What is Postpartum (perinatal) Depression?
Postpartum depression, often encompassed under the broader term perinatal depression, refers to a significant depressive episode that can occur during pregnancy or in the weeks or months following delivery. Perinatal depression includes both prenatal depression (occurring during pregnancy) and postpartum depression (occurring after childbirth). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, does not have a separate diagnostic category for postpartum depression; instead, it is diagnosed as a major depressive episode with peripartum onset if it begins during pregnancy or within four weeks following delivery.
Diagnostic Criteria:
1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt.
8. Diminished ability to think or concentrate, or indecisiveness.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Risk Factors:
Risk factors for perinatal depression include a history of depression, anxiety during pregnancy, stressful life events, lack of social support, and complications in pregnancy or childbirth.
Treatment:
Treatment for perinatal depression typically involves psychotherapy, medication, or a combination of both. Psychotherapy options may include cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), which are both effective for managing and treating depression. Antidepressant medications may also be used, taking into account the safety profiles for pregnant or nursing mothers. Additionally, support groups and community resources can be beneficial in providing social support and practical assistance to affected mothers.
Recognizing and treating perinatal depression is crucial for the well-being of both the mother and the child, as untreated depression can affect the ability to bond with the newborn and manage daily care activities.
Frequently Asked Questions
Services
What types of services do you provide?
We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.
What is the difference between therapy and medication management?
Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.
Does this replace my need for a therapist?
Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.
How does online psychiatry work?
Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.
What to Expect
What should I expect during a mental health assessment or evaluation?
You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.
How do I prepare for my first appointment? How long are typical appointments?
Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.
Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.
What should I do in case of an emergency or crisis?
If you’re having a medical or mental health emergency, call 911.
Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.
Appointments
How do I schedule an appointment?
To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!
Do you offer virtual/online appointments?
Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.
Are my appointments and information confidential?
Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.
Our providers specialize in…
For more information about each of these conditions, click on each word in the list.
- Addiction and Substance Use Disorder
- Dementia and Alzheimer’s Disease
- Anxiety Disorders
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorder
- Bipolar Disorder
- Depression
- Disruptive, Impulse-Control and Conduct Disorders
- Dissociative Disorders
- Eating Disorders
- Gender Dysphoria
- Hoarding Disorder
- Obsessive-Compulsive Disorder
- Opioid Use Disorder
- Perinatal Depression (formerly Postpartum)
- Personality Disorders
- Post-Traumatic Stress Disorder (PTSD)
- Prolonged Grief Disorder
- Schizophrenia
- Seasonal Affective Disorder (SAD)
- Sleep Disorders
- Somatic Symptom Disorder
