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Counseling Could Prevent Perinatal Depression

Doctors already are supposed to screen new mothers for depression, now they are also being urged to identify women at risk. Doctors shouldn't wait until women already are depressed to act, because counseling could prevent depression from setting in.

Up to 1 in 7 women experience what's called perinatal depression, depression during pregnancy or after childbirth. The U.S. Preventive Services Task Force said women with a range of risk factors including previous depression might benefit from preventive counseling.

Up to 1 in 7 women experience what's called perinatal depression.

Study found evidence that two types of counselling could help women at risk of the serious mood disorder, whether they're pregnant or have given birth within the past year. Cognitive behavioural therapy teaches people to manage negative thoughts, while interpersonal therapy focuses on improving relationship problems that contribute to depression. The counselling can be done one-on-one or in group settings.

What is perinatal depression? 

Perinatal depression refers to depressive disorders during pregnancy or the postpartum period. 

Symptoms include:

  • Loss of interest and energy

  • Depressed mood

  • Fluctuations in sleep or eating patterns

  • Reduced ability to think or concentrate

  • Feelings of worthlessness

  • Recurring thoughts of suicide

More serious than the "baby blues," it can leave mothers feeling intense sadness, anxiety and worthlessness, drained of energy and unable to bond with their baby. In severe cases, they may think about harming themselves or their baby.

How to tell who is at risk? The task force found wide-ranging risk factors including previous depression or depression in the family; physical or sexual abuse; an unplanned or unwanted pregnancy; and demographic factors such as low income or teen pregnancy.

The recommendation was published in the Journal of the American Medical Association (JAMA).

An accompanying editorial cautions that most women won't have easy access to specialists and may need options such as counselling via smartphone. And health providers will need to act quickly if counselling doesn't help and depression strikes.

Despite the challenges, the recommendations "have the potential to improve many lives," wrote Dr. Marlene Freeman, a psychiatrist at Massachusetts General Hospital, who wasn't involved with the task force.


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