What You Need to Know About ANGELS DREAM and Postpartum Depression

What is ANGELS DREAM? 

The ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) program at UAMS received a $250,000 federal grant to create a bi-lingual, statewide public awareness campaign designed to reduce the stigma associated with depression during and after pregnancy.  The project, called DREAM (Depression Relief Education in Antenatal Medicine) worked to increase the awareness, screening and resources available for treatment of this illness.

The grant provided funding to survey Arkansan obstetrical providers regarding their current practices and educational needs and to educate the public through a bi-lingual media campaign. The project is concluding with a second survey to providers to determine if the campaign was effective.

This web page provides mothers, mothers to be and their loved ones information and resources on perinatal depression. 

Emotional Changes During and After Pregnancy

Perinatal depression (PD) - depression either during or after pregnancy - is a physical condition with emotional symptoms that affects millions of women each year. As many as one in 10 pregnant women suffer from PD.
 
It is important to get help if you experience the symptoms of PD. Untreated depression can make pregnancy more difficult, increase the risk for complications and impact your ability to fully enjoy life and your relationships with your partner and family.
 
Without treatment, PD can progress to postpartum depression. The more depressed a new mother is, the more slowly her newborn develops. It is important to get help early!

Overview of Perinatal Depression

Pregnant women and new mothers experience a multitude of emotions.  They rejoice in the wonderful ones but are sometimes confused and overwhelmed by the negative feelings. Pregnancy can be a period of profound transition.  Most women have ups and downs, and the life stresses, physiological changes and relationship changes that crop up with pregnancy can make this a very stressful time.  They may experience unexpected emotions.    They may feel lonely, scared and depressed.  They may feel stressed, anxious and irritable about their present situation or the future.  Some pregnant or parenting mothers feel guilty about having these feelings. They might judge themselves or believe others are judging them for having these uncomfortable feelings.  Sometimes they show very little interest in the pregnancy or the baby.  If these feelings persist, the woman may be experiencing a clinical depression that needs treatment.  Research suggests that women who are susceptible to mood changes associated with hormonal changes are more prone to experience perinatal depression. In addition, the stressors associated with this major life change may also contribute.  Early detection and intervention is known to improve maternal well-being and child outcomes. 

For many women, pregnancy and motherhood begin as a joyful time. Others, however, are unprepared for the emotions and feelings that accompany pregnancy and the birth of a baby.

Clinical depression is an episode of depression lasting longer than 14 days. Perinatal depression is a clinical depression which can occur either during or after pregnancy.  It is a physical condition with emotional symptoms that affects millions of women each year.  As many as 10 – 20 % of women struggle with major depression before, during and after the delivery of a baby. Antepartum depression is the name given to a depression that occurs during a pregnancy. Postpartum depression is the name given to a depression linked to the birth of a baby, a miscarriage or termination.

Postpartum psychosis is different than postpartum depression and it is rare. It only affects about 1 in 1,000 women and is more common in women who suffer from bipolar disorder (or manic depressive disorder) or another psychotic disorder such as schizophrenia. Postpartum psychosis can suddenly begin within the first two to four weeks after delivery.  Postpartum psychosis is caused by too much of a certain neurotransmitter (dopamine) in the brain and needs immediate treatment. Symptoms include a change in thinking not based in reality. The new mother can hear voices that others don’t hear, can see things that others don’t see and can have distorted thinking such as her baby is evil and shouldn’t be alive.  This is a psychiatric emergency and the new mother needs to be supervised and taken for immediate medical attention.

“Baby Blues” is not postpartum depression, and doesn’t require treatment

Most new mothers get the “baby blues.” You may feel overwhelmed, exhausted, irritable, anxious and tearful for several days after giving birth. If you get plenty of rest, accept help from others and take good care of yourself, this should pass quickly.

Symptoms of depression that need treatment

If you feel down, sad or irritable for at least two weeks, it is important to look for other symptoms of depression.

Other symptoms can include:

A loss of interest in activities you would normally love
• A disinterest in eating, even after morning sickness has ended
• Trouble sleeping
• Feeling physically slowed down or sped up
• Feeling worthless or guilty for things that you shouldn’t
• Decreased ability to concentrate or remember
• Thoughts that it would be easier to be dead than alive

Many safe and effective treatments are available for pregnant and breastfeeding women.

• Talking to a health care provider
• Marital therapy if things aren’t going well in your relationship
• Bright-light therapy
• Medication — Many medications are safe to use during pregnancy and breast feeding. The risk of untreated depression is worse than the risk of using many medication. Ask your doctor about the safest approach for you and your baby. 

Other things that you can do to help your mood:

• Good nutrition and rest
• Moderate exercise
• Avoiding alcohol and drugs
• Family support

Other causes of depression:

• Thyroid disease — Symptoms can include either feeling cold or hot all the time
• Poor eating habits
• Living in an abusive or dangerous home environment
• Drinking alcohol, smoking cigarettes and using street drugs

Resources

ANGELS Web site
www.uams.edu/angels

ANGELS Call Center
501/526-7425 or toll free (866) 273-3835

Arkansas Mental Health Services Directory
http://www.arkansas.gov/dhhs/sgMH.html

Answers to common Questions about Postpartum Depression
The American College of Obstetrics and Gynecologists
http://www.acog.org/publications/patient_education/bp091.cfm

Frequently Asked Questions about Postpartum Depression
The National Women’s Health Information Center
http://www.qualitytools.ahrq.gov/summary/summary.aspx?view_id=1&doc_id=9215

La Parte Emocional de Usted: Acostumbrandose al Perido Post Parto
(The Emotional You: Postpartum Adjustment, Spanish)
Postpartum Education for Parents
http://www.sbpep.org/eyspan.htm

Postpartum Support International
www.postpartum.net


Treatment Resources

Mood Gym
A free self help program to teach cognitive behavior therapy skills to people vulnerable to depression and anxiety.
http://moodgym.anu.edu.au


Support Services

USA National Toll-free Suicide Hotlines
1-800-SUICIDE 1-800-273-TALK
1-800-784-2433 1-800-273-8255

Northwest Arkansas Crisis Intervention Center
Toll-free Statewide 1-888-274-7472

Mommy and Baby Fitness Classes
This is a three part workout program which benefits the mother and her baby.
Part I Warm –Up and Workout: 45 minute postnatal fitness class for mom and baby
Part II Infant Stimulation: 30 minute infant stimulation session
Part III Group Discussion: Topics include postpartum Depression

More information and newsletters at http://www.mommyandbabyfitness.net

MOM-ME Connection Support Group:

This is a special group for breastfeeding mothers that meets the first Wednesday of the month at 10:30am in Little Rock on the second floor of the Hickingbotham Outpatient Center at 9400 Kanis Rd. behind Baptist Health Medical Center.

Topics include:
• Breastfeeding
• Returning to Work
• Infant and Maternal Nutrition
• Parenting/Coping with Motherhood

Information available at 501-202-7378


 

ANGELS
University of Arkansas for Medical Sciences
Department of Obstetrics and Gynecology
4301 W. Markham St. #518
Little Rock, AR 72205