Postpartum psychosis is the most severe form of postpartum psychiatric illness, occurring in approximately 1 to 2 per 1000 women after childbirth. Although bipolar disorder is a risk factor for postpartum psychosis, a substantial number of women who develop postpartum psychosis have no history of psychiatric illness and experience psychiatric illness only in the context [...]

Postpartum depression is experienced by 10-15% of women and carries risks to both mother and baby.  Untreated maternal depression is associated with negative outcomes for children including behavioral problems, cognitive or developmental delays and impaired attachment.  Treatment of a mother’s depression can improve not only her own functioning and quality of life, but can improve [...]

While postpartum depression (PPD) is typically considered to be a woman’s illness, a number of studies have suggested that, although men do not experience any of the dramatic physiologic or hormonal changes that go along with pregnancy, new fathers may also suffer from PPD.  The most recent study was a meta-analysis published in the May [...]

Postpartum psychosis is rare, occurring in about 1 to 2 per 1000 women after delivery.  While there appears to be a strong link between postpartum psychosis and bipolar disorder, it is estimated that about half of women who present with postpartum psychosis have no psychiatric history prior to delivery, making it difficult to identify those [...]

While many women who smoke successfully quit smoking during pregnancy, most of these women return to smoking within 12 months of delivery.  Several studies have suggested that certain factors may increase the risk of postpartum relapse, including unwanted pregnancy, multiparity, and stressful life events.  Two recent studies indicate that postpartum depressive symptoms may also increase [...]

Several weeks ago, the U.S. House of Representatives passed the Melanie Blocker Stokes MOTHERS Act by a significant bipartisan minority.  The bill is now off to the Senate, where it sits in the Health, Education, Labor and Pension committee awaiting markup. While the bill was passed in the House and has gained the support of many [...]

Maguire and Mody’s report, GABAA R Plasticity during Pregnancy: Relevance to Postpartum Depression, in the July 2008, Neuron, provides evidence that an abnormal Gamma-aminobutyric acid (GABAA) receptor subunit in pregnant mice may be a useful model for postpartum depression.  The report describes how GABAA receptors, specifically, the delta-subunit-containing GABA receptor, are a preferred target for [...]

Our Perinatal and Reproductive Psychiatry team often discusses clinical cases in Rounds, a confidential forum in which we can get advice and consultation from peers who also work in the area of Women’s Mental Health.  We discussed a patient’s situation recently that highlighted the controversial area about how to prevent mood episodes in a woman [...]

Mood disorders and symptoms during pregnancy and the postpartum period are not uncommon and affect women across the world.  In spite of relatively high rates of depression among childbearing women, there are often inadequate resources for treatment, particularly in poorer countries. In countries lacking resources, health care is often managed by community health workers or [...]

Happy holidays from the Center for Women’s Mental Health! As we finish up 2008, we thank you for your support and interest in our program over the past year. The following are the ten most widely read posts from our blog over the past six months: 1. Use of Wellbutrin (Bupropion) During Pregnancy – February [...]

Exercise plays a vital role in achieving and maintaining good health.  Along with numerous other health benefits, recent studies have shown that exercise alleviates symptoms of depression and may be useful in treating mild to moderate major depressive disorder (MDD).  A study by Dunn and colleagues (2005) examined the efficacy of exercise as a treatment [...]

Last Wednesday, the UNC Medical Center opened an outpatient clinic for women with postpartum depression, and on November 3rd opened an inpatient unit for women with postpartum depression.  The inpatient unit is called “the first of its kind” in the United States, and is a progressive example of specialized health care initiatives for improved screening, [...]

While postpartum depression is common among new mothers, our ability to reliably detect this illness remains poor.  Recent studies have indicated that most obstetricians report that they screen for postpartum psychiatric problems at routine follow-up visits but typically do not use standardized instruments to assess for postpartum depression.  Unfortunately, studies which have measured the success [...]

Post-Traumatic Stress Disorder (PTSD) after childbirth is an understudied condition. Traditionally, much of the data have been based on case reports, indicating that PTSD can occur following a range of childbirth and child loss situations, including long or complicated labor, severe pain with labor or delivery, cesarean section, and unanticipated pregnancy outcome, such as child [...]

A recent population-based case-control study published in the American Journal of Obstetrics & Gynecology used Washington State birth certificates linked to hospital discharge data to evaluate the association between hospitalization for a psychiatric illness before delivery and risk of postpartum suicide attempt. The study compared women hospitalized for a postpartum suicide attempt (n = 355) [...]

The most recent issue of the New England Journal of Medicine includes the presentation of a case from the Center for Women’s Mental Health of a woman with bipolar disorder who developed postpartum psychosis after the birth of her child. The case highlights some of the clinical challenges in treating patients with bipolar disorder during [...]

Recently, the Massachusetts House of Representatives passed the Mental Health Parity House Bill 4423, which mandates that insurers and government programs cover mental health in the same capacity that they cover physical health. The Bill was introduced by Representative Ruth Balser (D-Newton). This bill builds on the first Mental Health Parity House Bill (2000) which [...]

If a woman does not breastfeed following delivery, prolactin levels decrease and fertility returns to normal, and pregnancy is possible. Even if a woman decides to breastfeed, she should still use some form of contraception, as prolactin levels vary depending on individual breastfeeding styles. Women may be fertile and become pregnant even before the resumption [...]

The Melanie Blocker Stokes MOTHERS Act — named for an Illinois woman who committed suicide three months after giving birth — was approved by the House of Representatives in October. This article from the North Jersey Record reports that the legislation has been held up in the Senate Health, Education, Labor and Pensions committee. Opposition [...]

While many studies have looked at the impact of postpartum depression in mothers on their children, there is very limited data on postnatal depression in the fathers and the potential impact it may have on their children. Researchers at the University of Oxford recently examined predictors of postnatal depression in the fathers and studied the [...]

The British Medical Journal recently published a brief, but comprehensive review of eating disorders in pregnancy by Veronica Bridget Ward. Eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified) most commonly occur in women of reproductive age and may be influenced by pregnancy and its associated weight gain and change in body [...]

Please sign this online petition to support passage of The Melanie Blocker Stokes MOTHERS Act. A companion bill passed in the House of Representatives last fall to a nearly unanimous bipartisan vote. Democratic Senators Obama and Clinton both support this legislation along with Republican Senators including Olympia Snowe of Maine. Please help us gain our [...]

The 22nd Annual Postpartum Support International (PSI) Conference will be held in Houston, TX from June 4 through June 7, 2008. The theme of this year’s conference is “Maternal Health, a Multisystemic View.” One of the featured speakers is Valerie Plame, former CIA agent and author of “Fair Game: My Life as a Spy, My [...]

Up to 25% of women experience migraine headaches during their reproductive years; often migraine headaches may be triggered or exacerbated by hormonal changes. It has been estimated that 7-14% of women experience migraines only during the premenstrual or menstrual phase of their cycles. Another 52-70% experience headaches throughout the month but note increased headache activity [...]

Previous studies have linked postpartum depression (PPD) to numerous risk factors, including depression during pregnancy, a history of depression prior to pregnancy, as well as marital problems, recent stressful events, and inadequate social supports. Research conducted at the University of Utah in Salt Lake City now suggests that obesity may place women at increased risk [...]

One treatment that has recently received a great deal of interest lately is fish oil. There is some preliminary evidence to suggest that the omega-3 fatty acids contained in fish and fish oil, including eicosapentanoic acid (EPA) and docosahexanoic acid (DHA), have an antidepressant effect. It has been discovered that mothers selectively transfer DHA to [...]

Although pregnancy has often been concerned a time of emotional well-being, several recent studies have indicated that women are vulnerable to depression during pregnancy. Analyzing data from the Kaiser Permanente Northwest HMO, researchers assessed the prevalence of depression before, during, and after pregnancy in a group of 4,398 women with pregnancies ending in a live [...]

Both antidepressant medications and cognitive therapy have been shown to be effective for the treatment of depression; however, the question remains as to whether one treatment is preferred over the other. Subjects enrolled in The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (men and women with major depression, ages 18-75) were initially treated with [...]

After delivery, women experience a dramatic drop in estrogen hormone levels. Many have hypothesized that this decline in estrogen levels may precipitate postpartum depression (PPD) in susceptible individuals, and several studies have explored the use of estrogen for the treatment of depression after delivery. In a double blind, placebo-controlled study including 61 women with PPD, [...]

BlogHer, Postpartum Support International (PSI), and Postpartum Progress are joining forces and asking that you take action to help the MOTHERS Act advance to the Senate floor with the support of as many Senators as possible. What is the MOTHERS Act? The Moms Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act, [...]

After the birth of a child, it is common for women to experience some type of mood disturbance. Typically, it is relatively mild (postpartum blues). However, about 10-15% of women experience a more severe and disabling illness, postpartum depression. It has been suggested that women who develop postpartum depression may be more sensitive to the [...]

Depression affects women almost twice as often as men, with about one in four women suffering from it in her lifetime. While depression may strike at any time, studies show that women are particularly vulnerable during their childbearing years. Despite the increasing awareness of this deeply concerning issue, many studies and health professionals still continue [...]

Because rates of postpartum illness are very high in women with bipolar disorder, it is generally recommended that mothers continue treatment with a mood stabilizer throughout the postpartum period to reduce their risk of relapse; however, the use of medications during the postpartum period is complicated by the issue of breastfeeding. All medications are secreted [...]

Many women imagine new motherhood as a time of total fulfillment, days filled with mother-infant bonding and boundless joy. In reality, however, many women experience significant mood changes following childbirth. Between 50 and 85% of new mothers experience a brief postpartum period of tearfulness and anxiety, termed the “maternity blues.” But some 10 to 15% [...]

Postpartum depression (PPD) is relatively common, occurring in about 10 to 15% of women after delivery. Non-pharmacologic interventions, including interpersonal psychotherapy, have been shown to be effective for the treatment of PPD. In addition, several reports have documented the efficacy of selective serotonin reuptake inhibitors (SSRIs) and the serotonin norepinephrine reuptake inhibitor venlafaxine (Effexor). In [...]

Postpartum depression (PPD) is a relatively common problem, affecting between 10% and 15% of women after delivery. Although it is difficult to reliably predict which women in the general population will experience postpartum mood disturbance, it is possible to identify certain subgroups of women who are more vulnerable to postpartum affective illness. Women who have [...]