Blog: Paltrow’s story raises awareness of postpartum depression

Increased awareness about postpartum depression (PPD) is critical to early diagnosis and treatment. At the UNC Center for Women’s Mood Disorders, we are grateful when high profile individuals, such as Gwyneth Paltrow share their personal stories about PPD.

View the full blog post from Dr. Samantha Meltzer-Brody here.

PPD has a prevalence rate of at least 10 percent, making it one of the most common complications of both the prenatal and postpartum period.  The first three months postpartum appear to be the most vulnerable period for the appearance of maternal depressive symptoms. Commons symptoms of PPD can include severe worry and anxiety and/or agitation, fears of hurting the baby or oneself, or not having any interest in the baby at all, feelings of being overwhelmed, feelings of guilt or worthlessness, tearfulness, changes in appetite, difficulty sleeping (even when the baby is sleeping), difficulty concentrating,  and loss of interest or pleasure in activities.

Fortunately, screening for PPD is easy to accomplish and effective treatments are available.  Well validated screening instruments developed specifically for use during the perinatal period are readily available and simple to administer.  One examples is the Edinburgh Postnatal Depression Scale (EPDS) which is available on-line. There is now widespread recognition of the critical importance of early detection and treatment of depression during pregnancy and the postpartum period. 

After a long fight, earlier this year Congress passed the MOTHERS Act as part of its health insurance reform legislation. The MOTHERS Act will focus national attention on PPD and increase research dollars to help those affected by it receive appropriate screening and treatment and help researchers understand what causes this illness and the best way to treat it.

In terms of treatment, there are multiple good therapeutic options including both psychotherapy and pharmacotherapy. Before treatment is initiated, a past psychiatric history must be obtained as it will influence the selection of the treatment modality.

In the United States, due to the increased attention of the positive effects of breastfeeding and the strong endorsement of breastfeeding by the American Academy of Pediatrics, most new mothers will breastfeed their infants, at least in the first three months. Therefore, treatment of many women with PPD will require a careful discussion of antidepressant use during lactation. 

In addition, it is very important to have frank discussions with new mothers regarding balancing the need for sleep with the demands of breastfeeding—not an easy task with a newborn in the house, but certainly something that can be readily accomplished with thoughtful planning and good partner support.  Ideally, a collaborative and multidisciplinary treatment approach that includes the patient’s psychiatrist or other mental health provider, obstetrician, and pediatrician is critically important and provides the best opportunity to individualizing treatment and returning the mother to wellness as quickly as possible.