication or alternative/complementary treatments (if necessary).

When a pregnant woman or new mom contacts me with concerns that she will develop depression, anxiety, or another PMAD, we develop an individualized wellness plan using the above steps. Each woman needs a plan that will work with her particular circumstances, beliefs, chemistry, and level of support. So much unnecessary suffering can be avoided when these basics are in place!

Financial disclosure:Dr Bennett is a perinatal psychologist (www.DrShosh.com) and is the author of Postpartum Depression For Dummies; she had no other relevant personal financial relationships to report.​