Perinatal Mental Health Disorders Flashcards
What are normal symptoms of pregnancy?
Mood is labile, teary
Self-esteem is unchanged
Can fall asleep but bladder or heartburn may awaken
No suicidal ideation/intent
Energy may be low but is restored with rest
Feels joy, anticipation, and appropriate worry
Increased appetite
What are symptoms of depression?
Gloomy, irritable, agitated or rageful mood
Guilt and/or low self-esteem
Difficulty falling or staying asleep
Suicidal thoughts, plans, or intentions
Fatigue that rest does not restore
Anhedonia
Dysregulated appetite
What are Baby Blues?
Not a disorder
Affects 60-80% of new mothers
Caused by hormone fluctuation and acute sleep deprivation
Lasts 2 days to 2 weeks after birth
Usually peaks 3-5 days after delivery
Symptoms of Baby Blues
Tearfulness
Lability
Reactivity
Exhaustion
Mostly happy
Self-esteem unchanged
Not related to stress or prior MH history
Baby Blues vs Major Depression
Severity/Intensity
Timing/Onset
Duration/Chronicity
If symptoms persist after 2 weeks postpartum, it is NOT Baby Blues
Diagnosing PPD in DSM-V
Major Unipolar Depression with Peripartum Onset
Diagnosing Postpartum Bipolar I/II in DSM-V
Bipolar I/II with Peripartum Onset
Peripartum Onset Definition
Depression in pregnancy or within four weeks following birth
How to diagnose Major Unipolar Depression with Peripartum Onset
Five or more must be present during the same two-week period:
Depressed mood most of the day, nearly every day
Loss of interest joy, or pleasure (anhedonia)
Significant weight change or appetite disturbance
Sleep disturbances (insomnia or hypersomnia)
Psychomotor retardation or agitation
Fatigue or loss of energy
Excessive or inappropriate guilt
Recurrent thoughts of death or recurrent suicidal thoughts.
How Depression Symptoms May Present
Overwhelm, inability to cope
Lack of feelings for or connection to the baby
Inability to care for self or family
Frequently co-morbid with anxiety
Isolated, socially withdrawn
Agitated, irritable
Not feeling like themselves
Increased somatic symptoms (headaches, back pain, GI distress, etc.)
Diagnosing Generalized Anxiety Disorder in the DSM-V
Must have three or more:
Excessive anxiety and worry (often about baby’s health)
Difficulty controlling their worry (Recurrent and persistent thoughts)
Agitation, irritability, rage which may then spiral into guilt and shame
Restlessness, feeling on edge, can’t sit still
Poor concentration, mind going blank
Sleep disturbance (difficulty falling asleep, staying asleep, or restless, unsatisfying sleep)
Increased somatic symptoms (muscle tension, palpitations, racing heartbeat, shortness of breath, GI distress)
Prevalence of Perinatal Anxiety
15.8% in pregnancy & 8-20% postpartum for mothers
4.1-16% in pregnancy & 2.4-18% postpartum for dads
Diagnosing Panic Disorder in the DSM-V
Must have 4 or more:
Episodes of intense fear or discomfort reaching a peak within minutes
Shortness of breath, dizziness, chest pain, sensations of choking or smothering
How or cold flashes, trembling, rapid heart rate, numbness or tingling sensations
Restlessness, agitation, irritability
Excessive worry or fear
Persistent fear of “going crazy,” losing control, or having a future attack
Often no identifiable trigger
Three greatest fears of Panic Disorder
Fear of dying
Fear of going crazy
Fear of losing control
Diagnosing Obsessive-Compulsive Disorder in the DSM-V
Obsessions:
Recurrent and persistent thoughts, urges, or impulses that are intrusive and unwanted and cause marked anxiety or distress
Individual attempts to ignore or suppress thoughts, urges, or images or to neutralize them with some other thought or action
Compulsions:
Repetitive behaviors that the individual feels driven to perform in response to the obsession
Behaviors or mental acts are aimed at preventing or reducing anxiety or distress
