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Melanie Cole: While life with a new baby can be thrilling and so rewarding. Many physical and emotional changes happen to a woman after she gives birth. This is Checkup Chat with EvergreenHealth. I'm Melanie Cole, and today we're discussing the difference between postpartum depression and baby blues, and when it's important to seek help. Joining me is Patricia Morgan. She's a Psychiatric Nurse Practitioner at EvergreenHealth, Perinatal Mood Disorder Clinic. Patricia, thank you so much for joining us today. Tell us a little bit about the postpartum mood disorders and how prevalent they are.

Patricia Morgan: Mood disorders happen to individuals any time from pregnancy through the first year of postpartum, approximately one in every five to seven individuals during that time period can experience a change significant enough to their mood, whether it's low mood or anxiety that they might actually want to seek help.

Host: So we've heard the term baby blues and postpartum depression. Are they the same thing?

Patricia Morgan: They are not. Baby blues is something that individuals can experience shortly after delivering. That's in the days up to close to the two week mark where they may be sad. A lot of frequent crying that just out of the blue so to speak, and sometimes it can be accompanied by sadness, sometimes just by emotion that they don't quite know what to do with. It could be anxiety. They could experience the up and downs within any given day. They might be a little bit irritable, might have trouble with sleep, and their irritability might get to the point where they're angry and they can't quite figure out why or they're just tired and all of these things can't happen at any point in time during the first two weeks. Postpartum depression is when you kind of reached that beyond the two week mark and the individual is persistently feeling sad, accompanied by some hopelessness or feeling overwhelmed. They get to the point where they might be crying more often than usual, not just a little part of the day. They might experience longer periods of crying accompanied by the sadness or accompanied by anxiety.

The insomnia gets to be worse or they can end up sleeping a lot, which is a complete opposite. They might feel changes in appetite, kind of that loss of wanting to eat, loss of interest in the things they normally are interested in, regardless of whether they can actually get to those things that they're interested in. They might have trouble concentrating, they might be withdrawing from their family or friends. The family and friends might be calling to wish them well or check in on them, but they would just feel very overwhelmed that they do not want to interact. It might even actually create a situation where they feel like they're so sad or want to withdraw. They don't really have the energy to bond with their baby. And of course there's always anxiety. It could be in the form of interest of thoughts or worrying about their baby or worrying about the myriad of things that can go wrong that takes up a good part of their day.

Host: Well, it certainly can be devastating and as you say, these symptoms can be really heartbreaking for a woman to go through. Tell us a little bit about who's at risk and as you've said, how common they are if somebody is at risk. Is this a conversation that families should have with their OB GYN before they have the baby?

Patricia Morgan: Absolutely. I highly encourage individuals from the moment they suspect they might be pregnant. Just even talking about their mental wellbeing with their OB. It's great to start the conversation. The individuals that may be more at risk. You want to think about your family history. Do you know family members that maybe have been depressed while you were growing up? How are you feeling about the changes, your stressors? Are the stressors in your life at the point where they're chronic and you find it difficult to deal with some of those? In the midst of also adding the physical and emotional difficulties with pregnancy. That can put you at risk for a greater shift in your mood after you deliver and I want to encourage individuals to even think about the first year postpartum. There are so many transitions from having a lifestyle where it's just you and your partner, life might be a little bit different when you add a little person, a third individual to your family. There's that shift. It's a very real shift. That doesn't necessarily mean that you will end up with depression or anxiety, but those are very real stressors. And then with each shift that your baby has, you know, your family structure has during the first year postpartum, those can also be points where you might consider paying a bit more, I guess, cluing more into your mental health. Just to kind of take a temperature for whether or not some of these symptoms of depression or anxiety are starting to creep up.

Host: Well, that's so important and thank you for that answer. Tell us a little bit about what someone does. If they notice symptoms in themselves or a partner notices this, what is the first step they should take? Who do they contact? What can they do?

Patricia Morgan: During pregnancy? Absolutely. Initiate the conversation with your OB provider. They're usually very happy to initiate a rating scale, which is called the Edinburgh Postnatal Depression Scale. That kind of takes a temperature for the symptoms you're experiencing. They also have access to referrals. Perhaps within EvergreenHealth in particular, they have access to providers such as myself who can then maybe set up an appointment for an initial evaluation where we get to kind of look at your experience of mental health concerns and then discuss maybe some coping skills, discuss ways to watch how your mood might change and when to know that it's time to intensify your resources. Also, our EvergreenHealth website would be a great place to look under the perinatal mood disorders. We have some resources such as Perinatal Support, Washington. They're a great local resource with trained individuals. You do not have to be in crisis. They're happy to chat with you and give you some pure support after you deliver. We have parent baby groups at the moment. They are remote, but they are a wonderful source of support, nonjudgmental support that can help an individual kind of figure out if they need more specialized support.

Host: Thank you for telling us about that. And Patricia, what about the family members? If they're siblings or a spouse involved, can these kinds of support groups help them so that they can help their loved one who's going through this?

Patricia Morgan: Absolutely. The EvergreenHealth Groups always invite family members to be part of that connection. In doing so they kind of get to hear their loved one's experience and get to hear other peers maybe discuss how they were supported during that postpartum period and those are takeaways for family members. The EvergreenHealth Group, called, This is Not What I Expected is also a wonderful place for partners, family members to drop in along with the individual who delivered and get some peer support for themselves as well as tips on how to engage in supportive nonjudgmental environment for their loved one.

Host: What would you like women that are going through this to know about taking better care of themselves. If they get postpartum depression or baby blues, what you want them to do for self care while they're trying to sort out whether they're going to look to medicational intervention support groups, all of these things. What would you like them to know about self care and taking care of themselves so they can take the best care of baby?

Patricia Morgan: What I normally tell individuals when they come to see me, we look at just the basic needs, which is sleep, feeding self and something that I know we don't do a lot of is giving ourselves grace. This is a transition, a period of time where you may lack some of the structure. This is completely new territory, so we want to encourage the environment at home where they can get solid blocks of sleep to the extent that you can with a newborn. We call in reinforcements when we can because we want the individual to get rest. We want the individual to eat, even if it's small meals. Even if they leave things on the counter as a way of being able to stop by and grab a little sustenance, we want to be able to remind the individual that this period of time is short. They will get through this. They're not alone and if they feel like they need to talk to somebody about whatever it is that they're feeling, that they reach out for just a peer.

And that's why we have these wonderful warm lines through Perinatal Support Washington, there is the Suicide Prevention Lifeline. You don't have to be in crisis to give those individuals a call. There is reaching out to your providers just saying, I'm experiencing this difficult time and that way your providers know to kind of keep track of that so that you don't have to. So there's a myriad of ways that you can get support, but in the moment at your home, I would say sleep, fortify yourself with as much rest as you possibly can given the requirements of your life, because that is what's going to help to protect your mood over a period of time. You can also reach out to the EvergreenHealth Postpartum Care Center. They are happy to discuss the free resources that are available within the community. They are happy to discuss national resources or perhaps if you need to set up an appointment with a provider such as myself. We're here for you.

Host: Thank you so much, Patricia, for coming on with us today. It's such a very important topic and thank you for sharing support and where women can find help if they think they're suffering from postpartum depression or even baby blues. Thank you again. That concludes this episode of Checkup Chat with EvergreenHealth. Please visit our website at evergreenhealth.com/perinatal-mood for more information and to get connected with one of our providers. Please remember to subscribe, rate, and review this podcast and all the other EvergreenHealth podcasts. I'm Melanie Cole.