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Scott Webb: The birth of a baby is usually a time of immense joy, but some women experience mental challenges before, during or after pregnancy. And sometimes these challenges are simply baby blues, and sometimes it can be postpartum depression.

And joining me today to help us all understand the differences and to emphasize the importance for new moms to seek treatment if they are experiencing more than just baby blues is Valerie Kading. She's the Group CEO of the Sierra Tucson Group.

This is Let's Talk: Mind, Body, Spirit by Sierra Tucson. Sierra Tucson ranked number one best addiction treatment centers 2020 in Arizona by Newsweek. I'm Scott Webb. Valerie, it's a real pleasure to speak with you today. What's the difference between baby blues and postpartum depression?

Valerie Kading: So women can experience baby blues and it's actually pretty common. It happens right after birth. And again, it's very common. A mom may feel very tearful. She may feel down and sad and maybe have some unexplained moments of crying, but it's really transient. And the sadness resolves typically over a few days or between two and three weeks.

On the other hand, postpartum depression is much more serious and occurs typically about two weeks or more after childbirth and can happen up to a year post birth. And the mom will experience at least five of serious mental health, mood symptoms, and even symptoms that are physical in nature.

So she can have a depressed mood. She can have a loss of interest in things that normally she would be very excited about and maybe some of her passions, she's no longer interested in. There's oftentimes a significant loss in weight or a change in her appetite. She can also have periods of either sleeping too much or not sleeping enough. She may also feel very lethargic and have no energy and feelings of guilt or feeling worthless. She can also have times where it's very difficult for her to concentrate and focus on things. And then, one of the most serious symptoms of postpartum depression are thoughts of death or even attempts to harm herself. So they're very different. They're very different.

Scott Webb: Yeah, it does sound that way. And it sounds like baby blues are, you know, fairly common and nothing to be alarmed about, as you say, fairly transient. When we talk about postpartum depression, what are the negative effects that can arise for women if it goes untreated?

Valerie Kading: When a mom has postpartum depression and has those symptoms of again either sleeping too much, not sleeping enough, feeling disengaged and having depressed mood, there can be poor bonding between the mother and the baby. The bonding between a mom and her baby are so critical, especially in the early years.

And when a mom is disengaged and is isolating and not having enough energy, that bonding really gets effected. She's more likely to have poor eye contact with the baby and, again, less physically engaged with the child. There's also a higher risk of her not engaging with her other children, so her other children in the family become effected as well.

And moms who are depressed have higher risk of marital issues, divorce, also using substances like alcohol or illicit substances to improve her mood. So these negative effects cannot just affect her baby, but also her own mental and physical health as well, and she's at higher risk for suicide. So having a mom who's very depressed and down and having these thoughts of suicide or even completing suicide can certainly impact that child and the family unit.

Scott Webb: Yeah, it sounds like it. So I guess I'm wondering when we talk about overall maternal mental health issues, what methods do clinicians use to help identify these issues and to help new moms with postpartum depression?

Valerie Kading: It's very important that clinicians be able to ask how a mom is doing and not just looking at her vital signs or her weight or if she's breastfeeding, but also asking about her mood and how she's been feeling. And thankfully, there are screening tools that are available to screen for postpartum depression and also depression during pregnancy.

And one of the widely used screening tools that is validated is the Edinburgh Postnatal Depression Scale or otherwise known as EPDs. Again, it's effectively used during pregnancy. It's very simple. A mom can fill it out and then the clinician will score it and can determine from there if she is suffering from postpartum depression or depression during pregnancy, and this tool is actually recommended for clinicians to use while a woman's pregnant and then also during the post period time.

Scott Webb: I guess I'm wondering too, is postpartum depression the only thing that women suffer from? In other words, are there other mental health issues that can occur during and after pregnancy?

Valerie Kading: Absolutely. So women can actually experience depression during pregnancy, and it happens at about 10 to 15% of women. So pregnancy is typically viewed as a time where women are happy and expecting this joyous birth and having a baby. The truth of the matter is that a significant amount of women will experience these depressive symptoms during pregnancy.

Women can also experience postpartum obsessive compulsive disorder or postpartum OCD. It affects about 5% of women. And when a woman experiences postpartum OCD, she experiences heightened anxiety and intrusive thoughts so she experiences obsessions and then also compulsive behavior, so behaviors that she exhibits in order to get rid of these obsessive thoughts. Those are certainly some things that you want to watch out for when a woman is again very anxious during the postpartum period. If she's obsessively and compulsively washing her hands or having ritualistic activities, that may be an indicator that she has postpartum OCD.

A woman may also experience what's called postpartum psychosis. This is actually very rare. It occurs in about only 1% of women, but it is considered a psychiatric emergency. And a woman who experiences this will have hallucinations, so either visual hallucinations or auditory hallucinations or be delusional. She may have paranoid thoughts. She may believe that she either has special powers or has, you know, special conversations or relationships with other figures that aren't present.

And the alarming thing is that sometimes these visual hallucinations or auditory hallucinations will tell her to hurt her child or that she'll have thoughts of hurting her child. And unlike postpartum OCD, she's not alarmed by these thoughts and she actually believes or follows these wishes and will actually end up attempting or wanting to harm her child. Again, this is extremely rare. It occurs in only 1% of women, but it is high risk for infanticide and also suicide for the moms. So when this happens, it is a serious issue where a mother should be referred to the emergency room.

Scott Webb: Yeah, very glad to hear that it happens in a very small percentage, as you say, you know, 1% or possibly less. But obviously, critical that this be recognized, diagnosed, and that action be taken. And I'm sure the COVID-19 has affected all of us in a variety of ways. Has it also impacted maternal mental health as well?

Valerie Kading: It absolutely has. It's really taken a toll on women who are pregnant and also those who have had a baby. So the pregnant women during the COVID pandemic have really experienced a heightened isolation and also anxiety, mostly due to the fear of COVID. Also with the restrictions and limitations on social gatherings, pregnant moms have certainly experienced feeling lonely. She normally would have a shower to celebrate the upcoming birth and many of those have been canceled because of the pandemic. And so these natural and normal celebratory events have just not happened for her. So she's lost the support.

There's also been limits on how many people can join medical appointments, OB appointments, and even during the birth of the child and after the birth of the child. A mom is now having a child with either just her spouse or by herself, and then not having this room full of flowers or, you know, having this joyous moment when a mom has the baby and is able to share the baby with the rest of the family and friends. So she's really had a very difficult time and it has again taken a real toll on how she feels about her baby and having that excitement and joy to share and experiencing a heightened level of anxiety during this pandemic.

Scott Webb: Yeah, definitely. And I was just picturing, remembering, my neighbors across the street. Their daughter had her first baby during the pandemic. And it was sort of heartbreaking in a way that, uh, after the baby was born, she would bring the baby by and she would have to stand outside. So she would stand outside the front door, so the grandma and grandpa could see the baby. And it was kind of emotional for me, you know, and those things that we took for granted when we had our babies, you know, not during a pandemic and watching what families, just right here on my street, had to go through, really kind of brought it home for me as I'm sure it did for you.

Valerie Kading: Yes. Yeah, it's definitely heartbreaking to see that and knowing that these women will never be able to recreate that or have that experience again/. It's certainly heartbreaking to see.

Scott Webb: Valerie, anything else you want to share with people today?

Valerie Kading: It's really my pleasure to have spoken with you and to have this time with you, because women suffer from maternal mental health issues. And it's really unfortunate that the resources to these women are really not readily available. And that sometimes when a mom does want to get help, it’s either not available or that the provider that she sees is not educated or equipped to help her.

So it's really been a pleasure and an honor for me to be able to create a virtual intensive outpatient program here at Sierra Tucson for moms suffering from postpartum depression. So, you know, we're here to help moms and I'm very much so involved in the creation of this program and the success of the program and how we help moms going forward. And we continue to treat moms in our residential level of care. And, again, very devoted and really committed to the wellbeing of moms in this world. I'm just happy to be able to share what we're doing here and also help educate anyone who's listening on this podcast. So thank you so much.

Scott Webb: Yeah. It's been my pleasure. You know, I can really hear the devotion in your voice. And I just love the Sierra Tucson model, mind, body, spirit, trying to help everyone including new moms and what they're dealing with, whether it's baby blues or more. So really lovely speaking with you today. And you stay well.

Valerie Kading: Thank you so much. You as well.

Scott Webb: Call (800) 842-4487 or go to SierraTucson.com for more information. Sierra Tucson, where change begins. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. This is Let's Talk: Mind, Body, Spirit from Sierra Tucson. I'm Scott Webb. Stay well.