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…not just the ones you think might be struggling.  …not just the ones who show up at the office saying “I don’t feel right…”

Yes, there are places that screen the moms that come to them.  But not every new mom.

There’s a whole campaign called “You Can’t Tell by Looking” out of Wisconsin, all about perinatal depression (well, perinatal mood and anxiety disorders, to be exact) and how no one including medical professionals can tell just by looking.

That is why it is important to screen every new mom at her first visit after giving birth, at 3 months postpartum, 6 months postpartum and all the way through that first year.  Because you can’t tell just by looking.  And when they come to you saying they have a problem, well… they HAVE a problem already.

The opportunity to potentially catch her before she got that far–because believe me, she has tried and tried to snap out of it, to pull up her boot straps, to “get a good night sleep”, to take a break, to eat better, to do some deep breathing, to try some exercise, to get some morning light, to get out with friends, to try fish oil and/or B 6 & 12 complex vitamins and/or a calcium & magnesium combination and/or …you get the picture?  She had to overcome her constant self-talk about being a bad mother–because that’s what her self-talk is telling her even though it isn’t true–just to call her doctor’s office in the first place.  She had to overcome her anxiety about talking to the potentially nosy or maybe judgmental receptionist–even if the receptionist isn’t like that at all, her thought process is telling her she will face nosy questions and harsh judgment.  She had to get past the fear that if she tells anyone she’s not feeling joyful about motherhood and that she’s had some weird thoughts, that someone may either take away her baby or put her away or…both!

Yeah.  Moms say these things about their pre-help postpartum experience ALL. THE. TIME.  ALL the time.  Waiting until she shows up, having gotten through all that, and then she gets screened?

A preventative and proactive approach would be to screen every new mother a minimum of three times in that first postpartum year.  It takes 5 minutes.  It’s a 10-item self-scorable survey.  And educational materials should be everywhere in your (OB, ped, etc) offices.  Like the posters etc. that are there for gestational diabetes and preeclampsia.  Perinatal mood and anxiety disorders touch ~20% of all new mothers in their pregnancies and through their first year after the baby is born.

If you’re waiting til they show up because they have a problem, well… it may be time to have a look at that.

A mom recently told me that her doctor said to her before he gave her the PPD screening (yay, screening!!!) that “there is no reason to be depressed” after having a baby.

She made a note-to-self and answered the questions as if she wasn’t feeling like she probably had “PPD”.

[Edit]–I need to mention that she then found a therapist and is very happy with the support she is receiving there. [/edit]

I think this happens when people–all kinds of people–don’t understand, are afraid, or don’t have referral resources.  Or maybe they are being told by their organization or other entity that they must screen each mom now.

PPD therapist Karen Kleiman, MSW, just published her third book “Therapy and the Postpartum Woman“.  The first two lines sum it up really well, and demonstrate the knowledge to come:  “Postpartum depression is not always what it looks like.  Women who are really ill can present well and look good.  Really good.”  There is a collective “amen” going up from women with and recovered from “PPD”.

All this to say, there is a broad, broad range of understanding out there.  And it’s better than it was only 10 years ago.