The debilitating effects of postpartum depression might have been circumvented had model and spokeswoman Chrissy Teigen understood that her history of infertility put her in a high-risk category, says Dr. Dawn Kingston, associate professor at the University of Calgary and co-developer of Canada’s first perinatal mental health screening guidelines.
Recently Teigen shared her story in Cosmopolitan and Us Magazine about her struggles with postpartum depression (PPD). It’s often surprising when a celebrity who can afford the best childcare has the same struggles as less privileged women, but there was a major warning sign that might have helped Teigen and her husband, musician John Legend, get help sooner. Teigen had a long history with infertility and research is showing that this may be a significant indicator.
Recent studies indicate that partners in an infertile couple have higher rates of perinatal depression and anxiety. While this may seem unsettling, seeking help early could give pregnant women and their partners who fall into this category an opportunity to find a therapist to help them navigate the difficult emotions they may be experiencing and head off worse problems down the road.
I had a chance to interview Dr. Dawn Kingston to learn more. Dr. Kingston is an associate professor in the Faculty of Nursing at the University of Calgary and an adjunct associate professor in the Department of Obstetrics and Gynecology at the University of Alberta. Her work includes co-creating Canada’s first perinatal mental health screening guideline. A former epidemiologist with the Maternal and Infant Health Surveillance Division of the Public Health Agency of Canada, Dr. Kingston started her career as a neonatal intensive care nurse and received her doctorate and master’s degree from McMaster University.
Why is it so easy to overlook symptoms of PPD?
Great question. There are a few things going on...
- Women aren't sure whether what they're experiencing is depression or just "hormonal swings"...so they ask advice from their friends and family. Often, their well-meaning significant others advise that they are just experiencing the blues, or normal hormonal swings, and as a result the new mom tends not to follow up with her doctor. As a result, the symptoms don't get picked up.
- Women think they have to have ALL the symptoms they read in a list of PPD symptoms - when every woman's experience is a bit different. Some feel exhausted and teary. Others feel irritable, angry and a loss of joy. Others struggle with a loss of confidence. Some have all.
- Important to know...that anxiety (relentless worry) is more common that depression in the prenatal and postnatal period
What are some key warning signs?
- From a symptom perspective...Symptoms that last 2 or more weeks (exhaustion, loss of joy, irritability, anger, sleeping more or less than usual, feeling like your confidence is dashed
- From a risk perspective...Anyone who has had depression or anxiety in the past; high stress in past year; difficulty in partner relationship; not a lot of friend or family support is at risk....Large risk for women who have had depression or anxiety IN PREGNANCY
Why are women still reluctant to admit they might be struggling?
Often women find it a relief when they do admit they are struggling. A main part of the reluctance, though, is confusion about their symptoms -- Is this depression or not? Is this anxiety or normal worry? Many don't want to "waste" their doctor's time by asking the question. However, until mental healthcare becomes a regular part of prenatal and postnatal care, women need to step out to ask their doctor whether there is something to their feelings or whether they are a normal part of being pregnant/a new mother
How can a new mother get help from people around her without shame?
- Most people find that if they share their struggles they are met with a compassionate response. Plus...most people have a "story" to relate to the struggling mom - someone they know who has struggled or they themselves.
- Best advice: Share that you've been struggling and it's been hard for you to share that. Stigma is busted in the magic of these kinds of heartfelt talks. Many women come away feeling like they are normal...others have this too.
- Because 1 in 4 women struggle with anxiety or depression in pregnancy and after birth...this is a very common experience. Women can be reassured that they are not alone in their experience.
A key point...most women who develop postnatal depression or anxiety had experienced them in pregnancy, or before they became pregnant.
You can learn more at Dr. Kingston's website, where she has written a series of articles about prenatal emotional health.
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