Dr. Dresner shares advice for women who have recently given birth and are feeling depressed.
The most important thing in treating postpartum depression is to make a careful diagnosis. So we don’t want to assume that because a patient called their obstetrician three days postpartum and says, “I can’t sleep. I am not sure if the baby is getting enough milk. My mother-in-law is visiting, and she is driving me crazy.” That’s not an opportunity necessarily to intervene with medications or to make a diagnosis.
So a certain constellation of symptoms need to be present. They need to persist for two weeks or more in order to make a diagnosis. In an individual, the previous history of depression, we might be quicker to make that diagnosis if the symptoms are pretty pronounced.
But in a first episode we would want to look for two weeks of symptoms of depressed mood, hopelessness, helplessness, feelings of guilt, difficulty sleeping, agitation. Typically in new mothers, we see a lot of feelings of incompetence, a doubt about their ability to parent the baby adequately, or to nurture the baby because they feel they have so little to give themselves.
Sometimes when we diagnose depression, we look for what we call vegetative symptoms of depression: problems with sleep, appetite, energy, libido, and if we only look at those symptoms, any new mother's going to look depressed because no new mother, you know, has a normal appetite or normal sleep patterns or a normal libido or normal energy, and so we really try to look at psychological symptoms primarily.
About Dr. Nehama Dresner, M.D.:
Dr. Nehama Dresner, M.D., is a licensed, Board-certified psychiatrist (in general psychiatry and psychosomatic medicine) with specialized training and nearly 20 years experience in Women's Mental Health and Medical Psychiatry. She is Associate Professor of Clinical Psychiatry and Obstetrics/Gynecology at Northwestern University Feinberg School of Medicine and is actively involved in medical education. A fellow in the Academy of Psychosomatic Medicine and the America Psychiatric Association, she speaks locally and nationally on issues related to psychological aspects of women's health and medical psychiatry. Dr. Dresner's clinical specialty is psychosomatic obstetrics, and gynecology, women's emotional development, and psychiatric treatment of the medically ill.